In a newborn with defects in anchoring fibrils, which skin finding is the most likely outcome?

In a newborn with defects in anchoring fibrils, the most likely skin finding is the presence of blisters. Anchoring fibrils are important components of the basement membrane zone in the skin, connecting the epidermis to the dermis. They play a critical role in providing structural stability and integrity to the skin.

When anchoring fibrils are defective or absent, the adhesion between the epidermis and dermis becomes compromised. This can lead to a condition known as epidermolysis bullosa, which is characterized by skin fragility and blister formation with minimal trauma. As a result, affected individuals often experience the formation of blisters on the skin, particularly in areas subject to friction or slight injury.

Other skin findings mentioned, such as easy bruising, an eczematous rash, and thickened skin, do not typically correlate with defects specifically affecting anchoring fibrils. Easy bruising is generally associated with underlying vascular or platelet disorders, while an eczematous rash often stems from allergic reactions or irritant contact dermatitis, and thickened skin (or lichenification) usually indicates chronic irritation rather than a structural defect like those found in anchoring fibrils. Thus, the presence of blisters is the hallmark outcome associated with these specific