Podiatry role in Epidermolysis Bullosa: The importance of allowing a patient to have a voice

Ms Laura Iacobaccio1

1Melbourne Health, Parkville, Australia

Background: Epidermolysis Bullosa (EB) is a group of rare congenital skin conditions characterised by skin fragility and recurrent blister formation, resulting from minor mechanical friction or trauma (1). Podiatry plays a vital role in the treatment of EB foot related complications. However, there is currently no EB podiatry guidelines and limited literature to assist clinicians.

Aim: To highlight the importance of patient/clinician communication  and recognising the role podiatry care has in EB management.

Case Study: Ms X, a 46-year-old with recessive dystrophic EB attends an adult EB multidisciplinary service. This patient received podiatry treatment, including standard sharps debridement of painful callus and corns to help her mobility. After this initial consultation, Ms X reportedly endured extreme pain 5-6 days post treatment, affecting her ability to weight-bear. Following this, Ms X provided written feedback, advising standard podiatry care is not always applicable to this patient group.

Results: The treating podiatrist now works closely with these patients to allow them to guide the treatment appropriate for the individual. The podiatrist is also actively working on raising awareness on the differences required in routine treatment when treating EB patients.

Discussion: In light of the complexity of this condition, this patient has highlighted the difficulties she has faced over the years with transitioning from different services and clinicians. Indicating the importance of strong communication skills and need for clinicians to allow patients to have a voice. This also emphasises the need for an international EB podiatry guideline to help clinicians alter their treatment accordingly.

Reference

  1. Harper, N., Orpin, S. & Heagerty, A. (2017). New referrals to an adult epidermolysis bullosa service. British Association of Dermatologists, 177(1), 78-85.

Biography:

Laura Iacobaccio is a senior podiatrist at The Royal Melbourne Hospital, working across the Diabetic Foot Unit, vascular, Epidermolysis Bullosa (EB) and Falls and Balance teams. Laura has worked in a variety of acute and sub-acute settings in both Australia and the UK. She has a special interest in the High Risk Foot and EB and is a contributing panel member for the international DEBRA EB podiatry guidelines.

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