BackgroundEpidermolysis bullosa is a group of diseases caused by mutations in genes for proteins responsible for cells’ anchorage at the dermo-epidermal junction. Their common feature are dysfunctional or even absent connections between cells. The typical clinical sign is the formation of blisters, with possible excessive scarring, in response to minimal skin irritation. End stage renal disease may be one of the comorbidities in patients with epidermolysis bullosa. The implementation of renal replacement therapy may be very difficult in this population. This is mainly due to problems in obtaining the proper dialysis access. The choice of appropriate method may be crucial for patient’s survival.Case presentationWe present a case of 29-year-old woman with Epidermolysis bullosa caused by laminin 5 gene mutation. The patient suffered from additional conditions: blindness, complete bilateral sensorineural deafness and oesophageal stenosis. When end stage renal disease was diagnosed, the problem of renal replacement therapy had to be faced. There have been few reports concerning ESRD in this specific group of patients in the available literature. In most of them the prognosis was very poor. Nevertheless, we were very determined to overcome all the difficulties. Special procedures and cooperation with the patient’s family allowed us to consider kidney transplantation as a treatment option.ConclusionThere should be no limitations in renal replacement therapy in patients with epidermolysis bullosa. Haemodialysis, peritoneal dialysis and kidney transplantation are all possible treatment options. Nevertheless, either method requires special procedures.

Background and Objectives: Nowadays, a significant part of the human population lives and works in urban agglomerations. Limited contact with nature, polluted air, stress, and a sedentary work style all contribute to problems with the physical and mental health of a considerable number of city dwellers. There are many studies indicating the positive, restorative properties of natural environments, such as forests, on human well-being. Our aim was to investigate whether suburban commercial forests in combination with informal environmental education can bring restorative properties to people, especially those who are economically active. Materials and Methods: Four psychological questionnaires were used to determine the restorative properties of a suburban commercial forest on young active people: the Profile of Mood Scale (POMS), the Positive and Negative Affect Schedule (PANAS), the Restorative Outcome Scale (ROS), and the Subjective Vitality Scale (SVS). The experiment involved 60 participants who took forest baths (the act of spending time in a forest and opening your senses to the natural surroundings to experience feelings of peace and wellbeing) in a suburban commercial forest surrounding Świdnik, a city of 40,000 inhabitants located directly next to Lublin (a provincial city with a population of 339,811). The volunteers were divided into three groups; Group A walked an educational route with educational boards (route A1). Group B walked another route with a forest educator who described various forest management activities conducted in this forest (route A2). Group C walked alone, without an educator, along route A2. All three groups arrived at the site of forest stand redevelopment as the end of their route. After a short 10-min exposure to this site, the volunteers again completed the psychological questionnaires. Results: Our study clearly indicates a positive effect from forest bathing in suburban commercial forests. Both the walk with a forest educator and the walk along the educational trail supported psychological recovery for the participants of the experiment, which shows that informal environmental education carried out in forests can be successfully combined with forest bathing, supporting the positive effects of this activity.

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