A patient with epidermolysis bullosa may develop severe malnutrition secondary to lesions in the gastrointestinal tract. Nutritional support may be necessary to maintain adequate caloric intake.
Lesions in epidermolysis bullosa that predispose to malnutrition:
(1) feeding difficulties due to severe lesions in the oral cavity
(2) dysphagia and feeding difficulties due to esophageal stricture or stenosis
(3) erosions or ulceration in the small intestine
(4) denuded skin with protein loss
Consequences of the malnutrition:
(1) weight loss
(2) poor healing of skin lesions
If the problem with nutrition is mild, then nasogastric feeding of a liquid diet may be sufficient to meet the caloric needs.
If the problems are moderate to severe, then consider:
(1) gastrostomy tube placement (if the small bowel is intact)
(2) total parenteral nutrition
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Specialty: Nutrition, Gastroenterology