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Belysheva T, Nasedkina T, Kletskaya I, Volchek D, Barinova I, Semenova V, Gadzhigoroeva A, Zelenova E, Valiev T, Sharapova E, Michenko A, Allenova A, Ponomareva D. Case report: Variability in clinical manifestations within a family with incontinentia pigmenti. Front Med (Lausanne) 2024; 11:1402577. [PMID: 39086952 PMCID: PMC11288940 DOI: 10.3389/fmed.2024.1402577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/28/2024] [Indexed: 08/02/2024] Open
Abstract
Diagnosing skin diseases in children can be a complex interdisciplinary problem. Incontinentia pigmenti (IP), also known as Bloch-Sulzberger syndrome, is a rare hereditary genodermatosis related to a mutation in the IKBKG gene. We present a family case of IP described from the perspective of various specialists, including dermatologists, oncologists, geneticists, dentists, and trichologists. The peculiarity of this case is the development of squamous cell carcinoma (SCC) on the shin of a 10-year-old female patient with IP. The patient had a positive family history: her mother and two sisters also displayed clinical manifestations of IP with involvement of skin, teeth and hair. The presence of exons 4-10 deletion in the IKBKG gene in all affected females was confirmed by detailed genetic evaluation using long-range PCR, and also high degree of X-chromosome inactivation skewing was demonstrated. The family underwent a comprehensive examination and was followed up for 2 years with successful symptomatic treatment of dermatologic manifestations. Recommendations were also made regarding dental and hair problems. By the end of the follow-up period, patients had stabilized, with the exception of a 36-year-old mother who developed generalized morphea. The study demonstrates the varying expressiveness of clinical symptoms among family members and emphasizes the importance of timely diagnosis for effective management of patients with IP.
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Affiliation(s)
- Tatiana Belysheva
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
| | - Tatiana Nasedkina
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Irina Kletskaya
- Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - Dana Volchek
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - Irina Barinova
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Vera Semenova
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Aida Gadzhigoroeva
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Ekaterina Zelenova
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Timur Valiev
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elena Sharapova
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
| | - Anna Michenko
- Federal State Budgetary Institution "Central State Medical Academy" of the Administrative Department of the President of the Russian Federation, Moscow, Russia
- Medical Scientific and Educational Center of Lomonosov Moscow State University, Moscow, Russia
- International Institute of Psychosomatic Health, Moscow, Russia
| | - Anastasiia Allenova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Zadurska M, Rakowska A, Czochrowska E, Laskowska M, Perkowski K, Strużycka I, Rudnicka L, Jurek A. Hair Evaluation in Orthodontic Patients with Oligodontia. Diagnostics (Basel) 2024; 14:945. [PMID: 38732359 PMCID: PMC11083739 DOI: 10.3390/diagnostics14090945] [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: 02/04/2024] [Revised: 03/03/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Oligodontia can be isolated or syndromic, associated with other ectodermal abnormalities. The aim of the study was to perform hair examination in orthodontic patients diagnosed with oligodontia with a low clinical expression of symptoms of ectodermal origin. All available orthodontic patients diagnosed with oligodontia in the permanent dentition were enrolled. Hair examination included clinical evaluation of the patients' hair, trichoscopy, trichogram and evaluation of the hair shafts under a polarized light microscope. In total, 25 patients, 18 males and 7 females, aged 6 to 24 years were evaluated for the presence of dental and hair abnormalities. The number of congenitally absent teeth ranged from 6 to 24 teeth and diastemas, microdontia, taurodontism and altered tooth shape were found in 23 patients. Hair disorders were found in 68% of the subjects. Hypotrichosis, the heterogeneity of shaft color and loss of pigment, androgenetic alopecia, telogen effluvium, trichoschisis, pili canaliculi, trichorrhexis nodosa and pseudomoniletrix were observed. Trichoscopy and trichogram are valid non-invasive diagnostic tests which could be used to differentiate between isolated and syndromic oligodontia in patients with a low clinical expression of ectodermal symptoms.
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Affiliation(s)
- Małgorzata Zadurska
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, 02-097 Warsaw, Poland (L.R.)
| | - Ewa Czochrowska
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Małgorzata Laskowska
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Konrad Perkowski
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
| | - Izabela Strużycka
- Department of Comprehensive Dentistry, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-097 Warsaw, Poland (L.R.)
| | - Agnieszka Jurek
- Department of Orthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.Z.); (E.C.); (M.L.); (K.P.)
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Bhat Y, Trumboo T, Krishan K. Hair shaft disorders in children – An update. Indian Dermatol Online J 2023; 14:163-171. [PMID: 37089857 PMCID: PMC10115339 DOI: 10.4103/idoj.idoj_7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/18/2022] [Accepted: 06/30/2022] [Indexed: 03/12/2023] Open
Abstract
Disorders of hair shaft are a diverse group of congenital and acquired abnormalities of the hair that can pose a diagnostic and therapeutic challenge to the dermatologists. Hair shaft abnormalities can occur as an isolated phenomenon or can be associated with an underlying genetic syndrome. Any change in the texture, appearance, and growth of the hair should prompt evaluation of the patient for the presence of any hair shaft anomaly. The diagnosis can be suggested by a complete history and physical examination of the hair-bearing areas as well as other ectodermal structures (nails and teeth). A key feature in the evaluation of hair shaft defects is to determine the fragility of the hair shaft that can be elucidated by performing the "tug test." Trichoscopy and light microscopy serve as valuable tools in establishing the specific type of hair shaft disorder. An update of the approach for the diagnosis and management is included in this review.
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Pili Torti: A Feature of Numerous Congenital and Acquired Conditions. J Clin Med 2021; 10:jcm10173901. [PMID: 34501349 PMCID: PMC8432236 DOI: 10.3390/jcm10173901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180° along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, cataracts, and chronic graft-vs.-host disease). The condition may also be induced by several drugs (epidermal growth factor receptor inhibitors, oral retinoids, sodium valproate, and carbamide perhydrate). The diagnosis of pili torti is based on trichoscopic or microscopic examination. As pili torti is a marker of numerous congenital and acquired disorders, in every case, the search for the signs of underlying conditions is recommended.
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Peña-Romero AG, Sáez-de-Ocariz M, Toussaint-Caire S, Morán-Villaseñor E, Orozco-Covarrubias L, Durán-McKinster C. Clinical, trichoscopy, and light microscopic findings in hypohidrotic ectodermal dysplasia: Report of 21 patients and a review of the literature. Pediatr Dermatol 2021; 38:442-448. [PMID: 33085121 DOI: 10.1111/pde.14415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Hypohidrotic ectodermal dysplasia (HED) is a genetic condition typified by alterations in skin structures including sweat glands, hair, nails, and teeth. Hair findings in HED have been poorly characterized in larger series. OBJECTIVE To characterize scalp and hair findings of patients with HED clinically and with trichoscopy and light microscopy. METHODS A cross-sectional study in 21 pediatric HED patients was performed using available clinical and scalp dermatoscopic images, as well as pulled-hair samples for clinical evaluation, trichoscopic, and light microscopic analyses. RESULTS Seventeen out of 21 patients (81%) were men. Twenty patients had straight hair. Sixteen patients had decreased hair density, 6 of whom had hair loss mainly in the temporal and occipital regions. Fourteen patients had hair whorls. On trichoscopy, we observed: single-hair follicular units (n = 19, 90%), scalp hyperpigmentation (n = 13, 62%), variable diameter of the hair shafts (n = 12, 57%), perifollicular scales (n = 8, 38%), scalp erythema (n = 8, 38%), and short curly pigtail hairs (n = 6, 29%). On light microscopy, findings included: hair shafts with irregular diameter (n = 7, 33%), heterogeneous hair color (n = 6, 29%), trichoptilosis (n = 2, 10%), and pili torti (n = 1, 5%). CONCLUSIONS In this series, hair findings in HED were similar to those described in previous studies. However, we describe two new clinical and two trichoscopic findings: decreased hair density mainly in the temporal and occipital regions, oblique upwards occipital hair follicles orientation, angled hairs, and short curly pigtail hairs. These heterogeneous findings may reflect the multiple factors and signaling pathways that can be affected in these syndromes.
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Affiliation(s)
| | | | - Sonia Toussaint-Caire
- Dermatopathology Department, Dermatology Division, Hospital General "Dr. Manuel Gea González", Tlalpan, Mexico City, Mexico
| | - Edna Morán-Villaseñor
- Dermatology Department, Instituto Nacional de Pediatría, Coyoacán, Mexico City, Mexico
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Ahmed A, Almohanna H, Griggs J, Tosti A. Genetic Hair Disorders: A Review. Dermatol Ther (Heidelb) 2019; 9:421-448. [PMID: 31332722 PMCID: PMC6704196 DOI: 10.1007/s13555-019-0313-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 12/23/2022] Open
Abstract
Hair loss in early childhood represents a broad differential diagnosis which can be a diagnostic and therapeutic challenge for a physician. It is important to consider the diagnosis of a genetic hair disorder. Genetic hair disorders are a large group of inherited disorders, many of which are rare. Genetic hair abnormalities in children can be an isolated phenomenon or part of genetic syndromes. Hair changes may be a significant finding or even the initial presentation of a syndrome giving a clue to the diagnosis, such as Netherton syndrome and trichothiodystrophy. Detailed history including family history and physical examination of hair and other ectodermal structures such as nails, sweat glands, and sebaceous glands with the use of dermoscopic devices and biopsy all provide important clues to establish the correct diagnosis. Understanding the pathophysiology of genetic hair defects will allow for better comprehension of their treatment and prognosis. For example, in patients with an isolated hair defect, the main problem is aesthetic. In contrast, when the hair defect is associated with a syndrome, the prognosis will depend mainly on the associated condition. Treatment of many genetic hair disorders is focused on treating the primary cause and minimizing trauma to the hair.
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Affiliation(s)
- Azhar Ahmed
- Department of Dermatology, King Fahad General Hospital, Medina, Saudi Arabia.
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA.
| | - Hind Almohanna
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Jacob Griggs
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
| | - Antonella Tosti
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, University of Miami Hospital, Miami, FL, USA
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Someshwar S, Lodha A. Hypohidrotic ectodermal dysplasia with autosomal inheritance: A rare entity. MULLER JOURNAL OF MEDICAL SCIENCES AND RESEARCH 2019. [DOI: 10.4103/mjmsr.mjmsr_41_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rudnicka L, Olszewska M, Waśkiel A, Rakowska A. Trichoscopy in Hair Shaft Disorders. Dermatol Clin 2018; 36:421-430. [DOI: 10.1016/j.det.2018.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Rossi A, Miraglia E, Fortuna M, Calvieri S, Giustini S. Topical cetirizine and oral vitamin D: a valid treatment for hypotrichosis caused by ectodermal dysplasia. J Eur Acad Dermatol Venereol 2017; 31:367-370. [DOI: 10.1111/jdv.13864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A. Rossi
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - E. Miraglia
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - M.C. Fortuna
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - S. Calvieri
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - S. Giustini
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
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