The bullous epidermolysis (EB) is a skin disorder characterized by the fragility of the skin, also known as "onion skin". However, this disease can manifest itself in many organ systems.
Children with bullous epidermolysis can have a multidisciplinary management for life with the support of dermatologists, cardiologists, hematologists / oncologists, nephrologists, dentists, ophthalmologists, nutritionists, pediatric speech therapists and speech therapists, neurologists, pain specialists, psychologists, social workers, community support, surgeons, gastroenterologists, medical scientists and scientists. In this sense, current treatments are intended to restore the integrity of the skin with protein, cell and genetic therapies.
EB is caused by defects in the anchoring of proteins between the epidermis and the dermis, which predispose patients to bullae, blisters and scars, resulting in the mechanical fragility of the skin. There are four subtypes of EB in which the dermal-epidermal junction proteins are affected: simple EB, coyonational EB, dystrophic EB and Kindler syndrome.
Endocannabinoid system and bullous epidermolysis
Cannabidiol (CBD) is the second most abundant cannabinoid compound found in the cannabis plant after tetrahydrocannabinol (THC). CBD has no psychotic effects and has become popular among people with chronic pain, anxiety and sleep disorders.
In humans, there are two main cannabinoid receptors that have been identified: CB1 and CB2. Both interact with the CBD. CB1 is expressed primarily in the brain and spinal cord, while the CB2 receptor is expressed in immune cells, which reduces inflammation. This cannabinoid is also a direct agonist of vaniloid receptors, involved in pain, inflammation and body temperature.
It has been shown that cannabinoid agents indirectly inhibit the proliferation of cultured human epidermal keratinocytes and stimulate apoptosis. In fact, the treatment of acne vulgaris with cannabinoids has been documented due to the decrease in human sebocyte proliferation. Finally, the CB1 receptor has also been implicated in epidermal regulation of differentiation by inhibition of transglutaminase, protein kinase C and activation of protein-1.
Topical CBD oil in children with bullous epidermolysis
In 2019, a clinical study analyzed 3 pediatric patients (6 months old, 3 and 10 years old) using topical CBD to treat bullous epidermolosis. The results reported that one patient stopped the oral opioid analgesic and all 3 reported faster wound healing, pain improvement and fewer blisters. However, more randomized double-blind clinical trials are needed to provide scientific benefits for Epidermolysis Bullosa.
CBD and sublingual THC in adults with EB
The CB1 and CB2 receptors have been detected in the human skin and in the presynaptic terminals of the primary circuits of afferent pain and are co-located with mu-opioid receptors at the spinal cord junction for peripheral nociceptive neurons. In addition, the activation of CB2 in keratinocytes produces a blocking response to certain harmful reactions through the release of endogenous opioids in peripheral tissues.
In 2018, an article published in the British Journal of Dermatology did studies Three patients with quider epidermolysis bullosa were treated with THC and sublingual CBD, four times a day, along with your previous treatments. All three patients reported a better pain score as well as a reduction in the overall intake of analgesic drugs and reduction of pruritus.
So far, investigations notified in patients with bullous epidermolysis they are showing the potential that cannabinoids have to inhibit the proliferation of dangerous epidermal cells and induce their apoptosis, in addition to relieving pain and pruritus perception. However, more research and controlled studies are needed to adequately assess the doses and the correct specific administration method for the treatment of epidermolysis bullosa with medicinal cannabis.
Did you like this post? Make an assessment. This post has been made based on existing research until the date of publication of the article. Due to the increase in studies on medical cannabis, the information presented may vary over time and we will inform in subsequent writings.
 Cohn, H. I., & Teng, J. M. C. (2016). Advancement in management of epidermolysis bullosa. Current Opinion in Pediatrics, 28 (4), 507-516. doi: 10.1097 / mop.0000000000000380
 Maccarrone M, Di Rienzo M, Battista N, Gasperi V, Guerrieri P, Rossi A, Finazzi-Agrò A. (2003). The Endocannabinoid System in Human Keratinocytes. The Journal of Biological Chemistry; 278 (36): 33896-33903. Doi: 10.1074 / jbc.m303994200
 Chelliah, M. P., Zinn, Z., Khuu, P., & Teng, J. M. C. (2018). Self-initiated use of topical cannabidiol oil for epidermolysis bullosa. Pediatric Dermatology, 35 (4), e224 – e227.doi: 10.1111 / pde.13545
 Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manag 2008; 4: 245–59.
 Schräder, N. H. B., Duipmans, J. C., Molenbuur, B., Wolff, A., & Jonkman, M. F. (2018). Combined THC and CBD to treat pain in epidermolysis bullosa: a report of three cases. British Journal of Dermatology. doi: 10.1111 / bjd.17341
Here’s what you want to know before visiting your local medical dispensary:You will need a physician’s recommendation, medical cannabis certification, or whatever appropriate documentation is required by your state. Ordinarily, you must be 18 or older to be eligible for a medical consent, but exceptions may be made in some states for minors with especially debilitating problems. You will often enroll with a medicinal dispensary. This is to maintain your medical cannabis recommendation or certification on file for legal and regulatory purposes. There’ll be a waiting room. This is to control the circulation of product and patients, but a straightforward dividing wall also gives patients privacy and direct one-on-one contact using a budtender to discuss medical problems. Many times, but not necessarily, your purchases will be tracked by medical dispensaries. This procedure can help budtenders and patients monitor effective medicine in addition to have a living listing of manufacturers and goods for future reference and follow up. Medicinal dispensaries usually permit you to smell and analyze the buds prior to buy. This may differ from state-to-state.
DOES AN APPLICANT NEED MUNICIPAL APPROVAL BEFORE RECEIVING A RETAIL CANNABIS LICENSE? Yes, municipal approval is required prior to the AGLC will issue a retail cannabis license. Applicants must get in contact with their planned municipality to find out requirements regarding municipal retail cannabis laws, zoning requirements, land-use restrictions, and place requirements regarding how close a retail store can be into a provincial medical care centre, college, or parcel of land designated as a school book.
Keep non-medical cannabis legal Adults who are 19 decades or older are in a position to:Have up to 30 gram of legal dried cannabis or the equivalent in their person. Share up to 30 gram of legal cannabis along with other adults in Canada. Buy cannabis goods from a Yukon Liquor Corporation licensed merchant. Grow up to four plants per household. It’s illegal to present non invasive cannabis to anyone under the age of 19 and also for anyone below the age of 19 to have any amount of non-medical cannabis in Yukon.It is dangerous and illegal to drive while under the influence of cannabis or other intoxicants.