The Consensus Conference was funded by Debra UK, Debra Austria and Debra Ireland. (Although the authors have acknowledged in other unrelated publications their extramural support for their own epidermolysis bullosa-related research programmes, none of these has provided funding for the Consensus Conference or the generation of this report.)

We aimed to develop and validate a novel rating scale for multiple system atrophy (Unified Multiple System Atrophy Rating Scale-UMSARS). The scale comprises the following components: Part I, historical, 12 items; Part II, motor examination, 14 items; Part III, autonomic examination; and Part IV, global disability scale. For validation purposes, 40 MSA patients were assessed in four centers by 4 raters per center (2 senior and 2 junior raters). The raters applied the UMSARS, as well as a range of other scales, including the Unified Parkinson's Disease Rating Scale (UPDRS) and the International Cooperative Ataxia Rating Scale (ICARS). Internal consistency was high for both UMSARS-I (Crohnbach's alpha = 0.84) and UMSARS-II (Crohnbach's alpha = 0.90) sections. The interrater reliability of most of the UMSARS-I and -II items as well as of total UMSARS-I and -II subscores was substantial (k(w) = 0.6-0.8) to excellent (k(w) > 0.8). UMSARS-II correlated well with UPDRS-III and ICARS (rs > 0.8). Depending on the degree of the patient's disability, completion of the entire UMSARS took 30 to 45 minutes. Based on our findings, the UMSARS appears to be a multidimensional, reliable, and valid scale for semiquantitative clinical assessments of MSA patients.

SummaryThis article summarizes recommendations reached following a systematic literature review and expert consensus on the diagnosis and management of cutaneous squamous cell carcinomas in people with epidermolysis bullosa. The guidelines are intended to help inform decision making by clinicians dealing with this complex complication of a devastating disease.What's already known about this topic?• Some subtypes of epidermolysis bullosa (EB), particularly severe generalized recessive dystrophic EB, are associated with the development of mucocutaneous squamous cell carcinomas (SCCs).• These tumours behave aggressively and are a leading cause of morbidity and mortality in at-risk patients with EB.What does this study add?• These guidelines will assist clinicians in the diagnosis, management and staging of EB-associated cutaneous SCCs based on available evidence and expert consensus.• They highlight the importance of a holistic multidisciplinary approach to the management of EB-associated SCCs, where patient involvement in decision making is paramount.

Generalized junctional epidermolysis bullosa (JEB) is caused by mutations in LAMA3,LAMB3,or\ud LAMC2,which together encode laminin-332, a hetero-trimeric protein consisting ofa3,b3, andg2chain. In nonlethal generalized intermediate JEB, laminin-332 is highly reduced, and hemidesmosomes are rudimentary or completely absent, leading to blister formation within the lamina lucida of the basement membrane upon minor trauma. The resulting chronic skin wounds invariably develop recurrent infections and scarring, which greatly impair patients’ quality of life. We report on a patient in whom gene-corrected epidermal sheets were transplanted onto a large nonhealing epidermal ulceration following a good manufacturing practice protoco