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Baskurt D, Vural S, Ertekin SS, Baykal C. Oral mucosa involvement in pediatric patients with xeroderma pigmentosum: a comprehensive review. Int J Dermatol 2024; 63:59-72. [PMID: 37964400 DOI: 10.1111/ijd.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder presenting with an inability to repair UV-induced DNA damage. This can lead to the development of neoplasms affecting multiple organ systems, with onset often in childhood. Unfortunately, no cure currently exists for XP, and management strategies focus on sun protection and early intervention for malignancies. Although most skin problems in XP patients are UV induced, various oral lesions are also described. However, the literature has not extensively characterized the oral manifestations and their prognostic significance. METHODS We conducted a comprehensive review to evaluate the prevalence and nature of oral mucosal lesions in pediatric XP patients. RESULTS Our literature search yielded 130 pediatric XP patients with oral involvement and 210 associated tumoral or non-tumoral lesions. Squamous cell carcinoma was the most common type of oral mucosal tumor reported, with other malignancies including basal cell carcinoma, melanoma, angiosarcoma, fibrosarcoma, and trichilemmal carcinoma. CONCLUSION Given the potential morbidity and mortality associated with oral mucosal tumors in XP patients, our study aims to raise awareness of these manifestations. Early diagnosis and treatment are crucial for managing these lesions effectively, and routine oral exams should be considered a critical component of dermatological evaluations for XP patients, especially in the pediatric age group.
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Affiliation(s)
- Defne Baskurt
- School of Medicine, Koç University, Istanbul, Turkey
| | - Secil Vural
- School of Medicine, Koç University, Istanbul, Turkey
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Sümeyre S Ertekin
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Muacevic A, Adler JR, Cotard V. Verrucous Carcinoma of Tongue in Xeroderma Pigmentosum: A Case Report and Literature Review. Cureus 2022; 14:e31706. [PMID: 36561591 PMCID: PMC9767790 DOI: 10.7759/cureus.31706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/22/2022] Open
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive genetic disorder characterized by intense skin photosensitivity that is often associated with corneal ulceration, erythema, malignant lesions in sun-exposed areas, and neurological damage in severe cases. XP is due to alterations in the nucleotide excision repair system which could eliminate DNA fragments damaged by ultraviolet radiation. We report a case of a 14-year-old admitted for photophobia and a conjunctival mass. He underwent laboratory tests, including a complete blood count (CBC), which was unremarkable, and serological tests such as rapid plasma reagin (RPR) and human immunodeficiency virus (HIV) test were negative. A consultation in Ophthalmology was requested, concluding in bilateral corneal dystrophy. A few months later he developed two masses, one on the distal border of the tongue and the other at the level of the parotid region. He underwent two excisional biopsies; the parotid mass revealed an ulcerated squamous cell carcinoma on a background of xeroderma pigmentosum, and the tongue tip mass revealed a well-differentiated infiltrating verrucous carcinoma with a smooth margin. Xeroderma pigmentosum is a rare genodermatosis affecting the skin, eyes and oral cavity. It is sometimes associated with cancers of internal organs and rarely of the tongue. This study reports a case of XP associated with verrucous carcinoma of the tongue and ocular complications. Currently, there is no curative treatment for XP, and the only treatments available are symptomatic and preventive.
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Dos Santos ES, Pérez‐de‐Oliveira ME, Normando AGC, Gueiros LAM, Rogatto SR, Vargas PA, Lopes MA, da Silva Guerra EN, Leme AFP, Santos‐Silva AR. Systemic conditions associated with increased risk to develop oral squamous cell carcinoma: Systematic review and meta‐analysis. Head Neck 2022; 44:2925-2937. [DOI: 10.1002/hed.27193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/10/2022] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | - Luiz Alcino Monteiro Gueiros
- Oral Medicine Unit, Departamento de Clínica e Odontologia Preventiva Universidade Federal de Pernambuco Recife Brazil
| | - Silvia Regina Rogatto
- Department of Clinical Genetics University Hospital of Southern Denmark, Vejle and Institute of Regional Health Research, University of Southern Denmark Odense Denmark
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis Piracicaba Dental School, University of Campinas Piracicaba Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis Piracicaba Dental School, University of Campinas Piracicaba Brazil
| | | | - Adriana Franco Paes Leme
- Brazilian Bioscience National Laboratory Brazil Center of Research in Energy and Materials Campinas Brazil
| | - Alan Roger Santos‐Silva
- Department of Oral Diagnosis Piracicaba Dental School, University of Campinas Piracicaba Brazil
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Maimouna M, Sofian B, Latifatou G, Joséphine Frédérique Mendouga E, Papa Macoumba G, Mamadou Moustapha D, Dirk VG. Unresectable and chemoresistant conjunctival squamous cell carcinoma on xeroderma pigmentosum treated by salvage radiation therapy: A case report and a review of the literature. Clin Case Rep 2022; 10:e6360. [PMID: 36188050 PMCID: PMC9508803 DOI: 10.1002/ccr3.6360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 04/11/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
Xeroderma pigmentosum (XP) is a rare genetic disease, which vital prognosis is conditioned by the occurrence of cancers essentially of the skin and ocular surfaces, requiring an early and adapted management. Radiation therapy (RT) is a very effective modality in the therapeutic arsenal alongside surgery, but it remains underused as it is wrongly considered to be deleterious for these patients. In this article, we report the case of a 10‐years‐old girl with XP treated with external beam RT for a squamous cell carcinoma (SCC) of the right ocular conjunctiva. The clinical tolerance was excellent and we obtained a good tumoral response. Therefore, the place of RT in these patients could/should be reconsidered, especially since these suspicions have still not been confirmed.
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Affiliation(s)
- Mané Maimouna
- Department of Radiation‐Oncology Dalal Jamm National University Hospital Dakar Senegal
| | - Benkhaled Sofian
- Institut Jules‐Bordet, Department of Radiation Oncology Université Libre de Bruxelles Brussels Belgium
| | - Guèye Latifatou
- Department of Radiation‐Oncology Dalal Jamm National University Hospital Dakar Senegal
| | | | - Gaye Papa Macoumba
- Department of Radiation‐Oncology Dalal Jamm National University Hospital Dakar Senegal
| | | | - Van Gestel Dirk
- Institut Jules‐Bordet, Department of Radiation Oncology Université Libre de Bruxelles Brussels Belgium
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Plante J, Strat N, Snyder A, Santa Lucia G, Winterfield L, Wine Lee L. Xeroderma pigmentosum presenting as a diffuse midline glioma in a patient with skin of color. JAAD Case Rep 2021; 13:141-143. [PMID: 34195325 PMCID: PMC8226388 DOI: 10.1016/j.jdcr.2021.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- John Plante
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Nicholas Strat
- School of Medicine, University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | - Alan Snyder
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Gabriella Santa Lucia
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Laura Winterfield
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Lara Wine Lee
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.,Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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6
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Pereira TDSF, Castro LP, Menck CFM, Maia MHT, Souza LLD, Fonseca FP, Pontes HAR, Pontes FSC, Gomez RS. Xeroderma pigmentosum variant: squamous cell carcinoma of the lower lip harboring exon 11 mutation of POLH. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e97-e105. [PMID: 34030998 DOI: 10.1016/j.oooo.2021.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/09/2021] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare inherited disease caused by deficiencies in DNA damage repair, which mainly results from the failure of nucleotide excision repair or defects in translesion DNA synthesis. The development of multiple malignancies is one of the most prominent features of this condition, which is clinically characterized by the occurrence of hyperpigmentation and lesions associated with sunlight exposure. Lip squamous cell carcinoma in patients with XP has rarely been reported, and information regarding the genetic analysis of these patients is limited. In this report, a case of a 20-year-old patient who developed squamous cell carcinoma in the lower lip is described. Although the tumor was surgically excised, the patient presented with recurrence a few months later. Targeted sequencing using a customized panel of DNA repair genes revealed a mutation in POLH, the gene encoding DNA polymerase eta. Therefore, molecular characterization is important to further improve the understanding of possible phenotype-genotype correlations and mechanisms involved in the pathogenesis of XP.
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Affiliation(s)
| | - Ligia Pereira Castro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Maria Helena Thomaz Maia
- Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Lucas Lacerda de Souza
- Department of Oral Pathology, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Pará, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Helder Antônio Rebelo Pontes
- Department of Oral Pathology, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Pará, Brazil
| | - Flavia Sirotheau Correa Pontes
- Department of Oral Pathology, University Hospital João de Barros Barreto, Federal University of Pará, Belém, Pará, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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7
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Baykal C, Atcı T, Yılmaz Z, Büyükbabani N. Skin tumors in xeroderma pigmentosum: Evaluation of a large series and a literature review. J Cutan Pathol 2021; 48:884-895. [PMID: 33569789 DOI: 10.1111/cup.13979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/06/2021] [Accepted: 02/02/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a rare genodermatosis with a lifelong propensity to develop malignant skin tumors. METHODS In this retrospective study, 24 XP patients were evaluated with regard to frequency and clinicopathological features of benign and malignant skin tumors. RESULTS Seventeen patients had at least one malignant skin tumor diagnosed: basal cell carcinoma (BCC) in 13 patients (n = 72), basosquamous carcinoma in three patients (n = 4), squamous cell carcinoma in six patients (n = 13), keratoacanthoma in three patients (n = 15), and melanoma in six patients (n = 18). Most melanomas (n = 15) were in situ lesions. Several benign skin tumors were noted such as tricholemmoma (n = 1), trichoepithelioma (n = 1), trichoblastoma (n = 1), follicular infundibulum tumor (n = 1), keratoacanthoma-like follicular lesion (n = 1), adnexal tumors with folliculosebaceous (n = 1) and tricholemmal differentiation (n = 1), and neurofibroma (n = 1). Benign vascular proliferations including pyogenic granulomas (n = 8), widespread telangiectasias, and senile angioma-like lesions were also observed in 3, 5, and 5 patients, respectively. CONCLUSIONS Similar to many reports, BCC was found to be the most common malignant skin tumor. The high prevalence of benign adnexal tumors of follicular differentiation, some of them showing mixed histopathological features and various vascular proliferations in our series raises the question of whether they indicate a formerly undescribed association with XP.
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Affiliation(s)
- Can Baykal
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tuğba Atcı
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Yılmaz
- Department of Dermatology and Venereology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nesimi Büyükbabani
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Carneiro MC, Kimura TDC, Tolentino EDS, Pieralisi N, Veltrini VC. Unusual intraoral cancer with unexpected outcome in a patient with xeroderma pigmentosum: An alert for antineoplastic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:e1-e11. [PMID: 31706804 DOI: 10.1016/j.oooo.2019.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/03/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal disorder characterized by extreme sensitivity to ultraviolet radiation. DNA repair mechanisms are impaired, and minimal sun exposure can lead to the development of cutaneous neoplasms in very young patients. Intraoral carcinomas are uncommon and, when present, are located mainly at the tongue tip. We report an unprecedented case of squamous cell carcinoma (SCC) in the floor of mouth of a 23-year-old woman with XP. The patient was referred to the oncologist, and 2 months after surgical resection, she underwent a single session of chemotherapy plus radiotherapy. However, she died 73 hours after undergoing her first chemotherapy session. Considering the unexpected outcome of this case, we also investigated possible exacerbated adverse effects of antineoplastic treatments (especially cisplatin-based chemotherapy) in patients with XP and reviewed the main characteristics of the disease, especially cases with oral manifestations reported in the literature.
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Affiliation(s)
| | | | | | - Neli Pieralisi
- Department of Dentistry, State University of Maringá, Maringá, PR, Brazil
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9
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Ventéjou S, Bagny K, Waldmeyer J, Cartault F, Machet L, Osdoit S. Skin cancers in patients of skin phototype V or VI with xeroderma pigmentosum type C (XP-C): A retrospective study. Ann Dermatol Venereol 2019; 146:192-203. [PMID: 30853323 DOI: 10.1016/j.annder.2018.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/24/2018] [Accepted: 11/28/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a rare genetic disease comprising 7 subgroups, A to G, all of which are associated with early onset of several forms of skin cancer. Our main objective was to determine the prevalence of skin cancers in a cohort of dark-skinned XP-C patients in Mayotte. PATIENTS AND METHODS A single-centre cohort consisting of all XP patients was followed in the island of Mayotte from December 2015 to May 2017 by dermatologists from the University Hospital of Saint-Denis (Reunion) during the course of dermatological missions. RESULTS Eighteen patients of median age 12.9 years (7 female/11 male) belonging to 14 families were included. All had XP-C and carried the same mutation. Median age at clinical diagnosis of XP was 1.8 years. A total of 144 skin cancers (94 squamous cell carcinomas [SCC], 30 basal cell carcinomas [BCC], 14 melanomas, 5 sarcomas and 1 sarcomatoid carcinoma) were observed in 11 of the 18 patients (61%). Eleven patients (61%) had at least 1 SCC, 6 (33%) had at least 1 BCC, 6 (33%) had at least 1 melanoma, and 4 (22%) had at least 1 sarcoma. In all, 95.5% of the cancers occurred in light-exposed skin areas. Median age was 5.4 years for the initial cancer and 6.4 years for the second. SCCs and sarcomas occurred earlier than CBCs and melanomas (P<0.0001). All patients had mild to severe poikiloderma and presented photophobia, and 50% had pigmented palmoplantar lesions. One-third had oral mucosal involvement while 78% had ocular or palpebral lesions. Nail and hair involvement was recorded in 17% of patients. The median sun protection score (evaluated on a 7-item scale) was 6/7. The median score on the quality-of-life questionnaire (DLQI) was 4/30. Severity of poikiloderma was significantly correlated with the occurrence of skin cancers. DISCUSSION AND CONCLUSION Our cohort showed a high prevalence of skin cancer in XP-C patients of phototype V and VI exposed to UV radiation in a tropical region. SCCs were the most common tumours. The prevalence of melanoma was high, with major risk compared to controls of the same skin phototype. In addition, we found a high prevalence of sarcomas (5 patients). Initial cancers occurred early (5.4 years) compared to data from the literature, and SCCs and sarcomas occurred significantly sooner than melanomas and BCCs.
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Affiliation(s)
- S Ventéjou
- Service de dermatologie, CHU de La Réunion, 97400 Saint-Denis, La Réunion, France; Service de dermatologie, CHU de Tours, 37000 Tours, France; Université François-Rabelais de Tours, 37000 Tours, France.
| | - K Bagny
- Service de dermatologie, CHU de La Réunion, 97400 Saint-Denis, La Réunion, France
| | - J Waldmeyer
- Service de pédiatrie, centre hospitalier de Mamoudzou, 97600 Mamoudzou,, Mayotte, France
| | - F Cartault
- Service de génétique, CHU de La Réunion, 97400 Saint-Denis, La Réunion, France
| | - L Machet
- Service de dermatologie, CHU de Tours, 37000 Tours, France; Université François-Rabelais de Tours, 37000 Tours, France
| | - S Osdoit
- Service de dermatologie, CHU de La Réunion, 97400 Saint-Denis, La Réunion, France
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Acellular Dermal Matrix: Treating Periocular Melanoma in a Patient with Xeroderma Pigmentosa. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1442. [PMID: 28894662 PMCID: PMC5585435 DOI: 10.1097/gox.0000000000001442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/13/2017] [Indexed: 11/26/2022]
Abstract
We report a 7-year-old girl with xeroderma pigmentosum (XP), who presented in our clinic with a large melanoma (35 × 50 × 20 mm, Breslow depth 18 mm) in the zygomatic-malar area. Palliative surgery was performed to maintain her residual vision and to reduce the pain caused by the compression of local structures. Because of the limited access of autologous skin grafts in pediatric patients with XP who are severely affected, we opted to use an acellular dermal matrix. There was 100% graft uptake, and the pain due to compression by the tumor was alleviated. This case demonstrates that acellular dermal matrices can be safely and effectively used in oncological facial reconstruction, especially in patients with progressive conditions such as XP.
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Kaloga M, Dioussé P, Diatta BA, Bammo M, Kourouma S, Diabate A, Gueye N, Dione H, Diallo M, Diop BM. Squamous Cell Carcinoma in African Children with Xeroderma Pigmentosum: Three Case Reports. Case Rep Dermatol 2016; 8:311-318. [PMID: 27920683 PMCID: PMC5126593 DOI: 10.1159/000452438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/11/2016] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Xeroderma pigmentosum is a rare autosomal recessive genetic disease. This disease predisposes patients to early-onset skin cancers, particularly squamous cell carcinoma. Here, we report 3 pediatric cases, including 2 deaths. OBSERVATION The subjects included 2 boys and 1 girl with skin type VI. All subjects were from consanguineous marriages, and the average age was 7.6 years. The patients all had ulcerative budding tumor lesions in the cephalic region, and the mean disease duration was 18 months. In all 3 cases, the diagnosis of xeroderma pigmentosum was made before the poikilodermal appearance of sun-exposed areas and photophobia. Neurological-type mental retardation was noted in 1 case. Histology confirmed squamous cell carcinoma in all 3 cases. The evolutions were marked by the death of 2 children (cases 1 and 3). In one case, the outcome was favorable following cancer excision and subsequent chemotherapy with adjuvant radiotherapy. CONCLUSION Squamous cell carcinoma is a serious complication related to xeroderma pigmentosum in Sub-Saharan Africa. Prevention is based on the early diagnosis of xeroderma pigmentosum, black skin photoprotection, screening and early treatment of lesions, and genetic counseling.
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Affiliation(s)
- Mamadou Kaloga
- Dermatology, University of Cocody, Abidjan, Côte d'Ivoire
| | - Pauline Dioussé
- Dermatology, Faculty of Health Sciences, University of Thies, Thies, Senegal
| | - Boubacar Ahy Diatta
- Dermatology, Hospital Aristide Le Dantec, Cheikh Anta Diop University, Dakar, Senegal
| | - Mariama Bammo
- Dermatology, Regional Hospital Thies, Thies, Senegal
| | - Sarah Kourouma
- Dermatology, University of Cocody, Abidjan, Côte d'Ivoire
| | - Almamy Diabate
- Dermatology, University Alassane Ouattara, Bouake, Côte d'Ivoire
| | - Ndiaga Gueye
- Dermatology, Regional Hospital Thies, Thies, Senegal
| | - Haby Dione
- Dermatology, Faculty of Health Sciences, University of Thies, Thies, Senegal
| | - Moussa Diallo
- Dermatology, Hospital Aristide Le Dantec, Cheikh Anta Diop University, Dakar, Senegal
| | - Bernard Marcel Diop
- Dermatology, Faculty of Health Sciences, University of Thies, Thies, Senegal
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Leclerc-Mercier S, Bodemer C, Michel B, Soufir N, Bourdon-Lanoy E, Frassatti-Biaggi A, Delanoe P, Fraitag S, Hadj-Rabia S. Melanoma in xeroderma pigmentosum type C children: Overrepresentation of desmoplastic type? J Am Acad Dermatol 2015; 72:e173-6. [DOI: 10.1016/j.jaad.2015.02.1124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 02/14/2015] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
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13
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Greaves M. Was skin cancer a selective force for black pigmentation in early hominin evolution? Proc Biol Sci 2014; 281:20132955. [PMID: 24573849 PMCID: PMC3953838 DOI: 10.1098/rspb.2013.2955] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/23/2014] [Indexed: 02/01/2023] Open
Abstract
Melanin provides a crucial filter for solar UV radiation and its genetically determined variation influences both skin pigmentation and risk of cancer. Genetic evidence suggests that the acquisition of a highly stable melanocortin 1 receptor allele promoting black pigmentation arose around the time of savannah colonization by hominins at some 1-2 Ma. The adaptive significance of dark skin is generally believed to be protection from UV damage but the pathologies that might have had a deleterious impact on survival and/or reproductive fitness, though much debated, are uncertain. Here, I suggest that data on age-associated cancer incidence and lethality in albinos living at low latitudes in both Africa and Central America support the contention that skin cancer could have provided a potent selective force for the emergence of black skin in early hominins.
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Affiliation(s)
- Mel Greaves
- Centre for Evolution and Cancer, Division of Molecular Pathology, Institute of Cancer Research, Brookes Lawley Building, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
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14
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Mortazavi H, Baharvand M, Mehdipour M. Oral potentially malignant disorders: an overview of more than 20 entities. J Dent Res Dent Clin Dent Prospects 2014; 8:6-14. [PMID: 25024833 PMCID: PMC4091702 DOI: 10.5681/joddd.2014.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 08/07/2013] [Indexed: 12/13/2022] Open
Abstract
Cancer of the oral cavity accounts for approximately 3% of all malignancies diagnosed annually in 270,000 patients world-wide. Oral cancer is the 12th most common cancer in women and the 6th in men. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs). Lack of awareness about the signs and symptoms of oralPMDs in the general population and even healthcare providers is believed to be responsible for the diagnostic delay of these entities. The aim of this article is to update and improve the knowledge of healthcare providers about oral PMDs.
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Affiliation(s)
- Hamed Mortazavi
- 1Associate Professor, Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Baharvand
- 1Associate Professor, Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mehdipour
- 1Associate Professor, Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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15
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Bologna SB, Harumi Nakajima Teshima T, Lourenço SV, Nico MMS. An atrophic, telangiectatic patch at the distal border of the tongue: a mucous membrane manifestation of xeroderma pigmentosum. Pediatr Dermatol 2014; 31:e38-41. [PMID: 24456184 DOI: 10.1111/pde.12272] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by clinical and cellular sensitivity, pigmentary changes, and early development of malignancies in sun-exposed mucocutaneous and ocular structures due to a defective ability to repair intracellular DNA damage. Individuals with XP also have a greater frequency of oral cancer, particularly squamous cell carcinoma of the anterior third of the tongue. The current study reports four cases of XP that exhibited a characteristic crescent-shaped, atrophic, telangiectatic area on the distal border of the tongue and correlates this lesion with the development of tumors at this site during follow-up. The tongue lesion was photographed and biopsied in the four patients. During routine follow-up visits, new biopsies were performed if additional tongue lesions were observed. The studied lesions were similar in the four patients. During follow-up, squamous cell carcinoma developed in one patient and pyogenic granuloma developed in three patients and was relapsing in one. The lesion remained stable in one patient during the study. The atrophic and telangiectatic patches probably occur because of chronic sun damage to the exposed portion of the tongue, and this area has a high predisposition for the development of benign and malignant tumors.
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Affiliation(s)
- Sheyla Batista Bologna
- Department of Dermatology, School of Medicine, University of São Paulo, São Paulo, Brazil
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Abstract
OBJECTIVES To describe the epidemiology and an aetiological model of ocular surface squamous neoplasia (OSSN) in Africa. METHODS Systematic and non-systematic review methods were used. Incidence was obtained from the International Agency for Research on Cancer. We searched PubMed, EMBASE, Web of Science and the reference lists of articles retrieved. Meta-analyses were conducted using a fixed-effects model for HIV and cigarette smoking and random effects for human papilloma virus (HPV). RESULTS The incidence of OSSN is highest in the Southern Hemisphere (16° South), with the highest age-standardised rate (ASR) reported from Zimbabwe (3.4 and 3.0 cases/year/100 000 population for males and females, respectively). The mean ASR worldwide is 0.18 and 0.08 cases/year/100 000 among males and females, respectively. The risk increases with exposure to direct daylight (2-4 h, OR = 1.7, 95% CI: 1.2-2.4 and ≥5 h OR = 1.8, 95% CI: 1.1-3.1) and outdoor occupations (OR = 1.7, 95% CI: 1.1-2.6). Meta-analysis also shows a strong association with HIV (6 studies: OR = 6.17, 95% CI: 4.83-7.89) and HPV (7 studies: OR = 2.64, 95% CI: 1.27-5.49) but not cigarette smoking (2 studies: OR = 1.40, 95% CI: 0.94-2.09). The effect of atopy, xeroderma pigmentosa and vitamin A deficiency is unclear. CONCLUSIONS Africa has the highest incidence of OSSN in the world, where males and females are equally affected, unlike other continents where male disease predominates. African women probably have increased risk due to their higher prevalence of HIV and HPV infections. As the survival of HIV-infected people increases, and given no evidence that anti-retroviral therapy (ART) reduces the risk of OSSN, the incidence of OSSN may increase in coming years.
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Affiliation(s)
- Stephen Gichuhi
- Department of Ophthalmology, University of NairobiNairobi, Kenya
- London School of Hygiene and Tropical MedicineLondon, UK
| | - Mandeep S Sagoo
- Moorfields Eye HospitalLondon, UK
- UCL Institute of Ophthalmology, University College LondonUK
| | - Helen A Weiss
- London School of Hygiene and Tropical MedicineLondon, UK
| | - Matthew J Burton
- London School of Hygiene and Tropical MedicineLondon, UK
- Moorfields Eye HospitalLondon, UK
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Hadj-Rabia S, Oriot D, Soufir N, Dufresne H, Bourrat E, Mallet S, Poulhalon N, Ezzedine K, Ezzedine E, Grandchamp B, Taïeb A, Catteau B, Sarasin A, Bodemer C. Unexpected extradermatological findings in 31 patients with xeroderma pigmentosum type C. Br J Dermatol 2013; 168:1109-13. [PMID: 23278166 DOI: 10.1111/bjd.12183] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Xeroderma pigmentosum type C (XP-C) is a rare, autosomal, recessive condition characterized by the association of various clinical manifestations mostly involving the skin and eyes. OBJECTIVES To evaluate the clinical manifestations in a homogeneous, genetically characterized cohort of patients with XP-C. METHODS All patients with XP-C, which was confirmed genetically or by unscheduled DNA synthesis, from the registry of our department and from the French association of patients 'Les Enfants de la Lune' were contacted. During a planned consultation, clinical information was collected using a standardized case-record form. RESULTS In total, 31 patients were seen. The mean age at diagnosis was 2.95 years; skin symptoms started at a mean age of 1.49 years. Among the patients, 52% had relatively short stature, with a height-for-weight z-score below -1 SD; 62% showed pyramidal syndrome and 45% had photophobia and/or conjunctivitis. Four patients had several pyogenic granulomas. Twenty-four patients (77%) had skin cancer. The mean age of onset of the first skin cancer was 4.76 years (range 2-14.5 years). Basal-cell carcinoma was the most frequent cancer. Melanomas were rare and mostly desmoplastic. Multinodular thyroid was the most frequent internal tumour. CONCLUSIONS Our data highlight several new aspects of XP-C. Patients with XP-C are at risk of developing pyogenic granulomas, desmoplastic melanomas and multinodular thyroid. Involvement of the central nervous system is frequent, but its mechanism remains unclear. The relatively short stature of the patients needs further investigation in order to be explained. XP-C is not only a cancer-prone disorder but is also a polysystemic disorder.
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Affiliation(s)
- S Hadj-Rabia
- Department of Dermatology, Hôpital Necker - Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France.
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18
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Expression of matrix metalloproteinase-13 and Ki-67 in nonmelanoma skin cancer in xeroderma pigmentosum and non-xeroderma pigmentosum. Am J Dermatopathol 2013; 35:45-9. [PMID: 22722466 DOI: 10.1097/dad.0b013e31825aa334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Xeroderma pigmentosum (XP) is a heterogenous group of genetic diseases in which basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer (NMSC) followed by squamous cell carcinoma (SCC). The aim of this study was to investigate the expression of matrix metalloproteinase (MMP)-13 and Ki-67 in SCC and BCC from patients with and without XP to elucidate their roles in the pathogenesis of these highly aggressive tumors in patients with XP. Immunolabeling using MMP-13 and Ki-67 antibodies was performed on tissue sections derived from skin biopsies of SCC and BCC of 15 patients with XP and 40 non-XP patients. There was no significant difference between XP and non-XP patients as regards MMP-13 expression by epithelial and stromal cells of SCC or BCC. Ki-67 expression in SCC and BCC of patients with XP was significantly higher than in non-XP patients. We concluded that the higher expression of Ki-67 in NMSC of patients with XP than of non-XP patients may reflect the growth and invasive capacity of these tumors in patients with XP. MMP-13 is expressed by tumor epithelial cells, stromal and inflammatory cells of NMSC of both XP and non-XP patients.
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Hajdarbegovic E, Verkouteren J, Balak D. Non-melanoma skin cancer: The hygiene hypothesis. Med Hypotheses 2012; 79:872-4. [DOI: 10.1016/j.mehy.2012.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 09/20/2012] [Indexed: 10/27/2022]
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Lopes-Cardoso C, Paes da Silva Ramos Fernandes LM, Ferreira-Rocha J, Teixeira-Soares C, Antônio-Barreto J, Humberto-Damante J. Xeroderma Pigmentosum - A case report with oral implications. J Clin Exp Dent 2012; 4:e248-51. [PMID: 24558564 PMCID: PMC3917633 DOI: 10.4317/jced.50727] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 05/04/2012] [Indexed: 11/20/2022] Open
Abstract
Xeroderma Pigmentosum is a rare autosomal recessive genetic disorder characterized by defective DNA repair leading to clinical and cellular hypersensitivity to ultraviolet radiation and carcinogenic agents. Important clinical features are: intense cutaneous photosensitivity, xerosis, poikiloderma, actinic keratosis, acute burning under minimal sun exposure, erythemas, hyperpigmented lentiginous macules, and malignant lesions in sun-exposed areas, including basocellular carcinoma, squamous cell carcinoma, and melanoma. There is a great involvement of many parts of the body, especially head and neck. The oral manifestations are mainly related to the occurrence of malignant tumors in the lips, tongue and buccal mucosa. This paper reports a rare case of Xeroderma Pigmentosum in a 41-year-old male presenting mainly dermatological, neurological and ophthalmological involvement. Oral implications such as severe oral pain and mouth opening limitation were present due to perioral scars. In addition, this paper discuss some important aspects concerning the role of the dental professional management of this entity, since XP patients require constant dental care and follow-up in order to control the occurrence of new lesions on the lips or inside oral cavity.
Key words:Actinic cheilitis, oral involvement, Xeroderma pigmentosum.
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Affiliation(s)
- Camila Lopes-Cardoso
- DDS, MSc, PhD student, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Julierme Ferreira-Rocha
- DDS, MSc. Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | | | | | - José Humberto-Damante
- DDS, MSc, PhD. Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Ramkumar HL, Brooks BP, Cao X, Tamura D, DiGiovanna JJ, Kraemer KH, Chan CC. Ophthalmic manifestations and histopathology of xeroderma pigmentosum: two clinicopathological cases and a review of the literature. Surv Ophthalmol 2011; 56:348-61. [PMID: 21684361 PMCID: PMC3137889 DOI: 10.1016/j.survophthal.2011.03.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 02/24/2011] [Accepted: 03/01/2011] [Indexed: 11/22/2022]
Abstract
Xeroderma pigmentosum is a rare, autosomal recessive disease caused by a defect in DNA repair. Patients with xeroderma pigmentosum often have cutaneous and ocular sun sensitivity, freckle-like skin pigmentation, multiple skin and eye cancers, and, in some patients, progressive neurodegeneration. Xeroderma pigmentosum predominantly affects the ultraviolet (UV) exposed ocular surface, resulting in eyelid atrophy and cancers, corneal dryness, exposure keratopathy, and conjunctival tumors. We report the clinical history and ocular pathology of two white women who had xeroderma pigmentosum with neurological degeneration: Case 1 (died at age 44 years) and Case 2 (died at age 45 years). Case 1, with mutations in the XPA gene, had more than 180 basal cell carcinomas of her skin and eyelids and died from complications of neurodegeneration. Case 2, with mutations in the XPD gene, was sun-protected and had three skin cancers. She died from complications of neurodegeneration and pneumonia. Both patients had bilateral pinguecula, corneal pannus, and exposure keratopathy. Case 1 had bilateral optic atrophy, and Case 2 had bilateral peripheral retinal pigmentary degeneration. Both patients developed retinal gliosis. The ophthalmic manifestations and pathology of xeroderma pigmentosum are discussed and reviewed with respect to this report and other cases in the literature. These cases illustrate the role of DNA repair in protection of the eyes from UV damage and neurodegeneration of the retina.
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Affiliation(s)
- Hema L. Ramkumar
- Immunopathology Section, Laboratory of Immunology, Chevy Chase, MD, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, 20611, USA
| | - Brian P. Brooks
- Unit on Pediatric, Developmental and Genetic Ophthalmology, Ophthalmic Genetics and Visual Function Branch; National Eye Institute, Peking University, Beijing, China
| | - Xiaoguang Cao
- Immunopathology Section, Laboratory of Immunology, Chevy Chase, MD, USA
- Department of Ophthalmology, People’s Hospital, Peking University, Beijing, China
| | - Deborah Tamura
- DNA Repair Section, Dermatology Branch, National Cancer Institute; National Institutes of Health, Bethesda, MD 20892-1857, USA
| | - John J. DiGiovanna
- DNA Repair Section, Dermatology Branch, National Cancer Institute; National Institutes of Health, Bethesda, MD 20892-1857, USA
| | - Kenneth H. Kraemer
- DNA Repair Section, Dermatology Branch, National Cancer Institute; National Institutes of Health, Bethesda, MD 20892-1857, USA
| | - Chi-Chao Chan
- Immunopathology Section, Laboratory of Immunology, Chevy Chase, MD, USA
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22
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Bradford PT, Goldstein AM, Tamura D, Khan SG, Ueda T, Boyle J, Oh KS, Imoto K, Inui H, Moriwaki SI, Emmert S, Pike KM, Raziuddin A, Plona TM, DiGiovanna JJ, Tucker MA, Kraemer KH. Cancer and neurologic degeneration in xeroderma pigmentosum: long term follow-up characterises the role of DNA repair. J Med Genet 2011; 48:168-76. [PMID: 21097776 PMCID: PMC3235003 DOI: 10.1136/jmg.2010.083022] [Citation(s) in RCA: 309] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The frequency of cancer, neurologic degeneration and mortality in xeroderma pigmentosum (XP) patients with defective DNA repair was determined in a four decade natural history study. METHODS All 106 XP patients admitted to the National Institutes of Health from 1971 to 2009 were evaluated from clinical records and follow-up. RESULTS In the 65 per cent (n=69) of patients with skin cancer, non-melanoma skin cancer (NMSC) was increased 10,000-fold and melanoma was increased 2000-fold in patients under age 20. The 9 year median age at diagnosis of first non-melanoma skin cancer (NMSC) (n=64) was significantly younger than the 22 year median age at diagnosis of first melanoma (n=38)-a relative age reversal from the general population suggesting different mechanisms of carcinogenesis between NMSC and melanoma. XP patients with pronounced burning on minimal sun exposure (n=65) were less likely to develop skin cancer than those who did not. This may be related to the extreme sun protection they receive from an earlier age, decreasing their total ultraviolet exposure. Progressive neurologic degeneration was present in 24% (n=25) with 16/25 in complementation group XP-D. The most common causes of death were skin cancer (34%, n=10), neurologic degeneration (31%, n=9), and internal cancer (17%, n=5). The median age at death (29 years) in XP patients with neurodegeneration was significantly younger than those XP patients without neurodegeneration (37 years) (p=0.02). CONCLUSION This 39 year follow-up study of XP patients indicates a major role of DNA repair genes in the aetiology of skin cancer and neurologic degeneration.
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Affiliation(s)
- Porcia T. Bradford
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD
| | - Alisa M. Goldstein
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD
| | - Deborah Tamura
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | | | - Takahiro Ueda
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | - Jennifer Boyle
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | - Kyu-Seon Oh
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | - Kyoko Imoto
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | - Hiroki Inui
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | | | - Steffen Emmert
- Dermatology Branch, National Cancer Institute, Bethesda, MD
| | - Kristen M. Pike
- Laboratory of Molecular Technology, National Cancer Institute at Frederick, Science Applications International Corporation, Frederick, MD
| | - Arati Raziuddin
- Laboratory of Molecular Technology, National Cancer Institute at Frederick, Science Applications International Corporation, Frederick, MD
| | - Teri M. Plona
- Laboratory of Molecular Technology, National Cancer Institute at Frederick, Science Applications International Corporation, Frederick, MD
| | - John J. DiGiovanna
- Dermatology Branch, National Cancer Institute, Bethesda, MD
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Margaret A. Tucker
- Genetic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, MD
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23
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Orosco RK, Wang T, Byrne PJ. Xeroderma Pigmentosum in an African-American. ACTA ACUST UNITED AC 2011; 73:162-5. [DOI: 10.1159/000328343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 04/05/2011] [Indexed: 11/19/2022]
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24
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Schaffer JV, Orlow SJ. Radiation Therapy for High-Risk Squamous Cell Carcinomas in Patients with Xeroderma Pigmentosum: Report of Two Cases and Review of the Literature. Dermatology 2011; 223:97-103. [PMID: 22024645 DOI: 10.1159/000324509] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Accepted: 01/21/2011] [Indexed: 11/19/2022] Open
Affiliation(s)
- Julie V Schaffer
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY 10016, USA. julie.schaffer @ nyumc.org
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