RESUMO
Epidermolysis bullosa (EB) is a genetic blistering disorder characterized by intense pain related to disease pathology and care-based interventions. Opioid-based therapies underpin pain care in EB; however, they are unable to provide adequate analgesia in a significant proportion of patients. Cannabinoid-based medicines (CBMs) have been studied increasingly for pain conditions of various aetiologies and pose as a novel dimension for pain care in EB. We present three patients with EB who were prescribed pharmaceutical-grade sublingually administered CBMs comprising tetrahydrocannabinol and cannabidiol. All three patients reported improved pain scores, reduced pruritus and reduction in overall analgesic drug intake.
Assuntos
Canabidiol/administração & dosagem , Dronabinol/administração & dosagem , Epidermólise Bolhosa/complicações , Dor/tratamento farmacológico , Óleos de Plantas/administração & dosagem , Administração Sublingual , Adulto , Analgésicos Opioides/administração & dosagem , Cannabis/química , Combinação de Medicamentos , Quimioterapia Combinada/métodos , Epidermólise Bolhosa/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Dor/diagnóstico , Dor/etiologia , Medição da Dor , Resultado do TratamentoRESUMO
Bullous pemphigoid is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or generalized bullous lesions. In up to 20% of affected patients, bullae may be completely absent, and only excoriations, prurigo-like lesions, eczematous lesions, urticated lesions and/or infiltrated plaques are observed. The disease is significantly associated with neurological disorders. The morbidity of bullous pemphigoid and its impact on quality of life are significant. So far, a limited number of national treatment guidelines have been proposed, but no common European consensus has emerged. Our consensus for the treatment of bullous pemphigoid has been developed under the guidance of the European Dermatology Forum in collaboration with the European Academy of Dermatology and Venereology. It summarizes evidence-based and expert-based recommendations.