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Laryngeal lesion associated with epidermolysis bullosa secondary to congenital plectin deficiency
Institution:1. ORL et chirurgie cervicofaciale pédiatrique, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France;2. Service de dermatologie, hôpital Claude-Huriez, CHRU Lille, 59037 Lille, France;3. Service d’anatomie et cytologie pathologiques, hôpital Necker–Enfants malades, AP–HP, 75015 Paris, France
Abstract:IntroductionEpidermolysis bullosa (EB) is a congenital disease characterized by fragility of epithelial structures. The skin is the organ primarily affected, resulting in the formation of skin blisters. Some forms of EB may also present mucosal lesions.Case reportWe report the case of a girl with epidermolysis bullosa simplex (EBS) associated with muscular dystrophy secondary to congenital plectin deficiency. She presented severe respiratory tract lesions extending from the oral cavity to the larynx. In particular, we describe our medical and surgical management of the laryngeal lesions, responsible for several episodes of respiratory distress and feeding difficulties.DiscussionEpidermolysis bullosa simplex associated with muscular dystrophy is a rare hereditary form of EB, as fewer than 50 cases have been reported in the literature. This form is characterized by mucosal lesions involving the upper aerodigestive tract, with consequences for feeding, phonation and breathing. Special care must be taken when performing diagnostic and therapeutic procedures to avoid worsening the lesions of this very fragile mucosa. Tracheotomy is a harmful procedure in these patients and should only be considered as a last resort.
Keywords:Epidermolysis bullosa  Congenital plectin deficiency  Larynx  Stenosis
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