Three new cases of transient bullous dermolysis of the newborn

We present 3 new patients with transient bullous dermolysis of the newborn (TBDN), which is a form of dystrophic epidermolysis bullosa. TBDN may be di agnosed by electron microscopy showing a sublamina densa cleavage; immunofl uorescence antigenic mapping demonstrating bullous pemphigoid antigen, lami nin-l, and type IV collagen along the epidermal roof of subepidermal clefts ; and indirect immunofluorescence with monoclonal antibodies revealing intr aepidermal type VII collagen. Although intraepidermal type VII collagen has been reported in other forms of dystrophic epidermolysis bullosa, we belie ve that the presence of type VII collagen in a striking intraepidermal gran ular array is a finding unique to TBDN. Our cases demonstrate the importanc e of immunodermatologic studies in the diagnosis of bullous disorders that are seen at birth because accurate diagnosis carries prognostic implication s. This variant of epidermolysis bullosa, in contrast to other forms of dys trophic epidermolysis bullosa, is a benign, self-limited disease.