Epidermolysis bullosa

Osteoporosis: fracture of the bones due to their weakness. The cause is poor bone calcification due to malnutrition, vitamin D deficiency and little physical activity (due to pain and functional limitations due to EB). The most important thing is prevention with the administration of vitamin D supplements, calcium in cases of insufficient intake and the study of bone mineral density by densitometry in patients at higher risk. In people with significant bone weakness and those with fractures, treatment with bisphosphonates, drugs that retain calcium in the bones and stop demineralization, can be performed. 

Growth delay: a delayed growth is typical of severe types of EB as a consequence of malnutrition. If it is not corrected, it will lead to a small size. The most important is also the prevention, doing an early nutritional intervention by supplements and gastrostomy if necessary to keep an adequate nutritional state. 

Late pubertal development: it is the absence of development of the secondary sexual characteristics and the growth spurt typical of puberty. It happens more frequently in children with chronic malnutrition. Like in the growth delay cases, it is essential its prevention by keeping an adequate nutritional state. If, despite improving the nutritional status, puberty does not start, the pediatrician or paediatric endocrinologist may recommend the administration of a medication that induces pubertal development.