Pain management of junctional epidermolysis bullosa in an 11-year-old boy

Epidermolysis bullosa is a group of hereditary blistering disorders for whi ch 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 juncti onal epidermolysis bullosa. Amitryptiline and cognitive behavioral techniqu es were effective in relieving chronic pain and discomfort, Oral midazolam 0.33 mg/kg administered 20 minutes prior to baths and dressing changes subs tantially improved his tolerance of wound care.