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 - silprazeres@maximedsul.com.br Cheila Bueno da Costa, RN, ET – enfermagem@maximedsul.com.br