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Saad R, Duipmans J, Yerlett N, Plevey K, McCuaig C, Woolfe W, Steinau K, Phillips J, Azzopardi N, Thompson K, Ferreira da Rocha AC, Torres-Pradilla M, Ott H, Patton D, Moore Z, Murphy P, Mayre-Chilton K. Neonatal epidermolysis bullosa: a clinical practice guideline. Br J Dermatol 2024; 190:636-656. [PMID: 38175636 DOI: 10.1093/bjd/ljae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/05/2024]
Abstract
DEBRA International is undertaking a long-term initiative to develop clinical practice guidelines (CPGs) for epidermolysis bullosa (EB), to -improve the clinical care of people living with EB. Current neonatal care is based on evidence, clinical expertise and trial and error, with collaboration between the EB specialist team, parent or carer and patient, and is dependent on the neonate's individual presentation and type of EB. Early intervention based on research and clinical practice is needed to establish a foundation of knowledge to guide international practitioners to create and improve standards of care and to be able to work effectively with those newly diagnosed with EB. This CPG was created by an international panel with expertise working with persons with EB. The CPG focuses on neonatal care using a systematic review methodology covering four key areas: (i) diagnosis and parental psychosocial support; (ii) hospital management: medical monitoring, wound care and pain; (iii) feeding and nutrition; and (iv) discharge planning and EB education. These four areas highlight the importance of a multidisciplinary team approach, to provide a patient-specific holistic care model that incorporates the needs and wishes of the parents and carers. The Hospital Implementation Tool included promotes transfer of theory to clinical practice.
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Affiliation(s)
- Rebecca Saad
- Sydney Children's Hospital Randwick, Sydney, NSW, Australia
| | - José Duipmans
- Center for Blistering Diseases, Department of Dermatology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Katie Plevey
- Great Ormond Street NHS Foundation Trust, London, UK
| | - Catherine McCuaig
- Sainte-Justine University Hospital Centre, and University of Montreal, Montreal, QC, Canada
| | - William Woolfe
- Sydney Children's Hospital Randwick, Sydney, NSW, Australia
| | - K Steinau
- Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA
| | | | | | - Kerry Thompson
- Person living with epidermolysis bullosa
- Royal Adelaide Hospital, Adelaide, SA, Australia
| | | | - Maurico Torres-Pradilla
- Dermatology Department, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia
- Dermatology Department, Fundación Universitaria de Ciencias de la Salud, Hospital Infantil Universitario de San José, Bogotá, Colombia
| | - Hagen Ott
- Division of Paediatric Dermatology and Centre for Rare Congenital Skin Diseases, Children's Hospital Auf der Bult, Hanover, Germany
| | - Declan Patton
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Zena Moore
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul Murphy
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Gila F, Alamdari-Palangi V, Rafiee M, Jokar A, Ehtiaty S, Dianatinasab A, Khatami SH, Taheri-Anganeh M, Movahedpour A, Fallahi J. Gene-edited cells: novel allogeneic gene/cell therapy for epidermolysis bullosa. J Appl Genet 2024:10.1007/s13353-024-00839-2. [PMID: 38459407 DOI: 10.1007/s13353-024-00839-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/12/2024] [Accepted: 01/30/2024] [Indexed: 03/10/2024]
Abstract
Epidermolysis bullosa (EB) is a group of rare genetic skin fragility disorders, which are hereditary. These disorders are associated with mutations in at least 16 genes that encode components of the epidermal adhesion complex. Currently, there are no effective treatments for this disorder. All current treatment approaches focus on topical treatments to prevent complications and infections. In recent years, significant progress has been achieved in the treatment of the severe genetic skin blistering condition known as EB through preclinical and clinical advancements. Promising developments have emerged in the areas of protein and cell therapies, such as allogeneic stem cell transplantation; in addition, RNA-based therapies and gene therapy approaches have also become a reality. Stem cells obtained from embryonic or adult tissues, including the skin, are undifferentiated cells with the ability to generate, maintain, and replace fully developed cells and tissues. Recent advancements in preclinical and clinical research have significantly enhanced stem cell therapy, presenting a promising treatment option for various diseases that are not effectively addressed by current medical treatments. Different types of stem cells such as primarily hematopoietic and mesenchymal, obtained from the patient or from a donor, have been utilized to treat severe forms of diseases, each with some beneficial effects. In addition, extensive research has shown that gene transfer methods targeting allogeneic and autologous epidermal stem cells to replace or correct the defective gene are promising. These methods can regenerate and restore the adhesion of primary keratinocytes in EB patients. The long-term treatment of skin lesions in a small number of patients has shown promising results through the transplantation of skin grafts produced from gene-corrected autologous epidermal stem cells. This article attempts to summarize the current situation, potential development prospects, and some of the challenges related to the cell therapy approach for EB treatment.
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Affiliation(s)
- Fatemeh Gila
- Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahab Alamdari-Palangi
- Department of Molecular Medicine, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maedeh Rafiee
- Department of Veterinary Sciences, University of Wyoming, Laramie, WY, USA
| | - Arezoo Jokar
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Ehtiaty
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aria Dianatinasab
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Hossein Khatami
- Department of Clinical Biochemistry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mortaza Taheri-Anganeh
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Jafar Fallahi
- Department of Molecular Medicine, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.
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Popenhagen MP, Genovese P, Blishen M, Rajapakse D, Diem A, King A, Chan J, Pellicer Arasa E, Baird S, Ferreira da Rocha AC, Stitt G, Badger K, Zmazek V, Ambreen F, Mackenzie C, Price H, Roberts T, Moore Z, Patton D, Murphy P, Mayre-Chilton K. Consensus-based guidelines for the provision of palliative and end-of-life care for people living with epidermolysis bullosa. Orphanet J Rare Dis 2023; 18:268. [PMID: 37667330 PMCID: PMC10476410 DOI: 10.1186/s13023-023-02870-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Inherited epidermolysis bullosa (EB) is a cluster of rare, genetic skin and mucosal fragility disorders with multi-system and secondary effects, in which blistering and erosions occur in response to friction/mechanical trauma. Considering the incurable and potentially life-limiting nature of the condition and the challenges posed by its symptoms, a palliative approach to EB-related care is necessary. However, knowledge and experience related to the provision of EB palliative care is minimal. Evidence-based, best care guidelines are needed to establish a base of knowledge for practitioners to prevent or ease suffering while improving comfort at all stages of the illness, not just the end of life. METHODS This consensus guideline (CG) was begun at the request of DEBRA International, an international organization dedicated to improvement of care, research, and dissemination of knowledge for EB patients, and represents the work of an international panel of medical experts in palliative care and EB, people living with EB, and people who provide care for individuals living with EB. Following a rigorous, evidence-based guideline development process, the author panel identified six clinical outcomes based on the results of a survey of people living with EB, carers, and medical experts in the field, as well as an exhaustive and systematic evaluation of literature. Recommendations for the best clinical provision of palliative care for people living with EB for each of the outcomes were reached through panel consensus of the available literature. RESULTS This article presents evidence-based recommendations for the provision of palliative healthcare services that establishes a base of knowledge and practice for an interdisciplinary team approach to ease suffering and improve the quality of life for all people living with EB. Any specific differences in the provision of care between EB subtypes are noted. CONCLUSIONS Because there is yet no cure for EB, this evidence-based CG is a means of optimizing and standardizing the IDT care needed to reduce suffering while improving comfort and overall quality of life for people living with this rare and often devastating condition.
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Affiliation(s)
- Mark P Popenhagen
- Department of Anesthesiology B090, Children's Hospital Colorado, University of Colorado School of Medicine, Anschutz Medical Campus, 13123 E 16Th Ave, Aurora, CO, 80045, USA.
- Section of Pediatric Anesthesiology, Children's Hospital Colorado, Aurora, CO, USA.
| | | | - Mo Blishen
- DEBRA New Zealand, Newtown, Wellington, New Zealand
| | | | - Anja Diem
- EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | | | - Jennifer Chan
- Lucile Packard Children's Hospital, Stanford, Menlo Park, CA, USA
| | | | - Simone Baird
- DEBRA Australia, Pittsworth, QLD, Australia
- , Melbourne, Australia
| | | | - Gideon Stitt
- Division of Clinical Pharmacology, University of Utah, Salt Lake City, UT, USA
| | | | | | - Faiza Ambreen
- DEBRA Pakistan, Lahore, Punjab, Pakistan
- , London, UK
| | - Caroline Mackenzie
- Guys and St Thomas' Foundation NHS Foundation Trust, EB Adult Service, East Hampshire, England, UK
| | | | - Toni Roberts
- DEBRA South Africa, Western Cape, Cape Town, South Africa
- , Cape Town, South Africa
| | - Zena Moore
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Declan Patton
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul Murphy
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
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Zidório APC, Carvalho KMBD, Dutra ES. Assessment of nutrient intakes of children and adolescents with recessive dystrophic epidermolysis bllosa, severe subtype. NUTR HOSP 2023; 40:286-294. [PMID: 36719008 DOI: 10.20960/nh.04330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction Background and aims: epidermolysis bullosa (EB) is a rare disease presenting with skin fragility and formation of blisters. Constant presence of skin lesions, loss of blood, wastage of heat through the open skin, increased turnover of proteins and infections, result in increased energy, protein, and micronutrient needs. This study investigated the intake adequacy of energy, protein, zinc, iron, and dietary fiber in children with epidermolysis bullosa. Methods: this cross-sectional, analytical study was conducted with children and adolescents of up to 18 years of age with recessive dystrophic EB, severe subtype. Demographic data and clinical manifestations affecting food consumption were collected. Nutritional assessment was performed through anthropometric data. We used a formula to estimate specific energy needs for EB, and ratio of skin lesions was also evaluated to assist in estimating energy needs. A protein adequacy of 115 % to 200 % of the Recommended Dietary Allowance was considered for the adequacy of protein intake. And the Dietary Reference Intake tables according to sex and age were used as a reference for micronutrients. Intake assessment was performed using seven consecutive daily food records. Sip feed consumption was considered for intake assessment. Results: all patients showed undernutrition and presented at least three clinical symptoms that affect food consumption: pseudosyndactyly, microstomy, and blisters in the oral cavity. Sip feed constituted between 20 % and 50 % of the patients' energy intake. Intake of iron and zinc was adequate for most patients (confidence of adequacy ≥ 0.85), while fiber intake was below the reference value. Conclusions: this study underscores the importance of nutritional monitoring for EB patients, which is often interpreted as a skin disease but has enormous nutritional repercussions.
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Affiliation(s)
- Ana Paula Caio Zidório
- Clinical Nutrition Unit. Hospital Universitário de Brasília. Faculdade de Ciências de Saúde. Universidade de Brasília
| | | | - Eliane Said Dutra
- Graduate Program in Human Nutrition. Faculdade de Ciências de Saúde. Universidade de Brasília
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Kleinman EP, Reimer-Taschenbrecker A, Haller CN, Paller AS, Levy ML, Eichenfield LF. Gastrostomy tube feeding in epidermolysis bullosa: A multi-center assessment of caregiver satisfaction. Pediatr Dermatol 2022; 40:270-275. [PMID: 36461900 DOI: 10.1111/pde.15207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/12/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND/OBJECTIVES Gastrostomy tubes (G-tubes) are a feasible intervention for nutritional support in patients with epidermolysis bullosa (EB) who suffer from gastrointestinal involvement. However, some parents may be apprehensive about this surgical intervention. The purpose of this study is to assess caregiver satisfaction and experiences after G-tube insertion in children with EB. METHODS Nine institutions sent an anonymous 89-item online questionnaire to caregivers of patients with EB and active G-tubes during an 8-week study period. The questionnaire consisted of eight sections and was formatted with multiple choice, Likert scales, dichotomous scales (yes/no), and free text. RESULTS Twenty caregiver surveys were completed. All caregivers were parents (100%). The average age of G-tube placement was 2.7 years (SD: 2.1, range 0-8) and duration of the G-tube utilization was an average of 12.0 years (SD: 7.8, range 1-25). EB subtypes were dystrophic (n = 15/20, 75%), junctional (n = 3/20, 15%), and simplex (n = 2/10, 10%). Almost all caregivers (n = 18/20, 90%) reported high levels of satisfaction with G-tube management (scores > 20 on the modified SAGA-8 scale). More than half of caregivers (n = 12/20, 60%) reported that, retrospectively, they would have desired earlier adoption of the G-tube. Caregivers rated mealtimes as more enjoyable and easier both for themselves and the individual with EB post-G-tube placement. CONCLUSION The survey demonstrates a high rate of satisfaction for G-tube use among caregivers of patients with EB across varying ages and household settings. The free-text responses provide unique insight into caregiver's individual experiences regarding G-tubes to be considered for future studies.
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Affiliation(s)
- Elana P Kleinman
- Rady Children's Hospital of San Diego, San Diego, California, USA.,University of California San Diego School of Medicine, San Diego, California, USA
| | - Antonia Reimer-Taschenbrecker
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.,Department of Dermatology, Medical Center-University of Freiburg, Freiburg, Germany
| | - Courtney N Haller
- University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Moise L Levy
- University of Texas at Austin Dell Medical School, Austin, Texas, USA.,Dell Children's Medical Center, Austin, Texas, USA
| | - Lawrence F Eichenfield
- Rady Children's Hospital of San Diego, San Diego, California, USA.,University of California San Diego School of Medicine, San Diego, California, USA
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Mughal AZ, Subramanian T, Jones R, James D, Ogboli M, Soccorso G. Evaluating the use of laparoscopic-assisted gastrostomy tube feeding in children with epidermolysis bullosa: A single-center retrospective study. J Pediatr Surg 2022; 57:39-44. [PMID: 34876295 DOI: 10.1016/j.jpedsurg.2021.10.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/21/2021] [Accepted: 10/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nutritional management of children with epidermolysis bullosa (EB) presents multiple challenges including reduced oral intake compounded by mucosal fragility. Gastrostomy tube feeding is effective in improving nutritional status however there is limited data on the safety and tolerance of this technique in EB children. We aim to review the effectiveness and morbidity of our minimally invasive two-port laparoscopic-assisted gastrostomy (LAG) approach using Seldinger techniques with serial dilatations in children with EB. METHODS A retrospective, observational cohort study was conducted on all consecutive EB patients who underwent LAG tube insertion between 2009 and 2019. Patient demographics, admission details and 12-month clinical outcomes were reported. RESULTS 32 EB patients underwent LAG placement. Median age at insertion was 7.3 (IQR ± 6.3) years, with 8 (25.0%) and 3 (9.4%) of patients also undergoing oesophageal dilatation and fundoplication, respectively. Minor complications arose in 58.1% of patients including: peri-stomal overgranulation (25.8%), gastrostomy infection (22.6%), pain (22.6%), mild gastrostomy leakage (16.1%), blockage (9.7%) and device failure (3.2%). 2 patients (6.5%) developed major complications with extensive gastrostomy site leakage. Improvements in growth were reflected in mean height Z-scores (-1.99 to -1.71). Mean weight Z-scores improved in patients aged 0-10 years (-2.30 to -1.61) and mean BMI Z-scores increased in patients more than 10 years (-2.71 to -1.46). No cases of gastrostomy-related mortality were reported. CONCLUSION LAG is well-tolerated in EB patients with improvements in growth and minimal morbidity 12-months post-gastrostomy insertion. An extended follow-up period is required to ascertain the long-term implications of gastrostomy feeding.
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Affiliation(s)
- Aishah Z Mughal
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
| | - Thejasvi Subramanian
- Department of Paediatric Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
| | - Rosie Jones
- Department of Dietetics, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
| | - Dawn James
- Department of Dermatology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
| | - Malobi Ogboli
- Department of Dermatology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
| | - Giampiero Soccorso
- Department of Paediatric Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
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Furukawa LK, Wolke ON. Care of the Patient with Epidermolysis Bullosa. Curr Anesthesiol Rep. [DOI: 10.1007/s40140-021-00484-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Epidermolysis bullosa (EB) is a group of rare congenital genetic conditions that result in painful blistering of the skin and mucous membranes, which occur with minor trauma or friction. There are many types and subtypes of EB that need to be distinguished, as the management and prognosis of each can vary significantly. We aim to perform an up-to-date literature review on congenital EB for healthcare providers in pediatrics. We performed a review of existing literature in the English language on EB via PubMed Clinical Queries, using key words such as "epidermolysis bullosa", "congenital" and "children". We reviewed EB based on the following subheadings: epidemiology, diagnosis, therapy, prognosis, and clinical prediction guidelines. EB is due to mutation in a number of genes, some types are autosomal dominant while others are autosomal recessive. The underlying mechanism is a defect in attachment between or within the epidermis and dermis of the skin. There are four main types: epidermolysis bullosa simplex, dystrophic epidermolysis bullosa, junctional epidermolysis bullosa, and Kindler syndrome. The diagnosis is suspected based on symptoms and confirmed by skin biopsy and definitive genetic testing. The severity of EB can range from mild to fatal. Severe complications may arise in some EB types and subtypes within the eye, ear, nose, upper airway, gastrointestinal and genitourinary tracts. There is no cure for the condition to date. Optimal management must be multidisciplinary, and involves wound care, pain control, controlling infections, nutritional support, and prevention and treatment of complications. EB presents in different forms. Treatment is supportive. The prognosis of milder forms is good. Children severely affected with EB and their families live a misery life with impaired quality of life. Health care workers must be aware of the suffering in these families and proactively support them.
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Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Kowloon, Hong Kong
| | - Samantha Chu
- Faculty of Medicine, The Chinese University of Hong Kong, Shenzhen, Hong Kong
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary, and The Alberta Children's Hospital, Calgary, Alberta, Canada
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Gundogan B, Dowlut N, Rajmohan S, Borrelli MR, Millip M, Iosifidis C, Udeaja YZ, Mathew G, Fowler A, Agha R. Assessing the compliance of systematic review articles published in leading dermatology journals with the PRISMA statement guidelines: A systematic review. JAAD Int 2021; 1:157-174. [PMID: 34409336 PMCID: PMC8361930 DOI: 10.1016/j.jdin.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
Background Reporting quality of systematic reviews and meta-analyses is of critical importance in dermatology because of their key role in informing health care decisions. Objective To assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. Methods This review was carried out in accordance with PRISMA guidelines. Included studies were reviews published across 6 years in the top 4 highest-impact-factor dermatology journals of 2017. Records and full texts were screened independently. Data analysis was conducted with univariate multivariable linear regression. The primary outcome was to assess the compliance of systematic reviews and meta-analyses in leading dermatology journals with the PRISMA statement. Results A total of 166 studies were included and mean PRISMA compliance across all articles was 73%. Compliance significantly improved over time (β = .016; P = <.001). The worst reported checklist item was item 5 (reporting on protocol existence), with a compliance of 15% of articles. Conclusion PRISMA compliance within leading dermatology journals could be improved; however, it is steadily improving.
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Affiliation(s)
- Buket Gundogan
- University College London Hospital, London, United Kingdom
| | - Naeem Dowlut
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Mimi R Borrelli
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Mirabel Millip
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Christos Iosifidis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yagazie Z Udeaja
- Luton and Dunstable University Hospital NHS Foundation Trust, Luton, United Kingdom
| | - Ginimol Mathew
- University College London Medical School, Gower Street, London, United Kingdom
| | | | - Riaz Agha
- Bart's Health NHS Foundation Trust, London, United Kingdom
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Marro M, De Smet S, Caldari D, Lambe C, Leclerc-Mercier S, Chiaverini C. Gastrostomy for infants with severe epidermolysis bullosa simplex in neonatal intensive care. Orphanet J Rare Dis 2021; 16:271. [PMID: 34116697 PMCID: PMC8196452 DOI: 10.1186/s13023-021-01896-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/29/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Severe epidermolysis bullosa simplex (EBS sev) is a rare genodermatosis characterized by congenital generalized blistering and mucosal involvement. Increased needs and decreased intake quickly lead to nutritional imbalance. Enteral nutrition support is proposed, but classical nasogastric tubes are not well tolerated in these patients and gastrostomy is preferred. OBJECTIVE AND METHODS To report the experience with EBS sev in neonatal units of French reference centers for gastrostomy. In this retrospective multicentric study, we included all patients with EBS sev who had gastrostomy placement before age 9 months during neonatal care hospitalization. RESULTS Nine infants (5 males/4 females) with severe skin and mucosal involvement were included. A gastrostomy was decided, at an early age (mean 3.7 months, range 1.4 to 8 months) in infants with mean weight 4426 g (range 3500 to 6000 g). Techniques used were endoscopy with the pull technique for 5 infants and surgery under general anesthesia for 4. Main complications were local but resolved after treatment. All infants gained weight after gastrostomy. The mean withdrawal time (n = 7) for the gastrostomy was 35.8 months (range 10.5 months to 6.5 years). Seven children had persistent oral disorders. CONCLUSIONS Gastrostomy in infants with EBS sev can be necessary in neonatal intensive care units. Both surgical and endoscopic pull techniques seem efficient, with good tolerance.
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Affiliation(s)
- M Marro
- Department of Dermatology, CRMRPM-Sud, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, 06200, Nice, France
| | - S De Smet
- Department of Neonatal Intensive Care, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France
| | - D Caldari
- Department of Pediatric Gastroenterology, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - C Lambe
- Department of Pediatric Gastroenterology, Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP), Paris, France
| | - S Leclerc-Mercier
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP), Paris, France
| | - C Chiaverini
- Department of Dermatology, CRMRPM-Sud, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, 06200, Nice, France.
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Togo CCG, Zidorio APC, Gonçalves VSS, Hubbard L, de Carvalho KMB, Dutra ES. Quality of life in people with epidermolysis bullosa: a systematic review. Qual Life Res 2020; 29:1731-45. [DOI: 10.1007/s11136-020-02495-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2020] [Indexed: 12/12/2022]
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Reimer A, Hess M, Schwieger-Briel A, Kiritsi D, Schauer F, Schumann H, Bruckner-Tuderman L, Has C. Natural history of growth and anaemia in children with epidermolysis bullosa: a retrospective cohort study. Br J Dermatol 2019; 182:1437-1448. [PMID: 31487386 DOI: 10.1111/bjd.18475] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Impaired growth and anaemia are major extracutaneous complications of epidermolysis bullosa (EB), but data on their development are lacking. OBJECTIVES To determine the clinical course of growth and anaemia in children with EB and clarify the impact of nutritional compromise, inflammation and genetic factors. METHODS A retrospective study was conducted of 200 children, 157 with recessive dystrophic EB (RDEB) and 43 with junctional EB (JEB)-generalized intermediate, followed at the main referral centre in Germany. Growth charts were calculated using the modified LMS method and were correlated with parameters of anaemia, nutrition, inflammation and the molecular defect in a linear model. RESULTS In our cohort of patients with RDEB, weight impairment started at 12-18 months old; by the age of 10 years, 50% showed wasting. The predicted median weight at age 20 years was 35·2 kg for men and 40·1 kg for women. In JEB, growth resembled that of healthy children. Anaemia was present from the second year of life onwards in RDEB and JEB. Low levels of haemoglobin, iron, vitamin D, zinc and albumin, high levels of C-reactive protein, and absence of collagen VII correlated significantly with low weight in RDEB. No correlation was observed in JEB. CONCLUSIONS The results highlight that nutritional compromise occurs early in children with RDEB and therefore may require interventions as of the first year or two of life. What's already known about this topic? Children with epidermolysis bullosa (EB) suffer from failure to thrive and anaemia as major extracutaneous complications. The course of growth and the development of anaemia in EB are poorly characterized. What does this study add? A molecularly well characterized cohort of 200 children with EB was followed with regard to anthropometrics, anaemia and inflammation. We demonstrate early onset of growth failure and anaemia, most pronounced in the subset of recessive dystrophic EB. Awareness of early growth delay and nutritional deficiencies will improve EB care in daily practice.
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Affiliation(s)
- A Reimer
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - M Hess
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - A Schwieger-Briel
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany.,University Children's Hospital Zurich, Zurich, Switzerland
| | - D Kiritsi
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - F Schauer
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - H Schumann
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - L Bruckner-Tuderman
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
| | - C Has
- Department of Dermatology, University Clinic for Dermatology and Venereology, Faculty of Medicine, University of Freiburg, Hauptstraβe 7, 79104, Freiburg, Germany
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13
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Salera S, Tadini G, Rossetti D, Grassi FS, Marchisio P, Agostoni C, Giavoli C, Rodari G, Guez S. A nutrition-based approach to epidermolysis bullosa: Causes, assessments, requirements and management. Clin Nutr 2019; 39:343-352. [PMID: 30857908 DOI: 10.1016/j.clnu.2019.02.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 01/23/2019] [Accepted: 02/15/2019] [Indexed: 12/15/2022]
Abstract
Inherited epidermolysis bullosa (EB) is a clinically and genetically heterogeneous group of rare diseases characterized by skin and mucous membrane fragility. EB primarily involves the skin and, in specific subtypes, the mucous membrane, resulting in complications which can strongly affect nutritional status (e.g. gastrointestinal complications, hand deformities, pain). The aims of nutritional support mainly include improving nutritional status, alleviating the stress of oral feeding and minimizing nutritional deficiencies, thus consequently improving growth, pubertal development, bowel function, immune status and wound healing. The aim of this review is to discuss knowledge of different aspects of the disease related to nutrition and growth.
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Affiliation(s)
- Simona Salera
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, 20122, Milano, Italy.
| | - Gianluca Tadini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, 20122, Milano, Italy
| | - Donata Rossetti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, 20122, Milano, Italy; Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università di Milano, 20122, Milano, Italy
| | - Francesca Sofia Grassi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, 20122, Milano, Italy; Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università di Milano, 20122, Milano, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, 20122, Milano, Italy; Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università di Milano, 20122, Milano, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Media Intensità di Cura, 20122, Milano, Italy; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122, Milano, Italy
| | - Claudia Giavoli
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Endocrinologia, 20122, Milano, Italy
| | - Giulia Rodari
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, 20122, Milano, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Endocrinologia, 20122, Milano, Italy
| | - Sophie Guez
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatria Alta Intensità di Cura, 20122, Milano, Italy
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14
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Mazereeuw-hautier J. Quoi de neuf en dermatologie pédiatrique? Ann Dermatol Venereol 2018; 145:VIIS32-VIIS46. [DOI: 10.1016/s0151-9638(18)31287-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Moss C. Does gastrostomy benefit patients with epidermolysis bullosa? We need to collaborate to find out. Br J Dermatol 2018; 179:7-8. [PMID: 30156277 DOI: 10.1111/bjd.16695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Moss
- Birmingham Women's and Children's NHS Foundation Trust, University of Birmingham, Steelhouse Lane, Birmingham, B4 6NH, U.K
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