Symptoms within each category can vary from relatively minor symptoms to, in the most severe forms, death in infancy.
In EBS, blistering occurs in top layer of skin, the epidermis. There are many subtypes of EBS. In the most common form, EBS localised, blistering occurs predominantly on the feet and hands and is worse in hot weather. In more severe forms, such as EBS Dowling-Meara, blistering is more widespread and severe.
Dystrophic EB is a group of disorders where blisters occur deeper, beneath the epidermis. Since the blisters are deeper, they tend to heal with scarring. Milder forms may give rise to blistering limited in extent, particularly around fingers and toes, ankles and knees, and may affect finger or toenails. The severe forms lead to more generalised blistering, which can lead to areas of chronic ulceration and scarring with resultant deformity of hands, feet and large joints.
The Herlitz form (junctional EB) is particularly severe, giving rise to chronic wounds, nail loss, failure to gain weight, difficulty in breathing and, in the vast majority of cases, death in the first year or two of life. In less severe forms of junctional EB, skin fragility is accompanied by dental enamel defects, nail abnormality and loss, and sometimes sparse hair.