With hemolytic disease of the fetus and newborn, death occurs from bilirubin encephalopathy, infectious complications such as pneumonia, sepsis, hemorrhages and treatment-related complications such as thromboembolism and air embolism during blood transfusion.
These basic types are based on a precise ultrastructural level depending on the way the bubbles are formed. The three main types of EB were clinically and histologically determined before the 1960s. In the 1970s, electron microscopy revealed abnormal epidermal keratin filaments in bullous simplex epidermolysis, undistributed skin fixation fibrils in dystrophic epidermolysis bullosa, and defective semi-oxidosomes in connective epidermal bullosis.
Cytolysis causes blisters in the epidermis or in the area of the main membrane of the skin. In simple epidermolysis bullosa, cytolysis causes the formation of blisters in the base or spinous layer of the epidermis, and keratinocytes often have an abnormal density and organization of keratin plexuses. In borderline EB, the epidermis separates from the main lamina, forming a vesicular cavity in the lamina lucida plane, where the structure and density of hemamidosomes are reduced. In dystrophic EB, the main plate remains attached to the epidermis, but a vesicular cavity forms under the dermo-epidermal connecting plate, and the fixed fibrils are abnormal, reduced in number, or absent altogether.
Electron microscopy determines the level of skin cleavage in EB and allows you to visualize and semi-quantify specific structures that change in certain subtypes of the disease. There is some perinuclear edema and disrupted cytolysis of basal cells, but usually the organelles are intact. Cytolysis is preceded by the aggregation and accumulation of tonifilaments that attach to hemidesmosomes at the dermo-epidermal junction. The main membrane zone is intact in all variants of simple epidermolysis bullosa.
Hemangiomas are benign tumors originating from endothelial cells that fill blood vessels. They can be capillary or cavernous. In capillary hemangioma, the tumor consists of small blood-filled areas, has a pink-red color and resembles strawberries. Capillary hemangiomas grow rapidly in the first 1-2 years of life, and then they become smaller and eventually disappear in 90-95% of cases. They are most often located on the skin, especially in the head and neck area. Capillary hemangiomas in most cases do not require any treatment.
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