International consensus on the treatment of epidermolysis bullosa (EB) during the COVID-19 pandemic suggests treating patients remotely whenever possible, according to results of a questionnaire published in the Journal of the American Academy of Dermatology.
Many patients with ED have medical issues that make them especially vulnerable to the SARS-CoV-2 virus, so a consensus of best practices for the treatment of patients with EB during the COVID-19 pandemic was deemed necessary. To create an international consensus, questionnaire responses from 44 EB experts representing various clinical areas and 5 continents were analyzed. Consensus was established when ≥70% of respondents agreed with a suggested treatment.
The primary alterations in methodology of care are to introduce photographs from the patient, to use teledermatology for patients with less severe EB, and to send dressing supplies directly to patients. For patients with significant internal disease, blood and urine tests should continue through local laboratories and doctors. If telehealth images are insufficient for assessment, appointments should be conducted at a local EB center. If an EB patient required anticoagulation to treat COVID-19, there may be additional bleeding from the skin or mucosae, which may be corrected through blood transfusion.
Further investigation regarding the expression of angiotensin converting enzyme 2, the cell receptor used to enter the cell by the SARS-CoV-2 virus, in wounded EB skin may be warranted, it was noted.
Murrell DF, Luck AW, Salas-Alanis JC, et al. Multidisciplinary care of epidermolysis bullosa during the COVID-19 pandemic – consensus: Recommendations by an international panel of experts. [published online July 16, 2020]. J Am Acad Derm. doi:10.1016/j.jaad.2020.06.1023