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Agarwala MK, Schwartz ME, Smith FJD. Pachyonychia Congenita: New Classification and Diagnosis. Indian J Dermatol 2016; 61:567. [PMID: 27688452 PMCID: PMC5029248 DOI: 10.4103/0019-5154.190110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Manoj Kumar Agarwala
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India. E-mail:
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Cammarata-Scalisi F, Natsuga K, Toyonaga E, Nishie W, Shimizu H, Avendaño A, Araque D, Da Silva G, Bellacchio E, Callea M. Early severe pachyonychia congenita subtype PC-K6a with a novel mutation in the KRT6A gene. J Eur Acad Dermatol Venereol 2016; 31:e94-e96. [PMID: 27445120 DOI: 10.1111/jdv.13800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/03/2016] [Indexed: 11/25/2022]
Affiliation(s)
- F Cammarata-Scalisi
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of The Andes, Mérida, Venezuela
| | - K Natsuga
- Department of Dermatology, School of Medicine, Hokkaido University, Sapporo, Japan
| | - E Toyonaga
- Department of Dermatology, School of Medicine, Hokkaido University, Sapporo, Japan
| | - W Nishie
- Department of Dermatology, School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, School of Medicine, Hokkaido University, Sapporo, Japan
| | - A Avendaño
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of The Andes, Mérida, Venezuela
| | - D Araque
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of The Andes, Mérida, Venezuela
| | - G Da Silva
- Unit of Medical Genetics, Department of Pediatrics, Faculty of Medicine, University of The Andes, Mérida, Venezuela
| | - E Bellacchio
- Bambino Gesù Children's Hospital IRCCS, Research Laboratory, Rome, Italy
| | - M Callea
- Department of Dentistry, Bambino Gesù Children's Hospital - IRCCS, Viale S. Paolo 15, 00147 Rome, Italy
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Kerns ML, Hakim JMC, Lu RG, Guo Y, Berroth A, Kaspar RL, Coulombe PA. Oxidative stress and dysfunctional NRF2 underlie pachyonychia congenita phenotypes. J Clin Invest 2016; 126:2356-66. [PMID: 27183391 DOI: 10.1172/jci84870] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/24/2016] [Indexed: 12/27/2022] Open
Abstract
Palmoplantar keratoderma (PPK) are debilitating lesions that arise in individuals with pachyonychia congenita (PC) and feature upregulation of danger-associated molecular patterns and skin barrier regulators. The defining features of PC-associated PPK are reproduced in mice null for keratin 16 (Krt16), which is commonly mutated in PC patients. Here, we have shown that PPK onset is preceded by oxidative stress in footpad skin of Krt16-/- mice and correlates with an inability of keratinocytes to sustain nuclear factor erythroid-derived 2 related factor 2-dependent (NRF2-dependent) synthesis of the cellular antioxidant glutathione (GSH). Additionally, examination of plantar skin biopsies from individuals with PC confirmed the presence of high levels of hypophosphorylated NRF2 in lesional tissue. In Krt16-/- mice, genetic ablation of Nrf2 worsened spontaneous skin lesions and accelerated PPK development in footpad skin. Hypoactivity of NRF2 in Krt16-/- footpad skin correlated with decreased levels or activity of upstream NRF2 activators, including PKCδ, receptor for activated C kinase 1 (RACK1), and p21. Topical application of the NRF2 activator sulforaphane to the footpad of Krt16-/- mice prevented the development of PPK and normalized redox balance via regeneration of GSH from existing cellular pools. Together, these findings point to oxidative stress and dysfunctional NRF2 as contributors to PPK pathogenesis, identify K16 as a regulator of NRF2 activation, and suggest that pharmacological activation of NRF2 should be further explored for PC treatment.
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Forrest CE, Casey G, Mordaunt DA, Thompson EM, Gordon L. Pachyonychia Congenita: A Spectrum of KRT6a Mutations in Australian Patients. Pediatr Dermatol 2016; 33:337-42. [PMID: 27041546 DOI: 10.1111/pde.12841] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare inherited disorder of keratinization characterised by hypertrophic nail dystrophy, painful palmoplantar blisters, cysts, follicular hyperkeratosis and oral leukokeratosis. It is associated with mutations in five differentiation-specific keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17. OBJECTIVES Living with Pachyonychia Congenita can be isolating. The aim of this paper is to document a single patient's experience within a national context. METHOD We report the case of a 2 year old female with an atypical presentation of PC due to a mutation in KRT6A with severely hypertrophic follicular keratoses, skin fragility, relative sparing of nail hypertrophy on one hand and failure to thrive in early infancy. In collaboration with the International Pachyonychia Congenita Research Registry (IPCRR), a database search was performed using Australian residency and KRT6A mutation as inclusion criteria. The IPCRR database was also searched for a matching KRT6A mutation. Six Australian patients were identified in addition to one patient with an identical mutation residing in the United States. The detailed standardized patient questionnaire data was manually collated and analysed. RESULTS Fingernail hypertrophy and oral leukokeratosis were the most common features. There was no recording of asymmetric distribution in any other Australian patient. Trouble nursing as an infant and follicular hyperkeratosis also occurred in the American patient, however they did not have asymmetric distribution and the oral leukokeratosis appeared later in life. CONCLUSION This case has unique features. Sharing information can assist patients navigating life with this condition.
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Affiliation(s)
| | - Genevieve Casey
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Dylan A Mordaunt
- South Australian Clinical Genetics Service, North Adelaide, South Australia, Australia.,Department of Paediatrics, University of Adelaide, North Adelaide, South Australia, Australia
| | - Elizabeth M Thompson
- South Australian Clinical Genetics Service, North Adelaide, South Australia, Australia.,Department of Paediatrics, University of Adelaide, North Adelaide, South Australia, Australia
| | - Lynne Gordon
- Flinders Medical Centre, Adelaide, South Australia, Australia
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Edwards KA, Terry SF, Gold D, Horn EJ, Schwartz M, Stuart M, Vernon SD. Realizing Our Potential in Biobanking: Disease Advocacy Organizations Enliven Translational Research. Biopreserv Biobank 2016; 14:314-8. [PMID: 27058463 DOI: 10.1089/bio.2015.0053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Biobanks are increasingly powerful tools used in translational research, and disease advocacy organizations (DAOs) are making their presence known as research drivers and partners. We examined DAO approaches to biobanking to inform how the enterprise of biobanking can grow and become even more impactful in human health. In this commentary, we outline overarching approaches from successful DAO biobanks. These lessons learned suggest principles that can create a more participant-centric approach and illustrate the key roles DAOs can play as partners in research initiatives. DAO approaches to biobanking for translational research include the following: be outcome driven; forge alliances that are unexpected-build bridges to enhance translation; come ready for success; be nimble, flexible, and adaptable; and remember that people matter. Each of these principles led to particular practices that have increased the translational impact of biobank collections. The research practices discussed can inform partnerships in all sectors going forward.
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Affiliation(s)
- Kelly A Edwards
- 1 Department of Bioethics and Humanities, University of Washington School of Medicine , Seattle, Washington
| | - Sharon F Terry
- 2 Genetic Alliance, Inc. , Washington, District of Columbia.,3 PXE International, Washington, District of Columbia
| | - Dana Gold
- 4 University of Washington , Seattle, Washington
| | | | - Mary Schwartz
- 6 Pachyonychia Congenita Project, Salt Lake City, Utah
| | - Molly Stuart
- 7 Strategic Change Consultant, Davis, California
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Aljuffali IA, Lin YK, Fang JY. Noninvasive approach for enhancing small interfering RNA delivery percutaneously. Expert Opin Drug Deliv 2015; 13:265-80. [DOI: 10.1517/17425247.2016.1121988] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Kaspar RL, Hickerson RP, González-González E, Flores MA, Speaker TP, Rogers FA, Milstone LM, Contag CH. Imaging Functional Nucleic Acid Delivery to Skin. Methods Mol Biol 2015; 1372:1-24. [PMID: 26530911 DOI: 10.1007/978-1-4939-3148-4_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Monogenic skin diseases arise from well-defined single gene mutations, and in some cases a single point mutation. As the target cells are superficial, these diseases are ideally suited for treatment by nucleic acid-based therapies as well as monitoring through a variety of noninvasive imaging technologies. Despite the accessibility of the skin, there remain formidable barriers for functional delivery of nucleic acids to the target cells within the dermis and epidermis. These barriers include the stratum corneum and the layered structure of the skin, as well as more locally, the cellular, endosomal and nuclear membranes. A wide range of technologies for traversing these barriers has been described and moderate success has been reported for several approaches. The lessons learned from these studies include the need for combinations of approaches to facilitate nucleic acid delivery across these skin barriers and then functional delivery across the cellular and nuclear membranes for expression (e.g., reporter genes, DNA oligonucleotides or shRNA) or into the cytoplasm for regulation (e.g., siRNA, miRNA, antisense oligos). The tools for topical delivery that have been evaluated include chemical, physical and electrical methods, and the development and testing of each of these approaches has been greatly enabled by imaging tools. These techniques allow delivery and real time monitoring of reporter genes, therapeutic nucleic acids and also triplex nucleic acids for gene editing. Optical imaging is comprised of a number of modalities based on properties of light-tissue interaction (e.g., scattering, autofluorescence, and reflectance), the interaction of light with specific molecules (e.g., absorbtion, fluorescence), or enzymatic reactions that produce light (bioluminescence). Optical imaging technologies operate over a range of scales from macroscopic to microscopic and if necessary, nanoscopic, and thus can be used to assess nucleic acid delivery to organs, regions, cells and even subcellular structures. Here we describe the animal models, reporter genes, imaging approaches and general strategies for delivery of nucleic acids to cells in the skin for local expression (e.g., plasmid DNA) or gene silencing (e.g., siRNA) with the intent of developing nucleic acid-based therapies to treat diseases of the skin.
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Affiliation(s)
- Roger L Kaspar
- TransDerm Inc., 2161 Delaware Ave, Santa Cruz, CA, 95060, USA.
| | - Robyn P Hickerson
- Centre for Dermatology and Genetic Medicine, University of Dundee, Dundee, UK
| | | | - Manuel A Flores
- TransDerm Inc., 2161 Delaware Ave, Santa Cruz, CA, 95060, USA
| | - Tycho P Speaker
- TransDerm Inc., 2161 Delaware Ave, Santa Cruz, CA, 95060, USA
| | - Faye A Rogers
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Leonard M Milstone
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher H Contag
- Molecular Imaging Program at Stanford (MIPS), E150 Clark Center, Stanford University School of Medicine, 318 Campus Drive, Stanford, CA, 94305, USA. .,Department of Pediatrics, E150 Clark Center, Stanford University School of Medicine, 318 Campus Drive, Stanford, CA, 94305, USA. .,Department of Radiology, E150 Clark Center, Stanford University School of Medicine, 318 Campus Drive, Stanford, CA, 94305, USA. .,Microbiology and Immunology, E150 Clark Center, Stanford University School of Medicine, 318 Campus Drive, Stanford, CA, 94305, USA.
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González-Ramos J, Sendagorta-Cudós E, González-López G, Mayor-Ibarguren A, Feltes-Ochoa R, Herranz-Pinto P. Efficacy of botulinum toxin in pachyonychia congenita type 1: report of two new cases. Dermatol Ther 2015; 29:32-6. [PMID: 26445325 DOI: 10.1111/dth.12297] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pachyonychia congenita (PC) is a rare genodermatosis caused by a mutation in keratin genes, which can lead to hypertrophic nail dystrophy and focal palmoplantar keratoderma (predominantly plantar), amongst other manifestations. Painful blisters and callosities, sometimes exacerbated by hyperhidrosis, are major issues that can have a significant impact on patient quality of life. Many alternative treatments for this condition have been applied with variable and partial clinical response, but a definitive cure for this disease has yet to be discovered. After obtaining informed consent, two patients with genetically confirmed PC type 1 were treated with plantar injections of botulinum toxin type A. Both patients showed a marked improvement in pain and blistering with an average response time of one week, a six-month mean duration of effectiveness, and a lack of any side effects or tachyphylaxis.
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Affiliation(s)
| | | | | | | | - Rosa Feltes-Ochoa
- Department of Dermatology, La Paz University Hospital, Madrid, Spain
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59
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Zakrewsky M, Kumar S, Mitragotri S. Nucleic acid delivery into skin for the treatment of skin disease: Proofs-of-concept, potential impact, and remaining challenges. J Control Release 2015; 219:445-456. [PMID: 26385169 DOI: 10.1016/j.jconrel.2015.09.017] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/07/2015] [Accepted: 09/09/2015] [Indexed: 01/26/2023]
Abstract
Nucleic acids (NAs) hold significant potential for the treatment of several diseases. Topical delivery of NAs for the treatment of skin diseases is especially advantageous since it bypasses the challenges associated with systemic administration which suffers from enzymatic degradation, systemic toxicity and lack of targeting to skin. However, the skin's protective barrier function limits the delivery of NAs into skin after topical application. Here, we highlight strategies for enhancing delivery of NAs into skin, and provide evidence that translation of topical NA therapies could have a transformative impact on the treatment of skin diseases.
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Affiliation(s)
- Michael Zakrewsky
- Center for Bioengineering and Department of Chemical Engineering, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Sunny Kumar
- Center for Bioengineering and Department of Chemical Engineering, University of California Santa Barbara, Santa Barbara, CA 93106, USA
| | - Samir Mitragotri
- Center for Bioengineering and Department of Chemical Engineering, University of California Santa Barbara, Santa Barbara, CA 93106, USA.
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Wallis T, Poole CD, Hoggart B. Can skin disease cause neuropathic pain? A study in pachyonychia congenita. Clin Exp Dermatol 2015; 41:26-33. [DOI: 10.1111/ced.12723] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2015] [Indexed: 11/30/2022]
Affiliation(s)
- T. Wallis
- University Hospitals Southampton; Southampton General Hospital; Southampton Hampshire UK
| | - C. D. Poole
- Department of Primary Care & Public Health; Cardiff University; Cardiff Glamorgan UK
| | - B. Hoggart
- Pain Management Research; Solihull Hospital; Heartlands NHS Foundation Trust; Solihull UK
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Almutawa F, Thusaringam T, Watters K, Gayden T, Jabado N, Sasseville D. Pachyonychia Congenita (K16) with Unusual Features and Good Response to Acitretin. Case Rep Dermatol 2015; 7:220-6. [PMID: 26464567 PMCID: PMC4592507 DOI: 10.1159/000438920] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare autosomal dominant disease whose main clinical features include hypertrophic onychodystrophy and palmoplantar keratoderma. The new classification is based on genetic variants with mutations in keratin KRT6A, KRT6B, KRT6C, KRT16, KRT17, and an unknown mutation. Here, we present a case of PC with unusual clinical and histological features and a favorable response to oral acitretin. CASE A 49-year-old male presented with diffuse and striate palmoplantar keratoderma, thickened nails, knuckle pads, and pseudoainhum. Histology showed compact hyperkeratosis, prominent irregular acanthosis, and extensive epidermolytic hyperkeratosis, suggestive of Vörner's palmoplantar keratoderma. However, keratin 9 and 1 were not mutated, and full exome sequencing showed heterozygous missense mutation in type I keratin K16. CONCLUSION To our knowledge, epidermolytic hyperkeratosis has not been previously described with PC. Our patient had an excellent response, maintained over the last 5 years, to a low dose of acitretin. We wish to emphasize the crucial role of whole exome sequencing in establishing the correct diagnosis.
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Affiliation(s)
- Fahad Almutawa
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Thusanth Thusaringam
- Division of Dermatology, McGill University Health Centre, Montreal, Que., Canada
| | - Kevin Watters
- Department of Pathology, McGill University Health Centre, Montreal, Que., Canada
| | - Tenzin Gayden
- Department of Pediatrics, McGill University Health Centre, Montreal, Que., Canada ; Department of Human Genetics, McGill University Health Centre, Montreal, Que., Canada
| | - Nada Jabado
- Department of Pediatrics, McGill University Health Centre, Montreal, Que., Canada ; Department of Human Genetics, McGill University Health Centre, Montreal, Que., Canada
| | - Denis Sasseville
- Division of Dermatology, McGill University Health Centre, Montreal, Que., Canada
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Cao YA, Hickerson RP, Seegmiller BL, Grapov D, Gross MM, Bessette MR, Phinney BS, Flores MA, Speaker TJ, Vermeulen A, Bravo AA, Bruckner AL, Milstone LM, Schwartz ME, Rice RH, Kaspar RL. Gene expression profiling in pachyonychia congenita skin. J Dermatol Sci 2015; 77:156-65. [PMID: 25656049 DOI: 10.1016/j.jdermsci.2015.01.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 01/05/2015] [Accepted: 01/07/2015] [Indexed: 01/26/2023]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a skin disorder resulting from mutations in keratin (K) proteins including K6a, K6b, K16, and K17. One of the major symptoms is painful plantar keratoderma. The pathogenic sequelae resulting from the keratin mutations remain unclear. OBJECTIVE To better understand PC pathogenesis. METHODS RNA profiling was performed on biopsies taken from PC-involved and uninvolved plantar skin of seven genotyped PC patients (two K6a, one K6b, three K16, and one K17) as well as from control volunteers. Protein profiling was generated from tape-stripping samples. RESULTS A comparison of PC-involved skin biopsies to adjacent uninvolved plantar skin identified 112 differentially-expressed mRNAs common to patient groups harboring K6 (i.e., both K6a and K6b) and K16 mutations. Among these mRNAs, 25 encode structural proteins including keratins, small proline-rich and late cornified envelope proteins, 20 are related to metabolism and 16 encode proteases, peptidases, and their inhibitors including kallikrein-related peptidases (KLKs), and serine protease inhibitors (SERPINs). mRNAs were also identified to be differentially expressed only in K6 (81) or K16 (141) patient samples. Furthermore, 13 mRNAs were identified that may be involved in pain including nociception and neuropathy. Protein profiling, comparing three K6a plantar tape-stripping samples to non-PC controls, showed changes in the PC corneocytes similar, but not identical, to the mRNA analysis. CONCLUSION Many differentially-expressed genes identified in PC-involved skin encode components critical for skin barrier homeostasis including keratinocyte proliferation, differentiation, cornification, and desquamation. The profiling data provide a foundation for unraveling the pathogenesis of PC and identifying targets for developing effective PC therapeutics.
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Affiliation(s)
- Yu-An Cao
- TransDerm Inc., Santa Cruz, CA 95060, USA
| | | | | | - Dmitry Grapov
- University of California at Davis, Davis, CA 95616, USA
| | - Maren M Gross
- Dharmacon part of GE Healthcare, Lafayette, CO 80026, USA
| | | | | | | | | | | | - Albert A Bravo
- Podiatric Medicine and Surgery, Pittsfield, MA 01201, USA
| | - Anna L Bruckner
- University of Colorado School of Medicine, Aurora, CO 80045, USA
| | | | - Mary E Schwartz
- Pachyonychia Congenita Project, Salt Lake City, UT 84109, USA
| | - Robert H Rice
- University of California at Davis, Davis, CA 95616, USA
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Hale GI, Wilson NJ, Smith FJD, Wylie G, Schwartz ME, Zamiri M. Mutations in GJB6 causing phenotype resembling pachyonychia congenita. Br J Dermatol 2014; 172:1447-9. [PMID: 25385569 DOI: 10.1111/bjd.13520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- G I Hale
- Department of Dermatology, University Hospital Crosshouse, Kilmarnock Road, Kilmarnock, KA2 0BE, U.K.
| | - N J Wilson
- Centre for Dermatology and Genetic Medicine, College of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, U.K
| | - F J D Smith
- Centre for Dermatology and Genetic Medicine, College of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, U.K
| | - G Wylie
- Alan Lyell Centre for Dermatology, Glasgow, U.K
| | - M E Schwartz
- Pachyonychia Congenita Project, Salt Lake City, UT, U.S.A
| | - M Zamiri
- Department of Dermatology, University Hospital Crosshouse, Kilmarnock Road, Kilmarnock, KA2 0BE, U.K.,Alan Lyell Centre for Dermatology, Glasgow, U.K
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O'Toole EA, Kaspar RL, Sprecher E, Schwartz ME, Rittié L. Pachyonychia congenita cornered: report on the 11th Annual International Pachyonychia Congenita Consortium Meeting. Br J Dermatol 2014; 171:974-7. [PMID: 25124823 DOI: 10.1111/bjd.13341] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 12/30/2022]
Abstract
This is a report of the research presented at the 11th Annual Meeting of the International Pachyonychia Congenita Consortium, held on 6 May 2014 in Albuquerque, NM, U.S.A. This year's meeting was divided into five corners concerning pachyonychia congenita (PC) research: (i) 'PC Pathogenesis Cornered', an overview of recent keratin research, for PC and other skin disorders; (ii) 'From All Corners of …', an outline of other genetic disorders that we can learn from; (iii) 'Fighting For Our Corner', an outline of National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases programmes and U.S. funding opportunities applicable to rare skin disorders; (iv) 'The PC Corner', focusing on recent clinical studies related to PC; and (v) 'Clinical Corners: Turning the Corner?', an update on ongoing PC clinical trials.
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Affiliation(s)
- E A O'Toole
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
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65
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Harris TM, Du P, Kawachi N, Belbin TJ, Wang Y, Schlecht NF, Ow TJ, Keller CE, Childs GJ, Smith RV, Angeletti RH, Prystowsky MB, Lim J. Proteomic analysis of oral cavity squamous cell carcinoma specimens identifies patient outcome-associated proteins. Arch Pathol Lab Med 2014; 139:494-507. [PMID: 25295583 DOI: 10.5858/arpa.2014-0131-oa] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
CONTEXT Global proteomic analysis of oral cavity squamous cell carcinoma was performed to identify changes that reflect patient outcomes. OBJECTIVES To identify differentially expressed proteins associated with patient outcomes and to explore the use of imaging mass spectrometry as a clinical tool to identify clinically relevant proteins. DESIGN Two-dimensional separation of digested peptides generated from 43 specimens with high-resolution mass spectrometry identified proteins associated with disease-specific death, distant metastasis, and loco-regional recurrence. RNA expressions had been correlated to protein levels to test transcriptional regulation of clinically relevant proteins. Imaging mass spectrometry explored an alternative platform for assessing clinically relevant proteins that would complement surgical pathologic diagnosis. RESULTS Seventy-two peptide features were found to be associated with 3 patient outcomes: disease-specific death (9), distant metastasis (16), and loco-regional recurrence (39); 8 of them were associated with multiple outcomes. Functional ontology revealed major changes in cell adhesion and calcium binding. Thirteen RNAs showed strong correlation with their encoded proteins, implying transcriptional control. Reduction of DSP, PKP1, and TRIM29 was associated with significantly shorter time to onset of distant metastasis. Reduction of PKP1 and TRIM29 correlated with poorer disease-specific survival. Additionally, S100A8 and S100A9 reductions were verified for their association with poor prognosis using imaging mass spectrometry, a platform more adaptable for use with surgical pathology. CONCLUSIONS Using global proteomic analysis, we have identified proteins associated with clinical outcomes. The list of clinically relevant proteins observed will provide a means to develop clinical assays for prognosis and optimizing treatment selection.
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Affiliation(s)
- Thomas M Harris
- From the Departments of Pathology (Drs Harris, Belbin, Wang, Ow, Childs, Prystowsky, and Lim and Ms Kawachi), Epidemiology & Population Health (Dr Schlecht), Developmental and Molecular Biology (Dr Angeletti), and Biochemistry (Dr Angeletti) and the Laboratory for Macromolecular Analysis & Proteomics (Drs Angeletti and Lim), Albert Einstein College of Medicine, Bronx, New York; High Performance and Research Computing, Department of Information Systems and Technology, UMDNJ, Newark, New Jersey (Dr Du); the Department of Otorhinolaryngology-Head & Neck Surgery, Montefiore Medical Center, Bronx, New York (Drs Ow and Smith); and the Department of Pathology, Henry Ford Hospital and Medical Group, Detroit, Michigan (Dr Keller)
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Sprecher E, Schwartz ME, Hansen D, Smith FJD. Disease classification using clinical and molecular features. J Dermatol 2014; 41:949. [DOI: 10.1111/1346-8138.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eli Sprecher
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - Mary E. Schwartz
- Pachyonychia Congenita Project; University of Utah; Salt Lake City Utah USA
| | - Dave Hansen
- Department of Dermatology; University of Utah; Salt Lake City Utah USA
| | - Frances J. D. Smith
- Epithelial Genetics Group; Division of Molecular Medicine; Colleges of Life Sciences and Medicine, Dentistry and Nursing; Medical Sciences Institute; Dundee UK
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Jiráková A, Rajská L, Rob F, Džambová M, Sečníková Z, Göpfertová D, Schwartz M, Smith F, Lotti T, Hercogová J. First case of pachyonychia congenita in the Czech Republic. Dermatol Ther 2014; 28:10-2. [PMID: 25174302 DOI: 10.1111/dth.12142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Pachyonychia congenita (PC) is a rare autosomal dominant skin disorder characterized predominantly by hypertrophic nail dystrophy, oral leukokeratosis, and painful palmoplantar keratoderma. It is associated with a mutation in one of five keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17. The International PC Research Registry (IPCRR) confirms that as of January 2014 there have been 547 cases of PC genetically confirmed. It is estimated that there are between 2000 and 10,000 cases of PC in the world. However, the exact prevalence of PC is not yet established. We report a case of PC-K6a, p.Arg164Pro, in a 40-year-old man. Initially he was diagnosed with onychomycosis and was treated with systemic antifungals. This is the first genetically confirmed case of PC in the Czech Republic.
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Affiliation(s)
- Anna Jiráková
- Department of Dermatovenerology, 2nd Faculty of Medicine, Charles University, Bulovka Hospital, Prague, Czech Republic
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Abstract
PURPOSE OF REVIEW Nail diseases in infants and children are an uncommon cause of consultation and are often difficult to diagnose and to manage. This review will cover nail diseases that are most commonly seen in clinical practice, including congenital and hereditary disorders and inflammatory, infective, and neoplastic nail diseases. The purpose of the review is to help the reader to recognize nail disorders at an early age and to manage them appropriately. RECENT FINDINGS Two recent large studies have reported the clinical findings of genetic disorders involving the nails, that is, pachyonychia congenita and epidermolysis bullosa. Only a few articles gave a comprehensive review of a disease, as occurred for onychomycosis, while the majority of the reports published in the recent literature involve single cases. SUMMARY Nail diseases in children and neonates are not easy to diagnose by nonexperts. Basic knowledge of the anatomy and biology of the nail facilitates their diagnosis as the understanding of their pathophysiology. This review gives hints at the most common nail diseases that affect infants and children.
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Ofaiche J, Duchatelet S, Fraitag S, Nassif A, Nougué J, Hovnanian A. Familial pachyonychia congenita with steatocystoma multiplex and multiple abscesses of the scalp due to the p.Asn92Ser mutation in keratin 17. Br J Dermatol 2014; 171:1565-7. [PMID: 24842198 DOI: 10.1111/bjd.13123] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Ofaiche
- Department of Dermatology, Montauban Hospital, Montauban, France
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Bergendal B. Orodental manifestations in ectodermal dysplasia-a review. Am J Med Genet A 2014; 164A:2465-71. [PMID: 24719393 DOI: 10.1002/ajmg.a.36571] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/12/2014] [Indexed: 12/26/2022]
Abstract
Oral signs and symptoms are present in most ectodermal dysplasias (EDs). The aim of this article is to summarize some of the literature on current knowledge of oral manifestations and orofacial function in EDs. The review will focus on the most common forms where dental manifestations can be crucial for a differential diagnosis of ED among individuals with hypodontia and oligodontia, and preferably where the investigations included persons who had a genetically verified diagnosis. Disturbances in tooth development are common and can appear as tooth agenesis, variations in size and shape of teeth, defects in the mineralized tissues, and problems in tooth eruption. Abnormalities in number, size, and shape of teeth, and reduced salivary secretion, present in isolated oligodontia as well as in hypohidrotic ED and incontinentia pigmenti. In some more rare EDs these symptoms appear in combination with clefts of lip and/or palate in some affected individuals. Leukokeratosis in the oral mucosa presents in 70% of genetically confirmed cases of pachyonychia congenita. Also, orofacial function is often affected in ED, due to malformations, an incomplete dentition, and low salivary secretion which can compromise chewing, swallowing, and speech. In conclusion, there is a clinical overlap in oral signs and symptoms between isolated oligodontia and the most common EDs. Studies with genetically confirmed diagnoses and larger cohorts, as well as multicenter collaboration and the establishing of international registries, would create a basis for refined diagnostics, where oral examinations should be an integrated part of clinical assessment.
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Affiliation(s)
- Birgitta Bergendal
- National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden
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Ichimiya M, Yamaguchi M, Nemoto K, Muto M. Novel mutation (p.L91P, c.272T>C) of keratin 17 in a case with pachyonychia congenita type 2. J Dermatol 2013; 40:757-8. [DOI: 10.1111/1346-8138.12212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Makoto Ichimiya
- Department of Dermatology; Yamaguchi University Graduate School of Medicine; Ube; Japan
| | - Michiya Yamaguchi
- Department of Dermatology; Yamaguchi University Graduate School of Medicine; Ube; Japan
| | - Kei Nemoto
- Department of Dermatology; Yamaguchi University Graduate School of Medicine; Ube; Japan
| | - Masahiko Muto
- Department of Dermatology; Yamaguchi University Graduate School of Medicine; Ube; Japan
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Goldberg I, Sprecher E, Schwartz ME, Gaitini D. Comparative study of high-resolution multifrequency ultrasound of the plantar skin in patients with various types of hereditary palmoplantar keratoderma. Dermatology 2013; 226:365-70. [PMID: 24030314 DOI: 10.1159/000351321] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 04/02/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High-variable-frequency ultrasound is used as an imaging tool for various cutaneous disorders. We utilized this tool in pachyonychia congenita (PC) patients, who typically present with plantar hyperkeratosis and often severely debilitating pain, compared to patients with epidermolytic palmoplantar keratoderma (EPPK) and mal de Meleda (MDM). OBJECTIVE To ascertain the feasibility of ultrasound technology for the diagnosis of PC. METHODS The study included a total of 16 patients, 7 with PC, 5 with EPPK and 4 with MDM, who underwent ultrasound examination of the plantar skin with high-resolution multifrequency ultrasound equipment. RESULTS Ultrasound scans performed over the proximal and distal plantar foot calluses in PC patients demonstrated hyperechoic dots and lines within the epidermis compatible with hyperkeratosis, engorged varicose veins in the dermis and an anechoic layer interposed between the epidermis and the dermis, corresponding to blister fluid below the calluses. In contrast to PC patients, patients with MDM and EPPK demonstrated no blisters. CONCLUSION PC patients, as opposed to a group of patients with MDM and EPPK, displayed subepidermal blistering beneath their calluses. This finding may help in the diagnosis of PC and in partially explaining plantar pain as part of PC symptomatology.
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Affiliation(s)
- I Goldberg
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Affiliation(s)
- Hong Guo
- Department of Medical Genetics; College of Basic Medical Science; Chongqing; China
| | - Dan Liu
- Department of Medical Genetics; College of Basic Medical Science; Chongqing; China
| | - Jun Wu
- Department of Dermatology; Xinqiao Hospital; Third Military Medical University; Chongqing; China
| | - Qiong Liao
- Department of Ophthalmology; Xinqiao Hospital; Third Military Medical University; Chongqing; China
| | - Yun Bai
- Department of Medical Genetics; College of Basic Medical Science; Chongqing; China
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Barbarot S. [What's new in pediatric dermatology?]. Ann Dermatol Venereol 2013; 139 Suppl 5:S202-16. [PMID: 23522707 DOI: 10.1016/s0151-9638(12)70135-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper is based on a review of the literature focused on pediatric dermatology, from October 2011 to september 2012. Our objective was to highlight the main advances in fields such as atopic dermatitis, infantile hemangiomas, infectious diseases, inflammatory disorders, and genodermatoses.
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Affiliation(s)
- S Barbarot
- Clinique dermatologique, Hôtel Dieu, CHU Nantes, Place Alexis Ricordeau, 44000 Nantes, France.
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Goldberg I, Fruchter D, Meilick A, Schwartz ME, Sprecher E. Best treatment practices for pachyonychia congenita. J Eur Acad Dermatol Venereol 2013; 28:279-85. [PMID: 23363249 DOI: 10.1111/jdv.12098] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 12/18/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Numerous therapeutic modalities have been proposed to treat the manifestations of pachyonychia congenita (PC). While research hopes lie with molecular therapies, patients are in need of answers regarding the efficacy of conventional treatments. AIM OF THE STUDY To determine patients' experience and preferences regarding conventional treatments for PC. METHODS The study population included 120 PC patients from 20 countries. The study was based on a patient survey developed by physicians and researchers from the International Pachyonychia Congenita Consortium and conducted via the internet. Using an effectiveness scale of 1 to 5, the patients were asked to grade treatments for different manifestations, including keratoderma, cysts, follicular hyperkeratosis, fingernail and toenail involvement. RESULTS Patients reported surgical treatments being most effective for cysts and mechanical treatments the most effective conventional therapeutic approach for all other investigated manifestations. The other conventional medical treatments were found to be non-effective to only slightly effective. Among patients with keratoderma, older people were more likely to report beneficial effect from mechanical treatments (P = 0.04), topical retinoids (P = 0.04) and topical steroids (P = 0.02). Likewise, females were more inclined to report filing and grinding beneficial than males (P = 0.02). Finally, carriers of KRT16 and KRT6a were more likely to benefit from keratolytics than carriers of mutations in KRT17 (P = 0.04). CONCLUSIONS None of the currently available therapeutic options for PC are ideal, although they provide some relief, with mechanical/surgical options being preferred over medical therapies. These results emphasize the need for more efficient and targeted therapies.
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Affiliation(s)
- I Goldberg
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
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Wilson NJ, Hansen CD, Azkur D, Kocabas CN, Metin A, Coskun Z, Schwartz ME, Hull PR, McLean WHI, Smith FJD. Recessive mutations in the gene encoding frizzled 6 cause twenty nail dystrophy--expanding the differential diagnosis for pachyonychia congenita. J Dermatol Sci 2013; 70:58-60. [PMID: 23374899 DOI: 10.1016/j.jdermsci.2012.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 11/14/2012] [Accepted: 12/22/2012] [Indexed: 10/27/2022]
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