| • | cleavage beneath the lamina densa |  
 | • | characterized by scarring, nail changes, and milia |  
 | • | recessive dystrophic EB – complete absence of anchoring fibrils |  
 | • | dominant dystrophic EB – reduced number and/or abnormal in appearance |  
   
autosomal recessive (Hallopeau-Siemens) 
| • | etiology = type VII collagen (anchoring fibrils)  (same as epidermolysis bullosa acquisita) |  
 | • | large bullae heal with atrophic scars and milia:  pseudo-webbing = “mitten hands” |  
 | • | mucous membranes often involved (may lead to esophageal stricture formation;  any epithelial lined organ) |  
 | • | corneal erosions, cicatricial alopecia |  
   
autosomal dominant (Cockayne-Touraine) 
 |