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Lipner SR. This Month in JAAD Reviews: October 2024: A link between incontinentia pigmenti and squamous cell carcinoma. J Am Acad Dermatol 2024:S0190-9622(24)02566-0. [PMID: 39111595 DOI: 10.1016/j.jaad.2024.07.1483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 08/18/2024]
Affiliation(s)
- Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York.
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2
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Hübner S, Schwieger-Briel A, Technau-Hafsi K, Danescu S, Baican A, Theiler M, Weibel L, Has C. Phänotypisches und genetisches Spektrum von Incontinentia pigmenti – eine große Fallserie. J Dtsch Dermatol Ges 2022; 20:35-44. [PMID: 35040575 DOI: 10.1111/ddg.14638_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
HINTERGRUND Incontinentia pigmenti ist eine seltene X-chromosomal dominant vererbte Systemerkrankung, die vor allem die Haut, aber auch andere neuroektodermale Gewebe wie Zähne, Haare, Augen und das zentrale Nervensystem betrifft. PATIENTEN UND METHODIK Diese multizentrische Fallserienstudie wurde an drei europäischen Hautkliniken durchgeführt und umfasste 30 Patienten mit Incontinentia pigmenti. Zwanzig Patienten wurden klinisch und genetisch untersucht, weitere zehn nur genetisch. ERGEBNISSE Die Studie umfasste 28 Frauen und zwei Männer mit einem medianen Alter von drei Jahren. Kutane Manifestationen zeigten sich bei allen 20 Patienten mit klinischen Daten. Stadium I wurde in 90 % dieser Patienten beobachtet. Stadium IV wurde bereits im Alter von einem Jahr beobachtet. Zahn- (81 %), Haar- (78 %) und neurologische Anomalien (53 %) waren häufiger als in bisherigen Berichten. Vierzehn Hautbiopsien zeigten typische Merkmale des entsprechenden Stadiums. Genetische Tests wurden bei 24 Patienten durchgeführt, von denen 14 die häufige Exon 4-10-Deletion und sieben andere pathogene Varianten aufwiesen, darunter drei unveröffentlichte Mutationen. In drei weiteren Fällen wurden keine genetischen Veränderungen gefunden. SCHLUSSFOLGERUNGEN In dieser Studie reichte der Phänotyp von lediglich subtil ausgeprägter Hautbeteiligung bis hin zu schweren Multisystemerkrankungen. Die extrakutane Beteiligung sollte zum Zeitpunkt der Diagnose und in regelmäßigen Abständen evaluiert werden, da sich einige Manifestationen erst mit der Zeit entwickeln. SUMMARY Background and objectives Incontinentia pigmenti is a rare X-linked dominantly inherited systemic disease affecting primarily the skin but also other neuroectodermal tissues such as teeth, hair, eyes, and the central nervous system. Patients and methods This multicenter case series study was conducted at three European departments of Dermatology including 30 patients with incontinentia pigmenti. Twenty patients were evaluated clinically and genetically, another ten only genetically. Results The study included 28 females and two males with a median age of three years. Cutaneous manifestations were present in all 20 patients with clinical data. Stage I was observed in 90 % of those patients. Stage IV was observed as early as one year of age. Dental (81 %), hair (78 %) and neurological anomalies (53 %) were more frequent than previously reported. Fourteen skin biopsies showed typical features of the corresponding stage. Genetic testing of 24 patients revealed the common exon 4-10 deletion in 14 cases and seven other pathogenic variants, including three unpublished mutations. In another three cases, no genetic alterations were found. Conclusions In this study, the phenotype ranged from only subtle cutaneous involvement to severe multisystemic disorders. Extracutaneous involvement should be evaluated at the time of diagnosis and in regular intervals, as some manifestations may develop over time.
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Affiliation(s)
- Stefanie Hübner
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Deutschland
| | | | | | - Sorina Danescu
- Klinik für Dermatologie, Iuliu Haţieganu Universität für Medizin und Pharmazie, Cluj-Napoca, Rumänien
| | - Adrian Baican
- Klinik für Dermatologie, Iuliu Haţieganu Universität für Medizin und Pharmazie, Cluj-Napoca, Rumänien
| | - Martin Theiler
- Pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Schweiz
| | - Lisa Weibel
- Pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Schweiz
| | - Cristina Has
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Deutschland.,Europäisches Referenznetzwerk (ERN) für seltene und nicht-diagnostizierte Hauterkrankungen
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3
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Hübner S, Schwieger-Briel A, Technau-Hafsi K, Danescu S, Baican A, Theiler M, Weibel L, Has C. Phenotypic and genetic spectrum of incontinentia pigmenti - a large case series. J Dtsch Dermatol Ges 2021; 20:35-43. [PMID: 34904373 DOI: 10.1111/ddg.14638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Incontinentia pigmenti is a rare X-linked dominantly inherited systemic disease affecting primarily the skin but also other neuroectodermal tissues such as teeth, hair, eyes, and the central nervous system. PATIENTS AND METHODS This multicenter case series study was conducted at three European departments of Dermatology including 30 patients with incontinentia pigmenti. Twenty patients were evaluated clinically and genetically, another ten only genetically. RESULTS The study included 28 females and two males with a median age of three years. Cutaneous manifestations were present in all 20 patients with clinical data. Stage I was observed in 90 % of those patients. Stage IV was observed as early as one year of age. Dental (81 %), hair (78 %) and neurological anomalies (53 %) were more frequent than previously reported. Fourteen skin biopsies showed typical features of the corresponding stage. Genetic testing of 24 patients revealed the common exon 4-10 deletion in 14 cases and seven other pathogenic variants, including three unpublished mutations. In another three cases, no genetic alterations were found. CONCLUSIONS In this study, the phenotype ranged from only subtle cutaneous involvement to severe multisystemic disorders. Extracutaneous involvement should be evaluated at the time of diagnosis and in regular intervals, as some manifestations may develop over time.
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Affiliation(s)
- Stefanie Hübner
- Department of Dermatology, Medical Center-University of Freiburg, Germany
| | - Agnes Schwieger-Briel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital, Zurich, Switzerland
| | | | - Sorina Danescu
- Department of Dermatology, Iuliu Hat˛ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adrian Baican
- Department of Dermatology, Iuliu Hat˛ieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Martin Theiler
- Pediatric Skin Center, Dermatology Department, University Children's Hospital, Zurich, Switzerland
| | - Lisa Weibel
- Pediatric Skin Center, Dermatology Department, University Children's Hospital, Zurich, Switzerland
| | - Cristina Has
- Department of Dermatology, Medical Center-University of Freiburg, Germany.,European Reference Network (ERN) on Rare and Undiagnosed Skin Disorders
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4
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Abstract
This article discusses the histologic findings in key nail unit diseases, including inflammatory, infectious, and neoplastic conditions. The emphasis is on clinicopathologic correlates, best practices to demonstrate the relevant histopathologic features, and pitfalls in diagnosis. Understanding the pathology of these disorders enhances clinical acumen and may affect the choice of biopsy procedures and treatment measures, with the outcome of better clinical care for patients with nail disease.
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Affiliation(s)
- Beth S Ruben
- Palo Alto Medical Foundation Medical Group, Dermatology, 795 El Camino Real, Clark Building, 2nd Floor, Palo Alto, CA 94301, USA.
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5
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A Young Woman With Multiple Painful Subungual Nodules: Answer. Am J Dermatopathol 2019; 41:777. [PMID: 31567299 DOI: 10.1097/dad.0000000000001206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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6
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Paulson N, Gibson J, Glusac E. Perianal and perineal keratoacanthoma: Two cases demonstrating histologic similarity to subungual keratoacanthoma. J Cutan Pathol 2019; 46:794-797. [DOI: 10.1111/cup.13518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/23/2019] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Nathan Paulson
- Department of PathologyYale School of Medicine New Haven Connecticut
| | - Joanna Gibson
- Department of PathologyYale School of Medicine New Haven Connecticut
| | - Earl Glusac
- Department of PathologyYale School of Medicine New Haven Connecticut
- Department of DermatologyYale School of Medicine New Haven Connecticut
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7
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Kibbi N, Totonchy M, Suozzi KC, Ko CJ, Odell ID. A case of subungual tumors of incontinentia pigmenti: A rare manifestation and association with bipolar disease. JAAD Case Rep 2018; 4:737-741. [PMID: 30167449 PMCID: PMC6113656 DOI: 10.1016/j.jdcr.2018.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nour Kibbi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Mariam Totonchy
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Kathleen C Suozzi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Christine J Ko
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Ian D Odell
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
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8
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Barros B, Helm K, Zaenglein A, Seiverling E. Keratoacanthoma-Like Growths of Incontinentia Pigmenti Successfully Treated with Intralesional Methotrexate. Pediatr Dermatol 2017; 34:e203-e204. [PMID: 28414858 DOI: 10.1111/pde.13142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report the case of a 17-year-old girl with incontinentia pigmenti who developed multiple large hyperkeratotic tumors within Blaschkoid hyperpigmented patches on her left leg. Biopsy demonstrated an endoexophytic nodule with irregular invaginations of keratinizing squamous epithelium and a central keratin-filled crater, consistent with keratoacanthoma-like lesions of incontinentia pigmenti. The tumors were successfully treated with intralesional methotrexate.
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Affiliation(s)
- Brittany Barros
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania
| | - Klaus Helm
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania.,Department of Pathology, Pennsylvania State University, Hershey, Pennsylvania
| | - Andrea Zaenglein
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania.,Department of Pediatrics, Pennsylvania State University, Hershey, Pennsylvania
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9
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Cardoso JC, Veraitch O, Gianotti R, Ferrara G, Tomasini CF, Singh M, Zalaudek I, Stefanato CM. 'Hints' in the horn: diagnostic clues in the stratum corneum. J Cutan Pathol 2017; 44:256-278. [PMID: 27717008 DOI: 10.1111/cup.12839] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 10/03/2016] [Accepted: 10/03/2016] [Indexed: 02/06/2023]
Abstract
The stratum corneum or horny layer is the uppermost layer of the epidermis, and is mainly responsible for the skin's barrier function. In spite of its complexity at the ultrastructural and molecular level, the features accessible to visualization on conventional histology are relatively limited. Nevertheless, knowledge of subtle clues that one may observe in the stratum corneum can prove useful in a wide range of situations in dermatopathology. We herein review a selection of common and rare entities in which the horny layer may reveal significantly important hints for the diagnosis. These clues include parakeratosis and its different patterns (focal, confluent, alternating, associated with spongiosis, epidermal hyperplasia or lichenoid changes), subcorneal acantholysis, infectious organisms in the stratum corneum (including fungal, bacterial and parasitic), thickening or thinning of the stratum corneum and the presence of different kinds of pigment. Even when normal, the horny layer may prove to be useful when seen in association with severe epidermal damage, a combination of features testifying to the acute nature of the underlying pathological process.
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Affiliation(s)
- José Carlos Cardoso
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - Ophelia Veraitch
- St John's Institute of Dermatology, St Thomas' Hospital, London, UK
| | - Raffaele Gianotti
- Dermatopathology Laboratory, Department of Dermatology, Universita' degli Studi di Milano, Milano, Italy
| | - Gerardo Ferrara
- Oncology Department, Anatomic Pathology Unit, Gaetano Rummo General Hospital, Benevento, Italy
| | - Carlo F Tomasini
- Dermatopathology, University Hospital Città della Salute e della Scienza, Turin, Italy
| | - Manuraj Singh
- Manuraj Singh, Department of Dermatology, St George's University Hospital, London, UK
| | - Iris Zalaudek
- Iris Zalaudek, Division of Dermatology, Non-Melanoma Skin Cancer Unit, Medical University of Graz, Graz, Austria
| | - Catherine M Stefanato
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.,St John's Institute of Dermatology, St Thomas' Hospital, London, UK
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10
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Jellinek NJ, Vélez NF. Dermatologic Manifestations of the Lower Extremity: Nail Surgery. Clin Podiatr Med Surg 2016; 33:319-36. [PMID: 27215154 DOI: 10.1016/j.cpm.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Nail surgery is a fundamental component of podiatric surgery. Nail disorders are common and may cause significant morbidity and occasionally mortality. Diagnosis of inflammatory and infectious conditions, and of benign or malignant tumors, often requires a biopsy of the nail unit. Excisional surgery may also be curative for certain tumors. This article reviews key elements of nail anatomy, surgical preparation, local anesthesia, and methods to achieve and maintain a bloodless field. A familiarity with these concepts should allow clinicians to develop a surgical plan and approach when patients present with a nail disorder requiring biopsy or surgical treatment.
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Affiliation(s)
- Nathaniel J Jellinek
- Dermatology Professionals, Inc, 1672 South County Trail, Suite 101, East Greenwich, RI 02818, USA; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA; Division of Dermatology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Nicole F Vélez
- Westmoreland Dermatology Associates, Monroeville, PA, USA
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11
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Martínez-López A, Blasco-Morente G, Pérez-López I, García-Durá E. Distal Digital Keratoacanthoma in Patients With Incontinentia Pigmenti. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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12
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Kwiek B, Schwartz RA. Keratoacanthoma (KA): An update and review. J Am Acad Dermatol 2016; 74:1220-33. [PMID: 26853179 DOI: 10.1016/j.jaad.2015.11.033] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 11/03/2015] [Accepted: 11/12/2015] [Indexed: 02/03/2023]
Abstract
Keratoacanthoma (KA) is a common but underreported tumor of the skin. Two striking features of KA are its clinical behavior with spontaneous regression after rapid growth and its nosological position on the border between benignity and malignancy. We review current knowledge on the clinical, histopathological, and dermoscopic features of KA to ensure a proper diagnosis and describe its variants, including different types of multiple KAs. We highlight current concepts of KA ethiopathogenesis with special emphasis on the genetic background of multiple familial KA, the role of Wnt signaling pathway, and induction of KA by BRAF inhibitors and procedures of esthetic dermatology. Finally, treatment strategies are presented with surgical excision as a first option, followed by other modalities, including intralesional chemotherapy, topical and systemic agents, lasers, cryotherapy, and photodynamic therapy.
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Affiliation(s)
- Bartlomiej Kwiek
- Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland.
| | - Robert A Schwartz
- Dermatology and Pathology, Rutgers University New Jersey Medical School, and Rutgers University School of Public Affairs and Administration, Newark, New Jersey
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13
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Distal Digital Keratoacanthoma in Patients With Incontinentia Pigmenti. ACTAS DERMO-SIFILIOGRAFICAS 2015; 107:257-8. [PMID: 26614487 DOI: 10.1016/j.ad.2015.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/01/2015] [Accepted: 08/08/2015] [Indexed: 11/22/2022] Open
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14
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Poziomczyk CS, Bonamigo RR, Santa Maria FD, Zen PRG, Kiszewski AE. Clinical study of 20 patients with incontinentia pigmenti. Int J Dermatol 2015; 55:e87-93. [DOI: 10.1111/ijd.13060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 02/13/2015] [Accepted: 04/08/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia S. Poziomczyk
- Section of Dermatology; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
- Department of Pathology Postgraduate Program; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
| | - Renan R. Bonamigo
- Section of Dermatology; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
- Department of Pathology Postgraduate Program; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
| | - Fernanda D. Santa Maria
- Department of Pathology Postgraduate Program; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
| | - Paulo R. G. Zen
- Department of Pathology Postgraduate Program; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
- Section of Clinical Genetics; Department of Clinical Medicine; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
| | - Ana E. Kiszewski
- Section of Dermatology; Federal University of Health Sciences of Porto Alegre; Porto Alegre Brazil
- Section of Pediatric Dermatology; Hospital da Criança Santo Antônio; Irmandade da Santa Casa de Misericórdia de Porto Alegre; Porto Alegre Brazil
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15
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Ferneiny M, Hadj-Rabia S, Regnier S, Ortonne N, Smahi A, Steffann J, Bonnefont JP, Fraitag S, Chosidow O, Bodemer C. Unique subungueal keratoacanthoma revealing incontinentia pigmenti. J Eur Acad Dermatol Venereol 2015; 30:1401-3. [DOI: 10.1111/jdv.13245] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Ferneiny
- Reference center for genodermatoses and rare skin diseases (MAGEC); Department of Dermatology; Necker-Enfants Malades Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
- Institut Imagine; Paris Descartes University - Sorbonne Paris Cité; Paris France
| | - S. Hadj-Rabia
- Reference center for genodermatoses and rare skin diseases (MAGEC); Department of Dermatology; Necker-Enfants Malades Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
- Institut Imagine; Paris Descartes University - Sorbonne Paris Cité; Paris France
- INSERM U1163; Institut Imagine; Paris France
| | - S. Regnier
- Department of Dermatology; Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; Créteil France
| | - N. Ortonne
- Department of Pathology; Hôpital Henri Mondor; Assistance Publique-Hôpitaux de Paris; Créteil France
| | - A. Smahi
- INSERM U1163; Institut Imagine; Paris France
| | - J. Steffann
- Institut Imagine; Paris Descartes University - Sorbonne Paris Cité; Paris France
- Molecular genetics laboratory; Necker-Enfants Malades Hospital; Assistance Publique- Hôpitaux de Paris; Paris France
| | - J.-P. Bonnefont
- Institut Imagine; Paris Descartes University - Sorbonne Paris Cité; Paris France
- Molecular genetics laboratory; Necker-Enfants Malades Hospital; Assistance Publique- Hôpitaux de Paris; Paris France
| | - S. Fraitag
- Reference center for genodermatoses and rare skin diseases (MAGEC); Department of Dermatology; Necker-Enfants Malades Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
- Department of Pathology; Necker-Enfants-Malades Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
| | - O. Chosidow
- Department of Dermatology; Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; Créteil France
| | - C. Bodemer
- Reference center for genodermatoses and rare skin diseases (MAGEC); Department of Dermatology; Necker-Enfants Malades Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
- Institut Imagine; Paris Descartes University - Sorbonne Paris Cité; Paris France
- INSERM U1163; Institut Imagine; Paris France
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16
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Prieto-Granada C, Rodriguez-Waitkus P. Cutaneous squamous cell carcinoma and related entities: Epidemiology, clinical and histological features, and basic science overview. Curr Probl Cancer 2015; 39:206-15. [DOI: 10.1016/j.currproblcancer.2015.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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17
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18
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Poziomczyk CS, Recuero JK, Bringhenti L, Maria FDS, Campos CW, Travi GM, Freitas AM, Maahs MAP, Zen PRG, Fiegenbaum M, Almeida STD, Bonamigo RR, Bau AEK. Incontinentia pigmenti. An Bras Dermatol 2014; 89:26-36. [PMID: 24626645 PMCID: PMC3938351 DOI: 10.1590/abd1806-4841.20142584] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 04/09/2013] [Indexed: 12/25/2022] Open
Abstract
Incontinentia pigmenti is a rare genodermatosis in which the skin involvement occurs
in all patients. Additionally, other ectodermal tissues may be affected, such as the
central nervous system, eyes, hair, nails and teeth. The disease has a X-linked
dominant inheritance pattern and is usually lethal to male fetuses. The
dermatological findings occur in four successive phases, following the lines of
Blaschko: First phase - vesicles on an erythematous base; second phase - verrucous
hyperkeratotic lesions; third phase - hyperchromic spots and fourth phase -
hypochromic atrophic lesions.
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Affiliation(s)
- Cláudia Schermann Poziomczyk
- Porto Alegre Health Sciences Federal University, Pathology Post-graduation Program, Porto AlegreRS, Brazil, MD, Dermatologist - MSc (in course) at the Pathology Post-graduation Program at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Júlia Kanaan Recuero
- Porto Alegre Health Sciences Federal University, Porto AlegreRS, Brazil, Medical Student at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Luana Bringhenti
- Porto Alegre Health Sciences Federal University, Porto AlegreRS, Brazil, Medical Student at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Fernanda Diffini Santa Maria
- Porto Alegre Health Sciences Federal University, Pathology Post-graduation Program, Porto AlegreRS, Brazil, DDS - MSc (in course) at the Pathology Post-graduation Program at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Carolina Wiltgen Campos
- Santa Casa de Misericórdia de Porto Alegre, Ophthalmology Program, Porto AlegreRS, Brazil, MD - Resident in the Ophthalmology Program at Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brazil
| | - Giovanni Marcos Travi
- Santa Casa de Misericórdia de Porto Alegre, Porto AlegreRS, Brazil, MD - Ophthalmologist with specialization in Pediatric Ophthalmology and Strabismus Licensed physician at Santa Casa de Misericórdia de Porto Alegre- Porto Alegre (RS), Brazil
| | - André Moraes Freitas
- Santa Casa de Misericórdia de Porto Alegre Ophthalmology Service, Ophthalmology Service, Retina Sector, Porto AlegreRS, Brazil, MD - Ophthalmologist - Chief of the Retina Sector at Santa Casa de Misericórdia de Porto Alegre Ophthalmology Service - Porto Alegre (RS), Brazil
| | - Marcia Angelica Peter Maahs
- Rio Grande do Sul Federal University, Porto AlegreRS, Brazil, DDS - Specialist in Orthodontics and Facial Orthopedics at Rio Grande do Sul Federal University (UFRGS). PhD in Dentistry at Rio Grande do Sul Pontifical Catholic University (PUCRS) - Substitute Professor of the Discipline of Orthodontics Applied to Speech Therapy at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Paulo Ricardo Gazzola Zen
- Porto Alegre Health Sciences Federal University, Pathology Post-graduation Program, Porto AlegreRS, Brazil, MD, PhD at the Pathology Post-graduation Program at Porto Alegre Health Sciences Federal University (UFCSPA) - Adjunct Professor of Genetics at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Marilu Fiegenbaum
- Porto Alegre Health Sciences Federal University, Basic Health Sciences Department, Porto AlegreRS, Brazil, Pharm. D. - PhD in Genetics and Molecular Biology at Rio Grande do Sul Federal University (UFRGS) - Adjunct Professor at the Basic Health Sciences Department at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Sheila Tamanini de Almeida
- Porto Alegre Health Sciences Federal University, Speech Therapy Department, Porto AlegreRS, Brazil, Speech-Language Pathologist (SLPs) - Specialist in Orofacial Motricity and Dysphagia. MSc in Health Sciences - Assistant Professor at the Speech Therapy Department at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Renan Rangel Bonamigo
- Porto Alegre Health Sciences Federal University, Pathology Postgraduation Program, Porto AlegreRS, Brazil, MD - PhD in Health Sciences at Rio Grande do Sul Federal University (UFRGS) - Head Professor of Dermatology and Professor of the Pathology Postgraduation Program at Porto Alegre Health Sciences Federal University (UFCSPA) - Porto Alegre (RS), Brazil
| | - Ana Elisa Kiszewski Bau
- Porto Alegre Health Sciences Federal University, Porto AlegreRS, Brazil, MD - PhD in Pathology at Porto Alegre Health Sciences Federal University (UFCSPA)- Adjunct Professor of Dermatology at Porto Alegre Health Sciences Federal University (UFCSPA). Pediatric Dermatologist at Santo Antonio Children's Hospital and at Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brazil
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Martin B. Nail histopathology. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:564-78. [PMID: 23871460 DOI: 10.1016/j.adengl.2013.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Accepted: 09/23/2012] [Indexed: 11/15/2022] Open
Abstract
The structure of the nail unit is complex and many dermatologists and dermatopathologists have an incomplete understanding of it. Familiarity with the anatomy and histology of this unit, however, is a key factor in improving the diagnostic yield of nail biopsy. Inflammatory or infectious conditions that affect the nail can have a marked impact on a patient's quality of life. A wide-ranging variety of tumors can also develop in this region and they may be life-threatening or require surgery that will result in functional defects. The author reviews the anatomy and histology of the nail unit as well as the basic histopathologic findings in the most common conditions affecting the nails.
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Affiliation(s)
- B Martin
- Departamento de Dermatopatología, St John's Institute of Dermatology, St Thomas' Hospital, Londres, UK.
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Ballester Nortes I, Allegue Gallego F, López-Ávila A, Ortiz Reina S, Requena Caballero L. Painful subungual tumours. Clin Exp Dermatol 2013; 38:802-4. [PMID: 23551236 DOI: 10.1111/ced.12053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2012] [Indexed: 11/29/2022]
Affiliation(s)
- I Ballester Nortes
- Department of Dermatology, Hospital Universitario Santa María del Rosell de Cartagena, Murcia, Spain
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Willard KJ, Cappel MA, Kozin SH, Abzug JM. Benign subungual tumors. J Hand Surg Am 2012; 37:1276-86; quiz 1286. [PMID: 22560606 DOI: 10.1016/j.jhsa.2012.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 04/02/2012] [Indexed: 02/02/2023]
Abstract
A variety of benign and malignant processes may affect the subungual region; however, most are relatively rare lesions. We present a review of the current literature regarding benign tumors affecting the subungual region.
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Affiliation(s)
- Katherine J Willard
- Department of Orthopaedics, University of Maryland School of Medicine, Timonium, MD 21093, USA
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Pereira MAC, Mesquita LADF, Budel AR, Cabral CSP, Feltrim ADS. X-linked incontinentia pigmenti or Bloch-Sulzberger syndrome: a case report. An Bras Dermatol 2010; 85:372-5. [PMID: 20676473 DOI: 10.1590/s0365-05962010000300013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 05/08/2009] [Indexed: 11/21/2022] Open
Abstract
Incontinentia pigmenti is a rare X-linked genodermatosis that affects mainly female neonates. Skin manifestations are the most common and occur in four quite distinct phases. A female infant presented vesiculobullous lesions on trunk and limbs, and a verrucous lesion on the right palm. Biopsy revealed eosinophil exocytosis and pigment incontinence, confirming the clinical hypothesis. Although uncommon, incontinentia pigmenti should be taken into consideration as a possible differential diagnosis when vesiculobullous and verrucous lesions are present in childhood.
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Absence of somatic mutations of NEMO in keratoacanthoma. J Invest Dermatol 2009; 129:2518-20. [PMID: 19404319 DOI: 10.1038/jid.2009.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
The role of the transcription factor NF-kappa B, particularly its coupling to inflammation and cancer, has generated considerable interest in recent years. NF-kappa B in the skin is crucial for morphogenesis and homeostasis. Perturbations in its activity are linked to developmental skin defects, inflammatory skin disease, and skin cancer. However, the most striking aspect of NF-kappa B function in the skin is its two-faced behavior--both activation and inhibition of the pathway causes inflammation. In this review, we focus on the role of NF-kappa B in the skin and summarize the current knowledge in the field arising from animal models as well as human disease studies.
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Affiliation(s)
- Inderpreet Sur
- Department of Bioscience and Nutrition, Karolinska Institute, Huddinge, Sweden
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Atasoy M, Aliagaoglu C, Sahin O, Ikbal M, Gursan N. Linear atrophoderma of Moulin together with leuconychia: a case report. J Eur Acad Dermatol Venereol 2006; 20:337-40. [PMID: 16503901 DOI: 10.1111/j.1468-3083.2006.01434.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Linear atrophoderma of Moulin has a distinctive disease pattern characterized by hyperpigmented atrophoderma and was described originally in 1992. It follows the line of Blaschko, and occurs without preceding inflammation, subsequent induration or scleroderma. The lesions usually develop during childhood or adolescence, and the prognosis is good. The diagnosis is made clinically and histopathologically. In our 18-year-old male patient, there were atrophic plaques unilaterally located on the trunk and arm, and white discoloration on all finger nails. Histopathological examination revealed epidermal atrophy together with disruption of collagen fibres.
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Affiliation(s)
- M Atasoy
- Atatürk University, Medical Faculty, Department of Dermatology, Erzurum, Turkey.
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Bittar M, Danarti R, König A, Gal A, Happle R. Late-onset familial onychodystrophy heralding incontinentia pigmenti. Acta Derm Venereol 2005; 85:274-5. [PMID: 16040424 DOI: 10.1080/00015550410026146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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