0.1% Topical Gentamicin for Recessive Dystrophic Epidermolysis Bullosa.

A recent study found that topical application of 0.1% Gentamicin w/w was a safe and effective way to promote COL7A1 expression in Dystrophic Epidermolysis Bullosa (DEB) patients, particularly those with Premature termination codon (PTC) mutations. The study was published in the journal, Indian Dermatology Online 2022. 

Epidermolysis Bullosa (EB) is a genetic disease that causes blistering of the skin even with a minor injury. At present, there is no cure for the management of EB except for a few studies that looked into the use of aminoglycosides as they promote the production of Collagen 7 expression in Recessive Dystrophic EB (RDEB). So, researchers from Chandigarh, India conducted a study to evaluate the efficacy of topical gentamicin in promoting collagen 7 expressions, promoting wound healing, and preventing new blister formation in patients of EB. 

An open-label study was performed for 3 months on patients aged >1 year with a confirmed diagnosis of dystrophic EB (DEB). All the participants were advised to apply 0.1% w/w gentamicin cream in a collagen base (Derbriment G™) twice daily on a representative area on right lower limb (RLL) and paraffin gauze dressings on the corresponding opposite side on the left lower limb (LLL). During the 12-week treatment period, skin lesions were clinically evaluated, and a repeat skin biopsy was sent for immunofluorescence antigen mapping. 

Results: 

• Out of 12 patients that were taken into the study only 8 could finish it. 
• The mean fluorescence intensity (MFI) of the study cohort increased from baseline to 12 weeks (a 95.75% increase). 
• Compared to those with unknown mutations, the percentage increase in MFI was greater among patients with known PTC mutations. 
• Clinical severity did not change significantly in terms of the mean number of blisters, erosions, and scarring during the study period. 
• No adverse effects were reported. 

Thus, the researchers concluded that Topical gentamicin 0.1 percent w/w is a safe and effective way to promote COL7A1 expression in DEB patients, particularly those with PTC mutations.

For the full article, click here: 10.4103/idoj.idoj_554_21 

Mahajan R, Manjunath S, Madakshira MG, et al. Topical Gentamicin 0.1% Promotes Collagen 7 Expression in Recessive Dystrophic Epidermolysis Bullosa. Indian Dermatology Online Journal. 2022;13(4):480-483.