Foot Care in Epidermolysis Bullosa: Evidence-based Guideline

M.T. Khan; M. O'Sullivan; B. Faitli; J.E. Mellerio; R. Fawkes; M. Wood; L.D. Hubbard; A.G. Harris; L. Iacobaccio; T. Vlahovic; L. James; L. Brains; M. Fitzpatrick; K. Mayre-Chilton

Disclosures

The British Journal of Dermatology. 2020;182(3):593-604. 

In This Article

Background

The Dystrophic Epidermolysis Bullosa Research Association (DEBRA) International is a worldwide network of national groups working for people affected by the genetic skin blistering condition EB. EB is a group of rare heritable skin fragility disorders, typically presenting as blistering of the skin from minor trauma.[1] While there are currently over 30 known subtypes of EB, there are four primary types: EB simplex (EBS), dystrophic EB (DEB), junctional EB (JEB) and Kindler syndrome (KS).[1,2] EB can be the result of either inherited or spontaneous dominant mutations, as seen in most forms of EBS and dominant DEB (DDEB), or from inherited recessive mutations as is the case with rare forms of EBS, recessive DEB (RDEB), JEB and KS (Table 1).[2] Ninety per cent of patients with EB have one or more podiatric manifestations, including blistering, hyperkeratosis, flat feet, nail dystrophy or structural abnormalities affecting foot positioning.[3,4] EB requires specialized podiatric care, but because of its rarity many podiatrists have limited knowledge of the disorder. Furthermore, there is a dearth of evidence regarding podiatric care of EB, and management decisions are usually based on experience and expert opinion.

The recommendations outlined in this clinical practice guideline (CPG) contain general information on foot care of people living with EB (Table 2 and Table 3). They explain the precautions that should be taken when treating people with EB, as well as recommendations for podiatry treatment.

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