Transient bullous dermolysis of the newborn affects a rare subset of patients with self-limited dystrophic disease; inheritance in most is autosomal dominant. Blistering at birth tends to be generalized but ceases within the 1st 1–2 yr. Resolution of clinical blistering and the immunohistochemically altered distribution of type VII collagen occur coincidentally.Recessive dystrophic epidermolysis bullosa (RDEB-Hallopeau-Siemens) is the most incapacitating form of epidermolysis bullosa, although the clinical spectrum is wide. Some patients have blisters, scarring, and milia formation primarily on the hands, feet, elbows, and knees . Others at birth have extensive erosions and blister formation that seriously impede their care and feeding. Mucous membrane lesions are common and may cause severe nutritional deprivation, even in older children, whose growth may be retarded. During childhood, esophageal erosions and strictures, scarring of the buccal mucosa, flexion contractures of joints secondary to scarring of the integument, development of cutaneous carcinomas, and the development of digital fusion may significantly limit the quality of life .
