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Epidermolysis bullosa simplex: a paradigm for disorders of tissue fragility
Pierre A. Coulombe, Michelle L. Kerns, Elaine Fuchs
Pierre A. Coulombe, Michelle L. Kerns, Elaine Fuchs
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Epidermolysis bullosa simplex: a paradigm for disorders of tissue fragility

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Abstract

Epidermolysis bullosa (EB) simplex is a rare genetic condition typified by superficial bullous lesions that result from frictional trauma to the skin. Most cases are due to dominantly acting mutations in either keratin 14 (K14) or K5, the type I and II intermediate filament (IF) proteins tasked with forming a pancytoplasmic network of 10-nm filaments in basal keratinocytes of the epidermis and in other stratified epithelia. Defects in K5/K14 filament network architecture cause basal keratinocytes to become fragile and account for their trauma-induced rupture. Here we review how laboratory investigations centered on keratin biology have deepened our understanding of the etiology and pathophysiology of EB simplex and revealed novel avenues for its therapy.

Authors

Pierre A. Coulombe, Michelle L. Kerns, Elaine Fuchs

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Figure 3

Ultrastructure of epidermal basal keratinocytes in EB simplex

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Ultrastructure of epidermal basal keratinocytes in EB simplex
These tran...
These transmission electron micrographs were obtained from ultrathin sections prepared from epoxy-embedded intact (nontraumatized) human skin that had been fixed for routine electron microscopy. (A) Sample from a normal individual. Note the columnar shape of the basal keratinocyte shown and the prominence of keratin IF (KIF) bundles and of dispersed melanin granules (me) in the cytoplasm. (B) Sample from an individual with EBS-DM. Note the two prominent aggregates (Ag) in the cytoplasm, between the nucleus (Nu) and basal lamina (bl). This cell also features KIF bundles, although they seem small compared with those in basal keratinocytes from normal individuals. (C) Sample from an individual with EBS-localized. Note the presence of many vacuoles (vac) in the cytoplasm, between the nucleus and basal lamina in the basal keratinocyte shown. This cell, which does not show obvious defects in KIF content or distribution, may correspond to a microblister. cf, collagen fibers; mi, mitochondria. Scale bar: 1 μm. Adapted from ref. 5.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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