Epidermolysis bullosa (EB) is a rare, inherited blistering skin disorder with many sub-types. The condition results in skin fragility and, depending on the type, can result in minor to severe blistering of the skin and mucous membranes along with scarring of the skin and nail changes. The charity supporting EB, DEBRA (www.debra.org.uk) estimates there are around 5000 people in the UK and as many as half a million people worldwide with the condition.
The foot, as a weight bearing area, is particularly vulnerable to the effects of the disease and patients require careful management, owing to the skin’s fragility. In a forthcoming issue of the British Journal of Dermatology, guidelines are to be published on this very topic. The working group, lead by podiatrist Tariq Khan, included 14 members including 6 podiatrists from the UK, Australia and the United States as well as patients with the condition, dietitians, a physiotherapist and dermatologists. The guidelines represent a compilation of all of the available papers published on this topic, appraised and formulated into the document. It covers issues around nail care, callus reduction and footwear. In addition, it identifies areas where more research is required to answer gaps in current knowledge.
The paper also suggests training for podiatrists (in countries where they practice) as a means of ensuring high quality patient care. It has been peer reviewed by a panel including patients and experts in the field. Once officially published, the charity DEBRA aims to disseminate the guidelines and review their implementation at various clinical sites. Despite its rarity, the guidelines will be an asset to anyone involved in the care of EB patients.
Khan, M. T., M. O'Sullivan, B. Faitli, J. Mellerio, R. Fawkes, M. Wood, L. Hubbard, A. Harris, L. Iacobaccio, T. Vlahovic, L. James, L. Brains, M. Fitzpatrick and K. Mayre-Chilton "Foot care in Epidermolysis bullosa: Evidence-based Guideline."
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