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CASE	
  REPORT
CANCER	
  AND	
  EPIDERMOLYSIS	
  
BULLOSA	
  	
  
Prazeres, Silvana¹
Costa, Cheila B. da²
INTRODUCTION
Cancer is one of the most serious complications arising
in patients with dystrophic epidermolysis bullosa.
Epidermolysis bullosa (EB) is a rare genetic disorder
characterized by extremely fragile skin and mucosa,
resulting in blisters and chronic wounds.
There are several studies demonstrating that
squamous cell carcinoma, malignant melanoma
infiltrative and basal cell carcinoma are often
found as one of the complications and causes of
death among individuals with recessive
dystrophic epidermolysis bullosa (RDEB).
INTRODUCTION
OBJECTIVE
The aim of this study is to report the accompaniment an
injured patient with RDEB in the right knee with
dermoid carcinoma.
	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  Photo	
  nº1	
  –	
  Right	
  knee	
  before	
  surgery	
  (02/08/2011)	
  
METHODOLOGY	
  
	
  
The registry of the case was conducted during weekly
home care visits, from September to December 2011,
observing the injury healing processes, adapting
nursing actions according to the evolution of
postoperatory carcinoma and grafting withdrawal.
The patient presented exudative and fetid knee lesions
with progressive worsening in recent months. He
made a biopsy and was diagnosed with squalors cell
carcinoma, keratinizing, invading the reticular dermis
and underwent surgery. It was to promote an
atraumatic dressing and tissue regeneration. Daily
heated dressings impregnated with soft silicone were
initiated.
METHODOLOGY	
  
	
  
RESULTS
The purpose of this treatment was to minimize
injury trauma and the surrounding area, reducing
pain, making less traumatic exchanges and less
withdrawal of the new tissue. It permitted an
appropriate and not traumatic tissue repair.
Photo nº2 – After surgery , right knee (25/09/2011) Photo nº3 – Right knee grafted area
15 postoperatic day( 17/10/2011)
Photo nº5 – Right knee (dez /2011)
Photo	
  nº	
  4-­‐	
  Right	
  knee	
  (nov/2011)	
  
The association of the dressing with soft silicone,
and oily solution based on the insaturated
essential fatty acids (AGEI) was effective. It was
observed the ability to stimulate the healing
process, from initial stimulation of the
inflammatory response to complete
reepithelization, that happened in about 60 days
after surgery.
RESULTS
1.POPE, Elena et al. A consensus approach to wound care in
epidermolysis bullosa. An Expert Panel Report. Australian, 2011.
2.PRAZERES, Silvana Janning et al (Org) Tratamento de feridas: teoria e
prática. Porto Alegre, Moriá Editora; 2009.
3. Fine, JD and Hintner H. Life with Epidermolysis Bullosa (EB): Etiology,
Diagnosis, Multidisciplinary Care and Therapy. Vienna, Springer, 2009.
REFERENCE
Contact:
Silvana Prazeres, RN, ET - silprazeres@maximedsul.com.br
Cheila Bueno da Costa, RN, ET – enfermagem@maximedsul.com.br

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EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report

  • 1. CASE  REPORT CANCER  AND  EPIDERMOLYSIS   BULLOSA     Prazeres, Silvana¹ Costa, Cheila B. da²
  • 2. INTRODUCTION Cancer is one of the most serious complications arising in patients with dystrophic epidermolysis bullosa. Epidermolysis bullosa (EB) is a rare genetic disorder characterized by extremely fragile skin and mucosa, resulting in blisters and chronic wounds.
  • 3. There are several studies demonstrating that squamous cell carcinoma, malignant melanoma infiltrative and basal cell carcinoma are often found as one of the complications and causes of death among individuals with recessive dystrophic epidermolysis bullosa (RDEB). INTRODUCTION
  • 4. OBJECTIVE The aim of this study is to report the accompaniment an injured patient with RDEB in the right knee with dermoid carcinoma.                                  Photo  nº1  –  Right  knee  before  surgery  (02/08/2011)  
  • 5. METHODOLOGY     The registry of the case was conducted during weekly home care visits, from September to December 2011, observing the injury healing processes, adapting nursing actions according to the evolution of postoperatory carcinoma and grafting withdrawal.
  • 6. The patient presented exudative and fetid knee lesions with progressive worsening in recent months. He made a biopsy and was diagnosed with squalors cell carcinoma, keratinizing, invading the reticular dermis and underwent surgery. It was to promote an atraumatic dressing and tissue regeneration. Daily heated dressings impregnated with soft silicone were initiated. METHODOLOGY    
  • 7. RESULTS The purpose of this treatment was to minimize injury trauma and the surrounding area, reducing pain, making less traumatic exchanges and less withdrawal of the new tissue. It permitted an appropriate and not traumatic tissue repair.
  • 8. Photo nº2 – After surgery , right knee (25/09/2011) Photo nº3 – Right knee grafted area 15 postoperatic day( 17/10/2011) Photo nº5 – Right knee (dez /2011) Photo  nº  4-­‐  Right  knee  (nov/2011)  
  • 9. The association of the dressing with soft silicone, and oily solution based on the insaturated essential fatty acids (AGEI) was effective. It was observed the ability to stimulate the healing process, from initial stimulation of the inflammatory response to complete reepithelization, that happened in about 60 days after surgery. RESULTS
  • 10. 1.POPE, Elena et al. A consensus approach to wound care in epidermolysis bullosa. An Expert Panel Report. Australian, 2011. 2.PRAZERES, Silvana Janning et al (Org) Tratamento de feridas: teoria e prática. Porto Alegre, Moriá Editora; 2009. 3. Fine, JD and Hintner H. Life with Epidermolysis Bullosa (EB): Etiology, Diagnosis, Multidisciplinary Care and Therapy. Vienna, Springer, 2009. REFERENCE Contact: Silvana Prazeres, RN, ET - silprazeres@maximedsul.com.br Cheila Bueno da Costa, RN, ET – enfermagem@maximedsul.com.br