Epidermolysis bullosa--dental management and anesthetic considerations: case report

Epidermolysis bullosa represents a group of hereditary skin disorders manifested by an exceptional tendency of the skin and mucosa to form bullae and vesicles as a result of trauma or friction. Comprehensive dental care for precooperative-age children with this disorder frequently is managed in the operating room under a general anesthetic. This case report describes an anesthetic protocol for dental management which was effective and resulted in minimal postoperative trauma. Eucerin cream, Gauztex bandages, and DuoDerm pads were used to lubricate and stabilize anesthetic armamentarium. Preoperative and postoperative erythromycin antibiotic therapy was instituted to prevent infection of the bullae present. Early diagnosis and institution of preventive measures can minimize the need for restorative and surgical management in these children. However, when anesthetic management is necessary, the use of appropriate consultants and adjuncts can provide valuable support.