What are the indications for referring a patient with Epidermolysis Bullosa to a specialist dermatology service?

Indications for referring a patient with Epidermolysis Bullosa (EB) to a specialist dermatology service include:

• Diagnostic uncertainty or difficulty in managing the condition in primary care.
• Severe or extensive skin involvement requiring specialist assessment and management.
• Complications such as recurrent infections, non-healing wounds, or significant skin damage.
• Need for multidisciplinary care including wound care, pain management, nutritional support, and genetic counselling.
• Psychosocial impact or quality of life issues related to EB that require specialist input.

Although the provided guidelines do not explicitly list referral criteria for Epidermolysis Bullosa, by analogy with other severe dermatological conditions such as atopic eczema and acne vulgaris, referral is indicated when there is diagnostic uncertainty, failure of standard management, severe disease, complications, or significant psychosocial impact requiring specialist input ¹,³. EB is a complex, rare genetic skin disorder that typically requires specialist dermatology involvement for optimal management.