title: Pain management of junctional epidermolysis bullosa in an 11-year-Old boy.
abstract: Epidermolysis bullosa is a group of hereditary blistering disorders for which there is no definitive therapy. Wound care is an important component of management. Regular dressing changes are required to protect blistered and eroded skin, and to prevent secondary infection and sepsis. These dressing changes can be very painful for patients with extensive erosions. We report our experience of pain management in an 11-year-old boy with severe junctional epidermolysis bullosa. Amitryptiline and cognitive behavioral techniques were effective in relieving chronic pain and discomfort. Oral midazolam 0.33 mg/kg administered 20 minutes prior to baths and dressing changes substantially improved his tolerance of wound care.
authors.affiliation: Division of Dermatology, British Columbia's Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Y K
authors.initials: YK
authors.lastname: Chiu
authors.forename: J S
authors.initials: JS
authors.lastname: Prendiville
authors.forename: S M
authors.initials: SM
authors.lastname: Bennett
authors.forename: C J
authors.initials: CJ
authors.lastname: Montgomery
authors.forename: T F
authors.initials: TF
authors.lastname: Oberlander
mesh_terms: D000639:Amitriptyline / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D002648:Child; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D016109:Epidermolysis Bullosa, Junctional / Q000150:complications*; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D059408:Pain Management
chemical_list: D018712:Analgesics, Non-Narcotic; D014151:Anti-Anxiety Agents; D000639:Amitriptyline; D008874:Midazolam