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Salamon G, Field-Werners U, Strobl S, Hübl V, Diem A. Facing the complex challenges of people with epidermolysis bullosa in Austria: a mixed methods study on burdens and helpful practices. Orphanet J Rare Dis 2024; 19:211. [PMID: 38773622 PMCID: PMC11110252 DOI: 10.1186/s13023-024-03163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/30/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND With approximately 500 people affected in Austria, epidermolysis bullosa (EB) is a rare genetic skin disease reducing the quality of life of those affected and their relatives. The intensive efforts of the patient organisation DEBRA Austria during the last decades have led to a unique situation of those affected and their relatives, with increased support and broader knowledge about the disease in the general population. The aim of the study is to evaluate the current situation of patients and their relatives living in Austria, with a focus on burdens and helpful practices. RESULTS The mixed-methods study consisted of two parts: a qualitative interview study to identify psychosocial aspects of EB in those affected and their relatives, and a subsequent online survey to further assess those aspects in a larger sample, resulting in a total of n=78 Austrian participants. The impact of EB on the quality of life of EB patients and their relatives in Austria is related to the current health status, psychological burden, mobility, visibility, financial situation as well as job prospects. Personal and social resources and external support have a significant influence on the individual situation. CONCLUSIONS The outcome is mapped to concrete implications regarding targeted support for EB patients and their relatives on an individual level and their needs in regard to the Austrian health care system.
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Affiliation(s)
- Gudrun Salamon
- Faculty of Psychology, Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria.
| | - Ursula Field-Werners
- Faculty of Psychology, Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria
| | - Sophie Strobl
- Faculty of Psychology, Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria
| | - Vinzenz Hübl
- Faculty of Psychology, Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria
| | - Anja Diem
- EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
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Becker SL, Kody S, Fett NM, Hines A, Alavi A, Ortega-Loayza AG. Approach to the Atypical Wound. Am J Clin Dermatol 2024:10.1007/s40257-024-00865-0. [PMID: 38744780 DOI: 10.1007/s40257-024-00865-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
The heterogeneity of atypical wounds can present diagnostic and therapeutic challenges; however, as the prevalence of atypical wounds grows worldwide, prompt and accurate management is increasingly an essential skill for dermatologists. Addressing the underlying cause of an atypical wound is critical for successful outcomes. An integrated approach with a focus on pain management and patient engagement is recommended to facilitate enduring wound closure. Advances in treatment, in addition to further research and clinical training, are necessary to address the expanding burden of atypical wounds.
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Affiliation(s)
- Sarah L Becker
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA
| | - Shannon Kody
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA
| | - Nicole M Fett
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Alex G Ortega-Loayza
- Department of Dermatology, Oregon Health & Science University, 3303 S Bond Ave Building 1, 16th Floor, Portland, OR, 97239, USA.
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Pabón-Carrasco M, Caceres-Matos R, Roche-Campos M, Hurtado-Guapo MA, Ortiz-Romero M, Gordillo-Fernández LM, Pabón-Carrasco D, Castro-Méndez A. Management of Skin Lesions in Patients with Epidermolysis Bullosa by Topical Treatment: Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:261. [PMID: 38275540 PMCID: PMC11154251 DOI: 10.3390/healthcare12020261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Epidermolysis bullosa (EB) is the overarching term for a set of rare inherited skin fragility disorders that result from mutations in at least 20 different genes. Currently, there is no cure for any of the EB subtypes associated with various mutations. Existing therapies primarily focus on alleviating pain and promoting early wound healing to prevent potential complications. Consequently, there is an urgent need for innovative therapeutic approaches. The objective of this research was to assess the efficacy of various topical treatments in patients with EB with the goal of achieving wound healing. A secondary objective was to analyse the efficacy of topical treatments for symptom reduction. A literature search was conducted using scientific databases, including The Cochrane Library, Medline (Pubmed), Web of Science, CINHAL, Embase, and Scopus. The protocol review was registered in PROSPERO (ID: 418790), and inclusion and exclusion criteria were applied, resulting in the selection of 23 articles. Enhanced healing times were observed compared with the control group. No conclusive data have been observed on pain management, infection, pruritus episodes, and cure rates over time. Additionally, evidence indicates significant progress in gene therapies (B-VEC), as well as cell and protein therapies. The dressing group, Oleogel S-10, allantoin and diacerein 1%, were the most represented, followed by fibroblast utilisation. In addition, emerging treatments that improve the patient's innate immunity, such as calcipotriol, are gaining attention. However, more trials are needed to reduce the prevalence of blistering and improve the quality of life of individuals with epidermolysis bullosa.
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Affiliation(s)
- Manuel Pabón-Carrasco
- Research Group PAIDI-CTS-1054: “Interventions and Health Care, Red Cross (ICSCRE)”, Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, 41009 Seville, Spain;
| | - Rocio Caceres-Matos
- Research Group PAIDI-CTS-1050: “Complex Care, Chronicity and Health Outcomes”, Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, 41009 Seville, Spain
| | | | | | - Mercedes Ortiz-Romero
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.O.-R.); (L.M.G.-F.); (A.C.-M.)
| | - Luis M. Gordillo-Fernández
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.O.-R.); (L.M.G.-F.); (A.C.-M.)
| | | | - Aurora Castro-Méndez
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.O.-R.); (L.M.G.-F.); (A.C.-M.)
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Silva CB, Okido ACC, Carlos DM, Wernet M, Barbosa NG. Experiences of mothers in the care of children and adolescents with epidermolysis bullosa. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0231en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract Objective to know and analyze mothers’ experiences in caring for children and adolescents with Epidermolysis Bullosa. Method a descriptive qualitative study was developed with ten mothers of children and adolescents with epidermolysis bullosa from different regions of Brazil using semi-structured interviews recorded remotely using Google Meet® between September and November 2021. The thematic analysis technique guided the appreciation of the empirical material. Results mothers aged between 23 and 53 years participated in the study. Two categories translate the maternal experience: i) the “shock” of the diagnosis and the initial challenges and ii) “Stop living to live for them”: the changes in the families’ daily life. Final considerations and implications for practice mothers experienced fear and insecurity when their child was diagnosed, and the care routine, especially the daily dressing changes, caused a physical and emotional burden. These results can support the follow-up of these families to provide them with care tools and emotional support.
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Silva CB, Okido ACC, Carlos DM, Wernet M, Barbosa NG. Vivências de mães no cuidado a crianças e adolescentes com Epidermólise Bolhosa. ESCOLA ANNA NERY 2023. [DOI: 10.1590/2177-9465-ean-2022-0231pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Objetivo conhecer e analisar as vivências de mães no cuidado a crianças e adolescentes com Epidermólise Bolhosa. Método estudo descritivo de abordagem qualitativa desenvolvido junto a dez mães de crianças e adolescentes com Epidermólise Bolhosa de diferentes regiões do Brasil, a partir de entrevistas semiestruturadas, áudio e vídeo gravadas, por via remota, utilizando-se a plataforma Google Meet®, entre setembro e novembro de 2021. A técnica da análise temática direcionou a apreciação do material empírico. Resultados participaram do estudo mães com idade entre 23 e 53 anos. Duas categorias traduzem a vivência materna: i) O “baque” do diagnóstico e os desafios iniciais e ii) “Deixar de viver para viver para ele”: as mudanças no cotidiano das famílias. Considerações finais e implicações para a prática as mães vivenciaram sentimentos de medo e insegurança diante do diagnóstico do filho e a rotina de cuidados, em especial, as trocas diárias de curativos, acarretaram sobrecarga física e emocional. Esses resultados podem subsidiar o acompanhamento dessas famílias de modo a instrumentalizá-las para o cuidado e apoiá-las emocionalmente.
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