Conflict of interest: none declared.
Clinical dermatology • Original article
The course of pregnancy and childbirth in three mothers with recessive dystrophic epidermolysis bullosa
Article first published online: 18 OCT 2011
© The Author(s). CED © 2011 British Association of Dermatologists
Clinical and Experimental Dermatology
Volume 37, Issue 1, pages 10–14, January 2012
How to Cite
Hanafusa, T., Tamai, K., Umegaki, N., Yamaguchi, Y., Fukuda, S., Nishikawa, Y., Yaegashi, N., Okuyama, R., McGrath, J. A. and Katayama, I. (2012), The course of pregnancy and childbirth in three mothers with recessive dystrophic epidermolysis bullosa. Clinical and Experimental Dermatology, 37: 10–14. doi: 10.1111/j.1365-2230.2011.04179.x
- Issue published online: 19 DEC 2011
- Article first published online: 18 OCT 2011
- Accepted for publication 8 May 2011
Background. Recessive dystrophic epidermolysis bullosa (RDEB) is an autosomal recessive skin disease caused by mutations in the type VII collagen gene (COL7A1), resulting in detachment of the entire epidermis due to loss or hypoplasticity of the anchoring fibrils that normally secure the basement membrane to the underlying dermis. Trauma-induced blistering is often complicated by chronic erosions and scarring. From that perspective, pregnancy in RDEB might be considered an indication for elective caesarean section in a bid to minimize perineal blistering. To date, only four cases of pregnancy and delivery in patients with RDEB have been reported.
Cases. We report three more women, each with RDEB-generalized other (RDEB-GO), all of whom had successful vaginal deliveries without major cutaneous or mucosal complications. One woman also had a second child, by vaginal delivery, indicating a lack of vaginal stenosis after the first birth.
Conclusions. These cases show that RDEB-GO is not an absolute primary indication for elective caesarean section and that, perhaps surprisingly, genital/perineal blistering and scarring are not inevitable consequences of childbirth. Moreover, breastfeeding is also feasible in women with RDEB-GO.