Nail involvement in epidermolysis bullosa

Nail abnormalities are a common feature in most subtypes of epidermolysis bullosa (EB), and they recently have been included among the criteria for scoring EB severity. Trauma undoubtedly contributes to the development of nail dystrophy, and for this reason the great toenails often are affected more severely. The nail abnormalities may be the first or the only symptom of EB. Nail abnormalities observed in EB are not specific or pathognomonic, as they result from nail bed and matrix scarring. The spectrum of clinical severity is large, and nail abnormalities may cause severe disability or just be a mild cosmetic problem. This article reviews the nail abnormalities observed in EB.