Epidermolysis bullosa: a rare challenge for peritoneal dialysis nurses

Epidermolysis bullosa is a genetic skin disorder characterised by blister formation in response to minimal trauma or friction. Our renal service was required to provide peritoneal dialysis (PD) for a young lady suffering from this rare disease and this paper provides an insight into the way in which we collaborated with the health care team and the patient and family to provide optimum dialysis management to suit the patient's specific clinical needs. The key challenges we faced included the placement of a suitable PD catheter and the subsequent exit site care. The patient had multiple skin lesions and required daily baths and special dressings to most of her body. In addition, we aimed to provide optimal dialysis with reduced fill volumes as although she was 24 years old she had the body frame of a young child. Communication and collaboration with the patient, family and a variety of medical teams involved in her care were critical to the success of PD. Individualised care and tailored PD therapy is necessary for every patient, but more so as we encounter patients with special conditions/needs.