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EPIDERMOLYSIS BULLOSA: A CLINICAL AND BACTERIOLOGIC STUDY:  REPORT OF FOUR CASES

A. BENSON CANNON, M.D.; MURRAY SANDERS, M.D.; JOSEPH L. RANKIN, M.D.
Arch Derm Syphilol. 1940;42(5):884-895. doi:10.1001/archderm.1940.01490170134013.
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This study of epidermolysis bullosa was undertaken when, in the course of making a routine clinical examination, we found that the patient, a 13 month old girl, had an abnormally high leukocyte count (10,200 per cubic millimeter). While looking for the cause of the leukocytosis we made a bacteriologic study of the bullous exudate from one of the lesions as well as of a smear of material from the throat, and to our surprise we obtained from both an almost pure culture of an unusual type of hemolytic streptococcus (group G, Lancefield).

The occurrence of Streptococcus haemolyticus in the bullous fluid of lesions of epidermolysis is in itself not uncommon. Marchionini,1 among others, reported that he found an abundant growth of this organism, as well as of Staphylococcus aureus, in the lesions which he examined, and it has for the most part been considered only a secondary contaminant. But

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