KEY POINTS
- This retrospective case series identified 4 patients with epidermolysis bullosa treated with radiotherapy between 2008 and 2022 at a large institution.
- Epidermolysis bullosa subtypes included 2 localized epidermolysis bullosa simplex cases and 2 intermediate dystrophic epidermolysis bullosa cases.
- Treated diseases and sites were heterogeneous: medulloblastoma treated with craniospinal and intracranial radiotherapy, cutaneous squamous cell carcinoma treated to acetabulum and ribs, pancreatic adenocarcinoma treated to the abdomen, and rectal adenocarcinoma treated to the pelvis.
- Maximum skin dose ranged from 7.7 Gy to 50.4 Gy, and mean skin dose ranged from 0.4 Gy to 6.6 Gy.
- Skin toxicity was limited to grade 2 dermatitis or erythema in 2 patients; no blisters or sores were reported in the irradiated field.
CLINICAL TAKEAWAY
Radiotherapy should not automatically be deferred in patients with epidermolysis bullosa solely because of concern for skin toxicity. This small series suggests that modern radiotherapy can be delivered without unexpected cutaneous toxicity when skin trauma and high-dose skin exposure are carefully managed. The evidence remains very limited, so planning should be individualized with dermatology, wound care, and nutritional support involvement.