Yenidoğanda Epidermolizis Bülloza Dermal Lezyonları Üzerine Topikal Anne Sütü Uygulamasının Yararlı Rolü: Bir Ön Deneyim

Abstract

Introduction: The nutritional, immunological and psychological effects of breast milk (BM) are well known with it’s both nutritional and health benefits on neonates and infants. Additionally, there have been several reports regarding incremental role of BM application in the management of dermatological conditions such as diaper cord rash, atopic eczema, diaper dermatitis and umbilical cord separation. However, according to best of our knowledge BM has not been applied on dermal Epidermolysis Bullosa (EB) lesions to date. Therefore, herein we aimed to report our initial experience with BM on dermal EB lesions in a neonate. Methods: One-day-old male term newborn was referred to Neonate Intensive Care Unit of our institution with bullous skin lesions overall the body. The baby was diagnosed with EB after Pediatric Dermatology consultation from the same university. Initially, Vaseline oil cream (Unilever, Blackfriars, London, UK) was applied for the skin care. In order to determine the effect of BM on wound healing, parents were informed and potential benefits were discussed, and then their subsequent consent were obtained for BM treatment. To assess wound healing and comparison, face and left hand were covered with BM firstly where Vaseline oil had not been applied. In order to compare the rate of recovery, BM treated regions and Vaseline cream applied areas were analyzed and compared, visually. After application of BM, the neonate was observed for 72 hours in terms for wound healing. Results: A noticeable improvement was observed in the areas where breast milk was applied in the third day of treatment in comparison to Vaseline covered areas. Conclusions: BM was promising in healing process of the skin lesions caused by EB according to our initial impression. However, since the application is only limited with a single case, wider cohorts are needed for better understanding of BM’s benefit on wound healing in dermal manifestation of EB lesions.

Keywords

• Epidermolysis bullosa,breast milk,wound healing

References

1. References 1- Has, C., & Fischer, J. (2019). Inherited epidermolysis bullosa: new diagnostics and new clinical phenotypes. Experimental dermatology, 28(10), 1146-1152. 2- Kulalı, F., Özbakır, H., Kundak, S., Kalkanlı, O. H., Eriş, D., Çolak, R., ... & Çalkavur, Ş. (2019). Epidermolizis Bülloza: Olgu Serisi. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi, 16(2). 3- Kramer, M. S., Chalmers, B., Hodnett, E. D., Sevkovskaya, Z., Dzikovich, I., Shapiro, S., ... & Shishko, G. (2001). Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. Jama, 285(4), 413-420. 4- Allam, N. A., Wafa, A., & Talat, A. M. (2015). The effect of topical application of mother milk on separation of umbilical cord for newborn babies. American Journal of Nursing, 4(5), 288-296. 5- Ahmadpour-Kacho, M., Zahedpasha, Y., Hajian, K., Javadi, G., & Talebian, H. (2006). The effect of topical application of human milk, ethyl alcohol 96%, and silver sulfadiazine on umbilical cord separation time in newborn infants. Arch Iran Med, 9(1), 33-38. 6- Kasrae, H., Amiri Farahani, L., & Yousefi, P. (2015). Efficacy of topical application of human breast milk on atopic eczema healing among infants: a randomized clinical trial. International journal of dermatology, 54(8), 966-971. 7- Seifi, B., Jalali, S., & Heidari, M. (2017). Assessment effect of breast milk on diaper dermatitis. Dermatology reports, 9(1).