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Tissue changes in epidermolysis bullosa acquisita were investigated by histo logical and histochemical methods. In an attempt to identify acid mucopolysac charides, staining was carried out with alcian blue solutions containing different concentrations of electrolytes. Methylation, saponification and digestion by hyaluronidase, sialidase and diastase were also applied. The alteration of collagen was examined by the luxol fast blue, trichrome and sulfation toluidine blue methods. The most striking abnormalities of the skin, whether clinically involved or not, were an increase of dermatan sulfate and a decrease of luxol fast blue positive collagen and oxytalan fibers in the upper dermis. The pathogenesis of epidermolysis bullosa acquisita was discussed on the basis of these results.

We present a case of junctional epidermolysis bullosa (EB) associated with urethral tract involvement. He was a 27-year-old man who had symblepharon of the right eye, hoarseness and urethral stricture in addition to generalized blister formation. Ultrastructural examination of a biopsy skin specimen demonstrated the characteristic morphology of junctional epidermolysis, a form of EB that has not been previously associated with urethral stricture.

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