Overview of Junctional Epidermolysis Bullosa

Junctional Epidermolysis Bullosa (JEB) is a rare, inherited skin disorder that causes the skin and mucous membranes to become extremely fragile. Even minor friction or trauma can lead to painful blisters and wounds. This condition is typically evident from birth and can vary in severity. Some forms, such as Herlitz type JEB, are life-threatening in infancy, while others may allow longer-term survival with ongoing care. JEB is caused by genetic mutations affecting proteins vital for skin integrity, leading to separation within the skin layers.

Types of Junctional Epidermolysis Bullosa

1. Herlitz Junctional Epidermolysis Bullosa (JEB-H):

The most severe form; blisters form soon after birth and affect the skin, airways, and internal linings. Often life-limiting.

2. Non-Herlitz JEB:

Milder forms with longer survival. Blisters may be limited to the skin and oral cavity.

3. Laryngo-onycho-cutaneous Syndrome:

A rare JEB subtype involving the eyes, nails, and airways along with skin symptoms.

Symptoms of Junctional Epidermolysis Bullosa

Fragile skin that blisters easily, especially in friction-prone areas

Widespread blistering in newborns

Chronic wounds that may get infected

Nail abnormalities or loss of nails

Hair loss in some cases

Breathing difficulties in severe types due to airway blistering

Difficulty swallowing due to internal blistering

Poor weight gain and growth delays

Causes of Junctional Epidermolysis Bullosa

Genetic mutations affecting proteins (like laminin-332) that anchor the skin’s layers.

Inherited in an autosomal recessive pattern (both parents must carry the gene).

Defects in genes such as LAMA3, LAMB3 or LAMC2.

Complications in Junctional Epidermolysis Bullosa

Life-threatening infections from open wounds

Scarring and skin thickening

Severe anemia due to chronic blood loss

Nutritional deficiencies

Airway obstruction in Herlitz JEB

Risk of aggressive skin cancers in adolescence or adulthood

Dental issues due to enamel defects

Risk Factors of Junctional Epidermolysis Bullosa

Family history of epidermolysis bullosa

Consanguineous (closely related) parentage

Genetic carriers of the faulty genes

Preventions of Junctional Epidermolysis Bullosa

Genetic counseling before pregnancy for at-risk families.

Prenatal genetic testing (chorionic villus sampling or amniocentesis).

Preimplantation genetic diagnosis (PGD) in IVF to avoid passing on the condition.