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Schneider LC, Hotz A, Gugelmeier M, Fischer J, Peitsch WK. Pseudoainhum and universal alopecia. J Dtsch Dermatol Ges 2024. [PMID: 38923334 DOI: 10.1111/ddg.15449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/05/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Lisa C Schneider
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Alrun Hotz
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Moritz Gugelmeier
- Department of Orthopedics, Trauma, Hand and Reconstructive Surgery, Center for Musculoskeletal Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Judith Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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2
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Gugelmeier M, Kostron A, Poser T, Schneider LC, Peitsch WK, Fuchs T. [Acute soft Tissue Infection with impending Loss of Finger in amniotic Band Syndrome of a 22-years-old Patient with palmoplantar Keratoderma congenital Alopecia Syndrome Type II]. HANDCHIR MIKROCHIR P 2023; 55:368-372. [PMID: 36972588 DOI: 10.1055/a-2013-2131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
We report on the treatment of a 22-year-old female patient with an acute soft tissue infection in the area of an amniotic band due to palmoplantar keratoderma congenital alopecia syndrome (PPKCA) type II, a very rare genodermatosis with less than 20 cases described in literature. An acute soft tissue infection distal from the pre-existing constriction ring with hyperkeratosis on the right small finger led to a decompensation of the venous and lymphatic drain with imminent loss of the finger. Due to urgent surgical treatment with decompression and debridement of the dorsal soft tissue infection, microsurgical circular resection of the constriction ring and primary wound closure the finger could be preserved. After soft tissue consolidation and hand therapy, the patient achieved free movement of the small finger with subjective freedom of symptoms and good aesthetic results.
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Affiliation(s)
- Moritz Gugelmeier
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Arthur Kostron
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Thomas Poser
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Lisa C Schneider
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Thomas Fuchs
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
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3
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Kobayashi H, Shiohama T, Nakashima M, Saitsu H, Suga Y, Ebata R, Shimojo N. Fulminant myocarditis following recurrent generalized erythrokeratoderma in a child with a heterozygous GJA1 variant. Am J Med Genet A 2020; 182:1933-1938. [PMID: 32449269 DOI: 10.1002/ajmg.a.61626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/09/2022]
Abstract
Pathogenic germline variants in the gap junction protein alpha 1 (GJA1) gene have been identified in several congenital disorders affecting cutaneous, skeletal, and cardiac tissues. Here, we describe a 12-year-old patient with a GJA1 c.113G>A, p.(Gly38Glu) variant, who presented with fulminant myocarditis following recurrent generalized erythrokeratoderma. His mother and younger sister had the same clinical manifestations with the same GJA1 variant, but did not have cardiac dysfunction. GJA1 variants have been reported in patients with congenital cardiac malformations, while acute myocarditis in GJA1-related disorders has not been reported so far.
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Affiliation(s)
- Hironobu Kobayashi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mitsuko Nakashima
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasushi Suga
- Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Ryota Ebata
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
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4
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Tchouakam DN, Tochie JN, Guifo ML, Choukem SP. Ainhum, a rare mutilating dermatological disease in a female Cameroonian: a case report. BMC DERMATOLOGY 2019; 19:12. [PMID: 31401977 PMCID: PMC6689862 DOI: 10.1186/s12895-019-0092-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/22/2019] [Indexed: 11/28/2022]
Abstract
Background Ainhum is an idiopathic dermatological disease characterized by a progressive constricting ring usually on the fifth toe, which may lead to spontaneous auto-amputation of the affected toe. Timely diagnosis and treatment are the key elements to avert amputations with resultant mutilating deformities, permanent handicaps and psychological sequelae. Though common in African descents, this pathology has not been described in the Cameroonian literature. Herein, we report the case of an adult Cameroonian woman presenting with ainhum. Case presentation A 54-year old Cameroonian was admitted to our primary healthcare centre with a 6-month history of a painful constriction band developing at the base of her right fifth toe. Her past history was uneventful. Based on the absence of trauma and spontaneous onset of the condition, the diagnosis of ainhum was most suggestive. She was managed surgically by excision of the band, disarticulated at right fifth metatarsophalangeal joint and skin closure. Her post-operative course after 1 year was uneventful. Conclusion Here we presented a case of ainhum, a rare dermatological disease with few reports. In view of the serious complications of ainhum such as mutilating deformities with permanent physical disabilities and psychological trauma, we draw clinicians’ attention, especially wound care specialists to this rare but potentially handicapping disease, for timely diagnosis and management.
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Affiliation(s)
- Diego Nitcheu Tchouakam
- Health and Human Development (2HD) Research Network, Douala, Cameroon.,Bogo District Hospital, Bogo, Cameroon
| | - Joel Noutakdie Tochie
- Health and Human Development (2HD) Research Network, Douala, Cameroon. .,Departement of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
| | - Marc Leroy Guifo
- Departement of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.,Department of Surgery, University Hospital Center, Yaounde, Cameroon
| | - Simeon Pierre Choukem
- Health and Human Development (2HD) Research Network, Douala, Cameroon.,Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
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5
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Richey PM, Stone MS. Resolution of pseudoainhum with acitretin therapy in a patient with palmoplantar keratoderma and congenital alopecia. JAAD Case Rep 2019; 5:219-221. [PMID: 30809564 PMCID: PMC6374960 DOI: 10.1016/j.jdcr.2018.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Patricia M Richey
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Mary S Stone
- Department of Dermatology and Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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Wang JF, Orlow SJ. Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options. Am J Clin Dermatol 2018; 19:733-757. [PMID: 30043128 DOI: 10.1007/s40257-018-0368-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Keratosis pilaris is a common skin disorder comprising less common variants and rare subtypes, including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and the spectrum of keratosis pilaris atrophicans. Data, and critical analysis of existing data, are lacking, so the etiologies, pathogeneses, disease associations, and treatments of these clinical entities are poorly understood. The present article aims to fill this knowledge gap by reviewing literature in the PubMed, EMBASE, and CINAHL databases and providing a comprehensive, analytical summary of the clinical characteristics and pathophysiology of keratosis pilaris and its subtypes through the lens of disease associations, genetics, and pharmacologic etiologies. Histopathologic, genomic, and epidemiologic evidence points to keratosis pilaris as a primary disorder of the pilosebaceous unit as a result of inherited mutations or acquired disruptions in various biomolecular pathways. Recent data highlight aberrant Ras signaling as an important contributor to the pathophysiology of keratosis pilaris and its subtypes. We also evaluate data on treatments for keratosis pilaris and its subtypes, including topical, systemic, and energy-based therapies. The effectiveness of various types of lasers in treating keratosis pilaris and its subtypes deserves wider recognition.
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Affiliation(s)
- Jason F Wang
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA
| | - Seth J Orlow
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 240 East 38th Street, 11th Floor, New York, NY, 10016, USA.
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7
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Guerra L, Castori M, Didona B, Castiglia D, Zambruno G. Hereditary palmoplantar keratodermas. Part I. Non-syndromic palmoplantar keratodermas: classification, clinical and genetic features. J Eur Acad Dermatol Venereol 2018; 32:704-719. [PMID: 29489036 DOI: 10.1111/jdv.14902] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/09/2018] [Indexed: 12/15/2022]
Abstract
The term palmoplantar keratoderma (PPK) indicates any form of persistent thickening of the epidermis of palms and soles and includes genetic as well as acquired conditions. We review the nosology of hereditary PPKs that comprise an increasing number of entities with different prognoses, and a multitude of associated cutaneous and extracutaneous features. On the basis of the phenotypic consequences of the underlying genetic defect, hereditary PPKs may be divided into the following: (i) non-syndromic, isolated PPKs, which are characterized by a unique or predominant palmoplantar involvement; (ii) non-syndromic PPKs with additional distinctive cutaneous and adnexal manifestations, here named complex PPKs; (iii) syndromic PPKs, in which PPK is associated with specific extracutaneous manifestations. To date, the diagnosis of the different hereditary PPKs is based mainly on clinical history and features combined with histopathological findings. In recent years, the exponentially increasing use of next-generation sequencing technologies has led to the identification of several novel disease genes, and thus substantially contributed to elucidate the molecular basis of such a heterogeneous group of disorders. Here, we focus on hereditary non-syndromic isolated and complex PPKs. Syndromic PPKs are reviewed in the second part of this 2-part article, where other well-defined genetic diseases, which may present PPK among their phenotypic manifestations, are also listed and diagnostic and therapeutic approaches for PPKs are summarized.
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Affiliation(s)
- L Guerra
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - M Castori
- Division of Medical Genetics, Casa Sollievo della Sofferenza-IRCCS, San Giovanni Rotondo, Foggia, Italy
| | - B Didona
- Rare Skin Disease Center, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - D Castiglia
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - G Zambruno
- Genetic and Rare Diseases Research Area and Dermatology Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
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Verma G, Sardana K, Gautam RK. Mutilating Keratoderma with Concomitant Alopecia and Keratoses Follicularis Spinulosa Decalvans: X-Linked Olmsted Syndrome and its Response to Isotretinoin. Indian Dermatol Online J 2017; 8:482-484. [PMID: 29204395 PMCID: PMC5707844 DOI: 10.4103/idoj.idoj_422_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We report a case of mutilating keratoderma with alopecia and keratoses follicularis spinulosa decalvans (KFSD), which was initially diagnosed as ectodermal dysplasia and Olmsted syndrome but was revisited as a case of X-linked Olmsted (XLO) syndrome. We focus on this uncommon entity (XLO) to highlight the differentials of alopecia with palmoplantar keratoderma.
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Affiliation(s)
- Gunjan Verma
- Department of Dermatology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - R K Gautam
- Department of Dermatology, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India
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Castori M, Morlino S, Sana ME, Paradisi M, Tadini G, Angioni A, Malacarne M, Grammatico P, Iascone M, Forzano F. Clinical and molecular characterization of two patients with palmoplantar keratoderma-congenital alopecia syndrome type 2. Clin Exp Dermatol 2016; 41:632-5. [DOI: 10.1111/ced.12857] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 11/26/2022]
Affiliation(s)
- M. Castori
- Division/Laboratory of Medical Genetics; San Camillo-Forlanini Hospital; Rome Italy
| | - S. Morlino
- Division/Laboratory of Medical Genetics; San Camillo-Forlanini Hospital; Rome Italy
| | - M. E. Sana
- Laboratory of Medical Genetics; Papa Giovanni XXIII Hospital; Bergamo Italy
| | - M. Paradisi
- Department of Dermatology and Plastic Surgery; Campus Biomedico University Hospital; Rome Italy
| | - G. Tadini
- Pediatric Dermatology, Department of Physiopathology and Transplantation; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano; University of Milan; Milan Italy
| | - A. Angioni
- Laboratory of Medical Genetics; IRCCS-Ospedale Pediatrico Bambino Gesù; Rome Italy
| | - M. Malacarne
- Laboratory of Human Genetics; Galliera Hospital; Genoa Italy
| | - P. Grammatico
- Division/Laboratory of Medical Genetics; San Camillo-Forlanini Hospital; Rome Italy
| | - M. Iascone
- Laboratory of Medical Genetics; Papa Giovanni XXIII Hospital; Bergamo Italy
| | - F. Forzano
- Department of Medical Genetics; Galliera Hospital; Genoa Italy
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Prabhu R, Kannan NS, Vinoth S, Praveen CB. Ainhum - A Rare Case Report. J Clin Diagn Res 2016; 10:PD17-8. [PMID: 27190888 DOI: 10.7860/jcdr/2016/17556.7648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/12/2016] [Indexed: 11/24/2022]
Abstract
The term 'AINHUM' is derived from the African word meaning 'to saw or cut'. True ainhum otherwise called dactylolysis spontanea is a condition involving soft tissue or digits with constricting rings commonly presenting in fifth toes, usually bilateral. It is to be differentiated from Pseudo-ainhum that occurs secondary to some hereditary and nonhereditary diseases that lead to annular constriction of digits. We report a rare case of true ainhum involving the left fourth toe only. It is a very rare case and a very few were reported worldwide. The highest incidence of ainhum has been reported in South Africa and South America. It is rarely reported in India. Ainhum when diagnosed and treated in early stages can be prevented from progressing to mutilating deformities.
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Affiliation(s)
- Ravi Prabhu
- Senior Resident, Department of General Surgery, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth , Pondicherry, India
| | - Narayanasamy Subbaraju Kannan
- Associate Professor, Department of General Surgery, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth , Pondicherry, India
| | - Sundaresan Vinoth
- Assistant Professor, Department of General Surgery, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth , Pondicherry, India
| | - Chinnappan Balasubramanian Praveen
- Assistant Professor, Department of General Surgery, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth , Pondicherry, India
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Wang H, Cao X, Lin Z, Lee M, Jia X, Ren Y, Dai L, Guan L, Zhang J, Lin X, Zhang J, Chen Q, Feng C, Zhou EY, Yin J, Xu G, Yang Y. Exome sequencing reveals mutation in GJA1 as a cause of keratoderma-hypotrichosis-leukonychia totalis syndrome. Hum Mol Genet 2014; 24:243-50. [DOI: 10.1093/hmg/ddu442] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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