Epidermolysis Bullosa Anatomy
To better understand epidermolysis bullosa, it helps to understand the anatomy of the skin.
The skin contains three main layers:
- The superficial layer that makes up the surface of the skin
- It is composed of skin cells and can be divided into 5 layers based on cell type.
- The top layer of the epidermis, the stratum corneum, is made of dead, flat skin cells that shed about every 2 weeks.
- The thickness of the epidermis varies, according to location: it is very thick over the soles of the feet, and very thin over the ears.
- Lies beneath the epidermis
- Also varies in thickness depending on the location of the skin. It is .3 mm on the eyelid and 3.0 mm on the back.
- The dermis is composed of 2 layers that contain a connective tissue called collagen
- The dermis contains blood vessels, nerves, sweat glands, and hair follicles.
- The number of structures in the dermis varies, according to location.
- The dermis under the arms contains more sweat glands and hair follicles than the dermis on the back.
- Subcutaneous layer:
- Mainly fat and connective tissue.
- Contains blood vessels and nerves.
- Lim KK, Su WP, McEvoy MT, Pittelkow MR. Generalized gravis junctional epidermolysis bullosa: case report, laboratory evaluation, and review of recent advances. Mayo Clin Proc. 1996 Sep;71(9):863-8. [8790263 ]
- Ozanic Bulic S, Fassihi H, Mellerio JE, McGrath JA, Atherton DJ. Thalidomide in the management of epidermolysis bullosa pruriginosa. Br J Dermatol. 2005 Jun;152(6):1332-4. 
- Vodegel RM, de Jong MC, Pas HH, Jonkman MF. IgA-mediated epidermolysis bullosa acquisita: two cases and review of the literature. J Am Acad Dermatol. 2002 Dec;47(6):919-25.