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Table 4 Diagnostically useful differences in antigenic staining in selected EB subtypes

From: Inherited epidermolysis bullosa

Common antigens

Abnormal staining in

Typical pattern of staining

Keratin 5

---

normal filamentous network within keratinocytes

Keratin 14

EBS, autosomal recessive

absent or markedly reduced staining of filaments within keratinocytes

Laminin-332 (laminin-5)

JEB-H

absent or markedly reduced staining along the DEJ

 

JEB-nH *

reduced staining along the DEJ

Type XVII collagen

JEB-nH *

reduced or absent staining along the DEJ

Type VII collagen

RDEB, severe generalized

usually absent staining along the DEJ

 

RDEB, generalized other

reduced staining along the DEJ

 

RDEB, inversa

variable staining along the DEJ

 

Dystrophic EB-BDN (only during periods of active blistering)

granular staining within basal and lower suprabasal keratinocytes; absent or markedly reduced staining along the DEJ

Plectin

EBS with muscular dystrophy; EBS with pyloric atresia; EBS-Ogna

absent or reduced staining along the DEJ; absent or reduced staining along the DEJ; reduced staining along the DEJ

α6β4 integrin

JEB with pyloric atresia; EBS with pyloric atresia

absent or reduced staining along the DEJ; absent or reduced staining along the DEJ

Kindlin-1

Kindler syndrome

absent or reduced staining along the DEJ

  1. DEJ = dermoepidermal junction
  2. * The majority of patients with JEB-nH have mutations in one of the three genes encoding for laminin-332, rather than within the gene for type XVII collagen. Of note, there are usually no phenotypic differences in these two antigenically distinct JEB-nH groups.
  3. Modified from Fine J-D et al, 2008 (reference [3]); refer to that reference for less frequent findings