Treatment of Dystrophic Epidermolysis Bullosa with Transforming Powder Dressing

An 18-year-old white male with dystrophic epidermolysis bullosa predominantly involving both knees, back, buttocks and thighs had undergone long-term wound care with products including a silicone foam (Mepilex, Molnlycke Health Care, Gothenburg, Sweden) and a polymeric membrane dressing (Polymem, Ferris Manufacturing Corp., Fort Worth, TX, USA). Daily dressing changes averaging 1.5 hours in length were performed by wound care nurses, as well as a full bath with antimicrobials twice weekly. In hopes of reducing the length of daily dressing changes, as well as the significant wound pain and pruritus, a new treatment was introduced in February 2015. Transforming powder (Altrazeal, Uluru, Inc., Addison, TX, USA) was applied following the twice-weekly antimicrobial baths, initially to small wounds on the knees (in order to evaluate both patient comfort and product efficacy). By early summer 2015, both knees were completely healed. Re-epithelialization was rapid, with decreased pain and pruritus. After an unrelated hospitalization in late summer 2015 allowed for a flare of the disease, transforming powder application began on the entire knees and the back in October 2015.