Combined tetrahydrocannabinol and cannabidiol to treat pain in epidermolysis bullosa: a report of three cases

Br J Dermatol. 2019 Apr;180(4):922-924. doi: 10.1111/bjd.17341. Epub 2018 Nov 14.


Epidermolysis bullosa (EB) is a genetic blistering disorder characterized by intense pain related to disease pathology and care-based interventions. Opioid-based therapies underpin pain care in EB; however, they are unable to provide adequate analgesia in a significant proportion of patients. Cannabinoid-based medicines (CBMs) have been studied increasingly for pain conditions of various aetiologies and pose as a novel dimension for pain care in EB. We present three patients with EB who were prescribed pharmaceutical-grade sublingually administered CBMs comprising tetrahydrocannabinol and cannabidiol. All three patients reported improved pain scores, reduced pruritus and reduction in overall analgesic drug intake.

Publication types

  • Case Reports

MeSH terms

  • Administration, Sublingual
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Cannabidiol / administration & dosage*
  • Cannabis / chemistry
  • Dronabinol / administration & dosage*
  • Drug Combinations
  • Drug Therapy, Combination / methods
  • Epidermolysis Bullosa / complications*
  • Epidermolysis Bullosa / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Pain / diagnosis
  • Pain / drug therapy*
  • Pain / etiology
  • Pain Measurement
  • Plant Oils / administration & dosage*
  • Treatment Outcome


  • Analgesics, Opioid
  • Drug Combinations
  • Plant Oils
  • Cannabidiol
  • Dronabinol