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Piccolo V, Russo T, Di Pinto D, Pota E, Di Martino M, Piluso G, Ronchi A, Argenziano G, Di Brizzi EV, Santoro C. Poikiloderma With Neutropenia and Mastocytosis: A Case Report and a Review of Dermatological Signs. Front Med (Lausanne) 2021; 8:680363. [PMID: 34179048 PMCID: PMC8222900 DOI: 10.3389/fmed.2021.680363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 04/27/2021] [Indexed: 12/02/2022] Open
Abstract
Poikiloderma with neutropenia (PN) is a very rare genetic disorder mainly characterized by poikiloderma and congenital neutropenia, which explains the recurrence of respiratory infections and risk of developing bronchiectasis. Patients are also prone to develop hematological and skin cancers. Here, we present the case of a patient, the only child of apparently unrelated Serbian parents, affected by PN resulting from the homozygous mutation NM_024598.3:c.243G>A (p.Trp81Ter) of USB1; early onset of poikiloderma (1 year of age) was associated with cutaneous mastocytosis. We also provide a review of the literature on this uncommon condition with a focus on dermatological findings.
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Affiliation(s)
- Vincenzo Piccolo
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Teresa Russo
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Daniela Di Pinto
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Elvira Pota
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martina Di Martino
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Piluso
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Ronchi
- Anatomic Pathology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | - Claudia Santoro
- Department of Women and Child Health and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Physical and Mental Health, and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Roebke LJ, Vander Maten JW, Alkhoury G. Hyperbaric oxygen management of recurrent cellulitis in poikiloderma with neutropenia. Am J Med Genet A 2021; 185:2150-2152. [PMID: 33836117 DOI: 10.1002/ajmg.a.62204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 11/08/2022]
Abstract
Poikiloderma with neutropenia (PN), is a rare autosomal recessive condition with many associated complications and manifestations. Here we present a patient with confirmed PN who is of one-quarter Chucktaw or Cherokee heritage with no known descent from the Navajo tribe. The patient's condition was complicated by chronic bilateral lower limb cellulitis and associated osteomyelitis which was unresponsive to extensive antibiotic regimens. Subsequent treatment with hyperbaric oxygen therapy (HBOT) was successful. To date, no author has reported on the treatment of recurrent cellulitis using HBOT in this patient population. Based on our experience, HBOT should be considered in patients with PN.
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Affiliation(s)
- Logan J Roebke
- University of Toledo, College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Josh W Vander Maten
- University of Toledo, College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Ghattas Alkhoury
- Department of Internal Medicine, University of Toledo College of Medicine, Toledo, Ohio, USA
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Gangadharan H, Singh K, Phadke S, Aggarwal A. Clinical Sequencing Solves a Diagnostic Dilemma by Identifying a Novel Pathogenic Variant in USB1 Gene Causing Poikiloderma with Neutropenia. Indian J Pediatr 2021; 88:270-271. [PMID: 32936385 DOI: 10.1007/s12098-020-03502-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Harikrishnan Gangadharan
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Komal Singh
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Shubha Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amita Aggarwal
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
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Bilgic Eltan S, Sefer AP, Karakus İS, Ozen A, Karakoc-Aydiner E, Baris S. Lymphopenia with Low T and NK Cells in a Patient with USB1 Mutation, Rare Findings in Clericuzio-Type Poikiloderma with Neutropenia. J Clin Immunol 2021; 41:1106-1111. [PMID: 33624217 DOI: 10.1007/s10875-021-00998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Sevgi Bilgic Eltan
- School of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey.,Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey.,The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Asena Pınar Sefer
- School of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey.,Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey.,The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | | | - Ahmet Ozen
- School of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey.,Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey.,The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Elif Karakoc-Aydiner
- School of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey.,Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey.,The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Safa Baris
- School of Medicine, Division of Pediatric Allergy and Immunology, Marmara University, Istanbul, Turkey. .,Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey. .,The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey.
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Binamer Y, Chisti MA. Kindler's Syndrome with Recurrent Neutropenia: Report of Two Cases from Saudi Arabia. J Pediatr Genet 2020; 12:69-72. [PMID: 36684545 PMCID: PMC9848764 DOI: 10.1055/s-0040-1721077] [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: 08/12/2020] [Accepted: 10/12/2020] [Indexed: 01/25/2023]
Abstract
Kindler syndrome (KS) is a rare photosensitivity disorder with autosomal recessive mode of inheritance. It is characterized by acral blistering in infancy and childhood, progressive poikiloderma, skin atrophy, abnormal photosensitivity, and gingival fragility. Besides these major features, many minor presentations have also been reported in the literature. We are reporting two cases with atypical features of the syndrome and a new feature of recurrent neutropenia. Whole exome sequencing analysis was done using next-generation sequencing which detected a homozygous loss-of-function (LOF) variant of FERMT1 in both patients. The variant is classified as a pathogenic variant as per the American College of Medical Genetics and Genomics guidelines. Homozygous LOF variants of FERMT1 are a common mechanism of KS and as such confirm the diagnosis of KS in our patients even though the presentation was atypical.
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Affiliation(s)
- Yousef Binamer
- Department of Dermatology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Muzamil A. Chisti
- Department of Dermatology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia,Address for correspondence Muzamil Amin Chisti, MD Department of Dermatology, King Faisal Specialist Hospital & Research CentreMBC 104, Riyadh 11211Kingdom of Saudi Arabia
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Akdogan N, Kindis E, Bostan E, Utine E, Alikasifoglu M, Ersoy-Evans S. Poikiloderma with Neutropenia, Clericuzio-Type Accompanied by Loss of Digits Due to Severe Osteomyelitis. J Clin Immunol 2020; 40:934-939. [PMID: 32620997 DOI: 10.1007/s10875-020-00815-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
Poikiloderma with neutropenia (PN), Clericuzio-type is a rare autosomal recessively transmitted genodermatosis caused by biallelic mutations in the USB1 gene and is characterized by early-onset poikiloderma and chronic neutropenia. Nail dystrophy, palmoplantar hyperkeratosis, hypogonadotropic hypogonadism, and recurrent infections can be associated with the disease. Herein, we present a 27-year-old Turkish male patient newly diagnosed as PN, Clericuzio-type after confirmation of a c.531delA (p.His179MetfsX86) homozygous deleterious mutation in exon 5 of the USB1 gene. The presented case highlights the importance of genetic testing for avoiding misdiagnosis based solely on clinical findings, as well as the benefit of a multi-disciplinary diagnostic approach, as he was initially misdiagnosed as Rothmund-Thompson syndrome and subsequently diagnosed as PN, Clericuzio-type at age 27 years.
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Affiliation(s)
- Neslihan Akdogan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Erdem Kindis
- School of Medicine, Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
| | - Ecem Bostan
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey
| | - Eda Utine
- School of Medicine, Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
| | - Mehmet Alikasifoglu
- School of Medicine, Department of Medical Genetics, Hacettepe University, Ankara, Turkey
| | - Sibel Ersoy-Evans
- School of Medicine, Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey.
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Hertel DP, Mohammad TF, Shwayder TA. Poikiloderma with neutropenia and associated squamous cell carcinoma: A case report. Pediatr Dermatol 2018; 35:e366-e367. [PMID: 30152552 DOI: 10.1111/pde.13645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Here, we describe a case of a patient with known poikiloderma with neutropenia who developed cutaneous squamous cell carcinoma in a chronically sun-exposed area at the age of 14. To date, there is only one other report of this association. This report highlights the need for routine skin cancer screening in patients with this diagnosis as well as the importance of a correct initial diagnosis.
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Affiliation(s)
- Daniel P Hertel
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - Tor A Shwayder
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
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Sakka R, Mahjoub B, Kerkeni E, Werdani A, Boussoffara R, Ben Cheikh H, M'rad R, Sfar MT. Poikiloderma with neutropenia in a Tunisian patient with a novel C16orf57 gene mutation. Pediatr Blood Cancer 2018; 65:e27262. [PMID: 29797650 DOI: 10.1002/pbc.27262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/06/2018] [Accepted: 05/07/2018] [Indexed: 12/23/2022]
Abstract
Poikiloderma with neutropenia (PN) is a genodermatosis characterized by poikiloderma, permanent neutropenia, recurrent infections, nail abnormalities, and palmoplantar hyperkeratosis. We report the case of a Tunisian patient with PN. Skin lesions started from the face and spread to the extremities and trunk. Neutropenia was initially periodic and concomitant with infections periods. DNA analysis identified a novel homozygous deletion of a 1-bp (c.161delC, p.P54RfsX60) in the C16orf57gene, presumed to be causative. This report presents the variability of the clinical manifestations and evolution of PN and emphasizes the importance of studying other patients with PN to better delineate mutations profile among populations.
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Affiliation(s)
- Rania Sakka
- Laboratory of Histology and Cytogenetics (Research Unit of Genetic, Genotoxicity and Childhood Diseases UR12ES10), Faculty of Medicine, University of Monastir, Street Avicenne, 5019, Monastir, Tunisia
| | - Bahri Mahjoub
- Department of Pediatrics, Tahar Sfar University Hospital, Mahdia, Tunisia
| | - Emna Kerkeni
- Laboratory of Histology and Cytogenetics (Research Unit of Genetic, Genotoxicity and Childhood Diseases UR12ES10), Faculty of Medicine, University of Monastir, Street Avicenne, 5019, Monastir, Tunisia
| | - Amina Werdani
- Department of Pediatrics, Tahar Sfar University Hospital, Mahdia, Tunisia
| | | | - Hassen Ben Cheikh
- Laboratory of Histology and Cytogenetics (Research Unit of Genetic, Genotoxicity and Childhood Diseases UR12ES10), Faculty of Medicine, University of Monastir, Street Avicenne, 5019, Monastir, Tunisia
| | - Ridha M'rad
- Laboratory of Human Genetics, Doctoral School of Science and Biotechnology, Faculty of Medicine of Tunis, University of Tunis El Manar, 1007 Tunis, Tunisia
| | - Mohamed Taher Sfar
- Department of Pediatrics, Tahar Sfar University Hospital, Mahdia, Tunisia
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Concolino D, Sestito S, Falvo F, Romano G, Ceravolo M, Anastasio E, Pensabene L, Colombo EA, Larizza L. Assessment of intrafamilial clinical variability of poikiloderma with neutropenia by a 10-year follow-up of three affected siblings. Eur J Med Genet 2018; 62:73-76. [PMID: 29753917 DOI: 10.1016/j.ejmg.2018.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/21/2018] [Accepted: 05/08/2018] [Indexed: 01/03/2023]
Abstract
Clericuzio-type poikiloderma with neutropenia is a well-defined nosological entity, but despite a remarkable number of clinical reports, no long term follow-up data has been presented to date regarding patients with this rare condition. Here we describe the results of clinical follow-up of three siblings, one male (Patient 1) and two females (Patients 2 and 3), subsequent to their first clinical and then molecular diagnosis of Clericuzio-type poikiloderma with neutropenia syndrome due to mutation of USB1gene. Patient 1 always expressed the most severe phenotype, while patients 2 and 3 showed an intermediate and mild phenotype, respectively, as observed since their first clinical evaluation. None of the patients developed skin cancer and/or myelodysplastic disorders considering the peripheral haematological findings. Lens opacity, never reported before, was found in two of the three patients. The long term follow-up observations confirm the stability over time of the pronounced intra-familial heterogeneity of clinical manifestations observed prior to and upon molecular diagnosis. We conclude that prolonged follow-up is an adjunct tool to monitor intra-familial variability of PN clinical spectrum which may favour surveillance of more serious complications of the disease among siblings, when a patient-specific clinical expressivity is present.
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Affiliation(s)
- Daniela Concolino
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy.
| | - Simona Sestito
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy
| | - Francesca Falvo
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy
| | - Giusy Romano
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy
| | - Miriam Ceravolo
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy
| | - Elisa Anastasio
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy
| | - Licia Pensabene
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy
| | - Elisa A Colombo
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, via Antonio di Rudinì 8, 20142, Milano, Italy
| | - Lidia Larizza
- Medical Cytogenetics and Molecular Genetics Laboratory, Centro di Ricerche e Tecnologie Biomediche IRCCS, Istituto Auxologico Italiano, Milan, Italy
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