Epidermolysis Bullosa‐Illustrating Difficulty in Classification

Abstract

RARE AND INTERESTING CASES 95 renction was present with moderately dense perivascniav infiltration of lymjiliocytes, polynioriilis and occasional eosin()])liils. Many arterioles and veniiles showed exteJisive fibrinoid necroses of Ilieir walls and intimal proliferation was evident in many vessels.Treatment and Progress: The bullons necrotic area healed slowly with the application of l)etaniethasone-17 valerate and sjentaniicin in a cream base. Systemic steroids were witliheld. The final ap])earance showed a flat l)igmented dejiressed scar.She remained well for the next six months but reported again in October, 19(11) with multiple small areas of pnrpnra and shallow nlceration on both lower le^s.Fni'thei-investi<iations at this time showed: Blood nrea -44 mg./lOO ml.; ])lasma creatinine -0-0 mg./lOO ml.; endogenous creatinine clearance -50% of average normal.Once again, the condition cleared with the same ci'eam as above, this time qnite ra])idly. However, at tlie same time as the skin eruption she had been given an oral diuretic foi' her moderate congestive cardiac failnre, ankle anlema and lung congestion.