Karan Lal, DO: Available Treatment Options for Epidermolysis Bullosa Patients

Karan Lal, DO, in his new HCPLive interview, Karan Lal, DO, delved into the topic of dystrophic epidermolysis bullosa (DEB) and explained the differences between the recessive and dominant versions of the condition.

Lal serves as Affiliated Dermatology Scottsdale director of pediatric dermatology, director of cosmetic surgery, and social media chair of the Society for Pediatric Dermatology.

He first described some of the distinctions between both subtypes of DEB, explaining first the ways in which dominant DEB manifests in patients.

“So for dominant dystrophic EB, where people just have some nail findings, there's really nothing,” he explained. “It's just good nail care for EB pruriginosa. Typically, we think about the topical steroid dapsone, either orally or topically, and dupilumab really has been the home header for this condition.”

Dominant DEB is known to be significantly less severe, affecting only a patient’s nails in the mildest of cases. Lal then described recessive DEB, known commonly as “butterfly disease.”

“For recessive dystrophic EB, we now have some options which include topical gene therapies,” he said. “They're not FDA-approved yet, but hopefully they will be in the future. And you guys have heard about this B-VEC, which is essentially a non-replicating herpes virus that contains collagen VII.”

Lal explained the benefits of the therapy, a topic he had previously discussed in recent interviews with HCPLive.

“It's a topical that's applied on wounds that are hard to heal,” he noted. “And this is great, because a lot of this cutaneous disease is the most difficult to manage.”

Lal later went into his experiences helping younger DEB patients with wound care and related activities. He had worked with the American Academy of Dermatology's (AAD) Camp Discovery program, for children 8-16 years of age who often have EB.

“So we did dressing changes, usually 3 times a week,” he said. “Some parents do them every day…So if you're a parent, and you have a child with a recessive dystrophic EB and you're changing dressings everyday or every other day, that's 4 to 6 hours, and there's pain involved. It's a very difficult process.”

To find out more about Lal’s HCPLive interview on DEB, check out the full interview above.