EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
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Transcript of EWMA 2013 - EP579 - Cancer and epidermolysis bullosa - case report
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 - [email protected] Cheila Bueno da Costa, RN, ET – [email protected]