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Ramos FJM, Corpas TD, Corrales AE, Puchades AM. Congenital localized absence of skin (Bart syndrome) in a patient with dominant dystrophic epidermolysis bullosa. An Pediatr (Barc) 2023; 99:447-448. [PMID: 37598075 DOI: 10.1016/j.anpede.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/26/2023] [Indexed: 08/21/2023] Open
Affiliation(s)
| | - Tania Díaz Corpas
- Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, Spain
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2
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Sharif SA, Mohammadzadeh A, Heidari MM, Por RE. A case report of Bart syndrome. Clin Case Rep 2023; 11:e7612. [PMID: 37384233 PMCID: PMC10293584 DOI: 10.1002/ccr3.7612] [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] [Received: 03/20/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/30/2023] Open
Abstract
Bart syndrome is a rare condition characterized by epidermolysis bullosa (EB), aplasia cutis (AC), and nail abnormalities. Aplasia cutis congenita type VI was first described in 1966 by Bart et al. This article reports a case of Bart syndrome with ear malformation in a male Afghan newborn. To the authors' knowledge, this is the first case of Bart syndrome reported in an Afghan family.
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Affiliation(s)
| | | | | | - Rasoul Etesam Por
- Student Research CommitteeKashan University of Medical SciencesKashanIran
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3
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ÇİÇEKCİ F. Anesthesia management in Bart's syndrome: A case report. ACTA MEDICA ALANYA 2022. [DOI: 10.30565/medalanya.975253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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4
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Martinez-Moreno A, Ocampo-Candiani J, Alba-Rojas E. Epidermolysis bullosa with congenital absence of skin: Review of the literature. Pediatr Dermatol 2020; 37:821-826. [PMID: 32686866 DOI: 10.1111/pde.14245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Bart syndrome was initially described as association of congenital absence of skin (CAS), nail abnormalities, and epidermolysis bullosa (EB). Further reports of patients with CAS and EB have been made with wide clinical heterogeneity among them. Current guidelines recommend the elimination of eponyms and use of the descriptive term EB with CAS. METHODS We performed a PubMed and Medline database search of patients with Bart syndrome or EB with CAS. We included case reports or case series that contained clinical and demographic information. RESULTS After review, 55 articles were included, reporting 96 patients. CAS involved the lower extremities in all patients, with additional upper limb, trunk, or head involvement in 17%. In all patients, the time to healing ranged from 2 weeks to 6 months; most received only conservative treatment. The subtype and frequency of associated EB most frequently reported were recessive dystrophic EB (41.4%) and dominant dystrophic EB (22.8%). Extracutaneous features were present in 29 patients; with pyloric atresia and ear malformations being the most common. The prognosis varied based on the subtype of EB and the presence of additional comorbidities; 50% of the patients with junctional EB with pyloric atresia and CAS died during the first months of life, while mortality among those with recessive dystrophic EB was 6.8%. CONCLUSION Epidermolysis bullosa with CAS is a clinically heterogeneous disorder, most often associated with recessive dystrophic EB, but other EB subtypes may occur. Further investigations are necessary to better establish a pathological mechanism for CAS, and its association with EB.
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Affiliation(s)
- Adrian Martinez-Moreno
- Department of Dermatology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, México
| | - Jorge Ocampo-Candiani
- Department of Dermatology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, México
| | - Erika Alba-Rojas
- Department of Dermatology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, México
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5
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Shahidi‐Dadras M, Niknezhad N, Asadi‐kani Z, Zaresharifi S, Hamedani B, Abdollahimajd F. Bart syndrome associated with skeletal deformities: An uncommon case report. Dermatol Ther 2019; 32:e13131. [DOI: 10.1111/dth.13131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 12/27/2022]
Affiliation(s)
| | - Nasim Niknezhad
- Skin Research CenterShahid Beheshti University of Medical Sciences Tehran Iran
| | - Zahra Asadi‐kani
- Skin Research CenterShahid Beheshti University of Medical Sciences Tehran Iran
| | - Shirin Zaresharifi
- Skin Research CenterShahid Beheshti University of Medical Sciences Tehran Iran
| | - Behnaz Hamedani
- Skin Research CenterShahid Beheshti University of Medical Sciences Tehran Iran
| | - Fahimeh Abdollahimajd
- Skin Research CenterShahid Beheshti University of Medical Sciences Tehran Iran
- Clinical Research Development Unit, Shohada‐e Tajrish HospitalShahid Beheshti University of Medical Sciences Tehran Iran
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6
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Yaşar Ş, Yaşar B, Cebeci F, Bayoğlu D, Nuhoğlu Ç. Topical sucralfate cream treatment for aplasia cutis congenita with dystrophic epidermolysis bullosa: a case study. J Wound Care 2019; 27:768-771. [PMID: 30398936 DOI: 10.12968/jowc.2018.27.11.768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Bart syndrome consists of aplasia cutis congenita (ACC) and dominant or recessive dystrophic epidermolysis bullosa (DEB), associated with skin fragility and nail dysplasia. ACC in DEB is thought to be caused by trauma, the most cited cause being in utero formation of bullae consequent to friction of the limbs. Epidermolysis bullosa (EB) refers to a hereditary mechanobullous disease following trauma, characterised by formation of blisters on the skin and mucous membranes. There are four categories of the disease, including epidermolysis bullosa simplex, junctional epidermolysis bullosa, dystrophic epidermolysis bullosa and Kindler syndrome. Infection, sepsis and death may occur as a consequence of generalised blistering with complication. We present the case of a newborn diagnosed with DEB and whose lesions became almost fully epithelialised after treatment with 10% topical sucralfate.
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Affiliation(s)
- Şirin Yaşar
- Associate Professor; Haydarpasa Numune Training and Research Hospital, Department of Dermatology, Istanbul, Turkey
| | - Bulent Yaşar
- Associate Professor; Başkent University, Department of Gastroenterology, Istanbul, Turkey
| | - Filiz Cebeci
- Associate Professor; Goztepe Training and Research Hospital, Department of Dermatology, Istanbul
| | - Duygu Bayoğlu
- Haydarpasa Numune Training and Research Hospital, Department of Pediatric Clinic, Istanbul, Turkey
| | - Çağatay Nuhoğlu
- Associate Professor, Haydarpasa Numune Training and Research Hospital, Department of Pediatric Clinic, Istanbul, Turkey
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7
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Alfayez Y, Alsharif S, Santli A. A Case of Aplasia Cutis Congenita Type VI: Bart Syndrome. Case Rep Dermatol 2017; 9:112-118. [PMID: 29033814 PMCID: PMC5624250 DOI: 10.1159/000478889] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 06/20/2017] [Indexed: 01/16/2023] Open
Abstract
Aplasia cutis congenita type VI, also known as Bart syndrome, is a rare genetic mechanobullous disorder characterized by congenital localized absence of skin, mucocutaneous blistering lesions, and nail abnormalities. We present the case of a 4-h-old male newborn who presented with complete absence of skin over the anteromedial aspect of both lower legs associated with nail dystrophy since birth. After a few days, he developed blisters that were consistent with epidermolysis bullosa in histopathological examination. There was no systemic involvement such as pyloric atresia, ureteral stenosis, renal abnormalities, or arthrogryposis. All laboratory work and imaging studies were normal. A diagnosis of Bart syndrome was made based on previous presentation. We managed the patient with conservative methods. Complete epithelialization occurred after several weeks.
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Affiliation(s)
- Yasmin Alfayez
- Dermatology Department, King Fahad Armed Force Hospital, Jeddah, Saudi Arabia
| | - Sahar Alsharif
- Dermatology Department, King Fahad Armed Force Hospital, Jeddah, Saudi Arabia
| | - Adel Santli
- Dermatology Department, King Fahad Armed Force Hospital, Jeddah, Saudi Arabia
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8
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Type VI Aplasia Cutis Congenita: Bart's Syndrome. Case Rep Dermatol Med 2015; 2015:549825. [PMID: 26609453 PMCID: PMC4644546 DOI: 10.1155/2015/549825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 10/17/2015] [Accepted: 10/18/2015] [Indexed: 11/17/2022] Open
Abstract
Bart's syndrome is characterized by aplasia cutis congenita and epidermolysis bullosa. We present the case of a newborn male who developed blisters on the mucous membranes and the skin following congenital localized absence of skin. Bart's syndrome (BS) is diagnosed clinically based on the disorder's unique signs and symptoms but histologic evaluation of the skin can help to confirm the final diagnosis. The patient was managed conservatively with topical antibacterial ointment and wet gauze dressing. Periodic follow-up examinations showed complete healing. We emphasized that it is important to use relatively simple methods for optimal healing without the need for complex surgical interventions.
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9
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Omran A, Elimam D, Mobarak RAE, Ibrahim M, El-Sharkawy S. Bart syndrome with ear malformation. Sultan Qaboos Univ Med J 2015; 15:e143-e145. [PMID: 25685377 PMCID: PMC4318598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/07/2014] [Accepted: 08/19/2014] [Indexed: 06/04/2023] Open
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10
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Chiaverini C, Charlesworth A, Fernandez A, Barbarot S, Bessis D, Bodemer C, Bursztejn AC, Cobo AM, Del Rio M, D'Incan M, Labrèze C, Langlet C, Mazereeuw J, Miquel J, Vabres P, Meneguzzi G, Lacour JP. Aplasia cutis congenita with dystrophic epidermolysis bullosa: clinical and mutational study. Br J Dermatol 2014; 170:901-6. [DOI: 10.1111/bjd.12741] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2013] [Indexed: 12/11/2022]
Affiliation(s)
- C. Chiaverini
- French Reference Centre for Inherited Epidermolysis Bullosa; Archet Hospital; BP 3079 06202 NICE Cedex3 France
- INSERM U1081, CNRS UMR7284; Institute for Research on Cancer and Aging, Nice (IRCAN); University of Nice Sophia Antipolis, Faculty of Medicine; 28 Avenue Valombrose F-06107 Nice France
| | - A. Charlesworth
- French Reference Centre for Inherited Epidermolysis Bullosa; Archet Hospital; BP 3079 06202 NICE Cedex3 France
- INSERM U1081, CNRS UMR7284; Institute for Research on Cancer and Aging, Nice (IRCAN); University of Nice Sophia Antipolis, Faculty of Medicine; 28 Avenue Valombrose F-06107 Nice France
| | - A. Fernandez
- French Reference Centre for Inherited Epidermolysis Bullosa; Archet Hospital; BP 3079 06202 NICE Cedex3 France
| | - S. Barbarot
- Competence Centre for Rare Skin Diseases; Department of Dermatology; CHU Nantes; Nantes France
| | - D. Bessis
- Department of Dermatology; Saint Eloi Hospital; Montpellier France
| | - C. Bodemer
- French Reference Centre for Genetic Skin Disorders (MAGEC); CHU Necker for Sick Children; University-Paris Descartes; Institute Imagine; APHP; Paris France
| | | | - A.-M. Cobo
- Department of Genetics; Donostia Hospital; San Sebastian Spain
| | - M. Del Rio
- Regenerative Medicine Unit; Department of Bioengineering; CIEMAT and CIBER on Rare Diseases; Universidad Carlos III; Madrid Spain
| | - M. D'Incan
- Department of Dermatology; Estaing Hospital; Clermont-Ferrand France
| | - C. Labrèze
- National Centre for Rare Skin Disorders and Diseases; Pellegrin Enfants Hospital; Bordeaux France
| | - C. Langlet
- Department of Pediatrics 2; Hautepierre Hospital; Strasbourg France
| | - J. Mazereeuw
- Reference Centre for Rare Skin Diseases; Department of Dermatology; Larrey Hospital; Toulouse France
| | - J. Miquel
- Department of Dermatology; Pontchaillou Hospital; Rennes France
| | - P. Vabres
- Department of Dermatology; Bocage Hospital; Dijon France
| | - G. Meneguzzi
- INSERM U1081, CNRS UMR7284; Institute for Research on Cancer and Aging, Nice (IRCAN); University of Nice Sophia Antipolis, Faculty of Medicine; 28 Avenue Valombrose F-06107 Nice France
| | - J.-P. Lacour
- French Reference Centre for Inherited Epidermolysis Bullosa; Archet Hospital; BP 3079 06202 NICE Cedex3 France
- INSERM U1081, CNRS UMR7284; Institute for Research on Cancer and Aging, Nice (IRCAN); University of Nice Sophia Antipolis, Faculty of Medicine; 28 Avenue Valombrose F-06107 Nice France
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11
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Abstract
A new-born girl presented with congenital absence of skin on the right leg and nail abnormalities. On second day of life, she developed multiple blistering skin lesions and died on seventeenth day of life. A positive family history of two other siblings, one male and one female who had blistering skin lesions and died within one and a half month of birth, was present. The diagnosis of Bart's syndrome was made on clinical presentation, family history and skin biopsy.
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Affiliation(s)
- Aruna Rajpal
- Department of Dermatology and Venerology, KJ Somaiya Medical College and Research Centre, Mumbai, India.
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12
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Conservative treatment of a patient with epidermolysis bullosa presenting as bart syndrome: a case report. Case Rep Med 2010; 2010:302345. [PMID: 20490278 PMCID: PMC2871554 DOI: 10.1155/2010/302345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 02/08/2010] [Accepted: 03/15/2010] [Indexed: 12/01/2022] Open
Abstract
We presented a case of a newborn male with aplasia cutis congenita on the lower limb. The case was treated with conservative method. As for the conservative treatment, daily hydrodebridement with 1/200 diluted povidone-iodine and serum physiologic was performed, followed by closure of the wound with a dexpanthenol + chlorhexidine + fusidic acid-impregnated sterile gauze bandage. the followup that occured after three weeks, the wound was completely epithelialized, but a hypopigmented scar remained in the limb.
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13
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Almeida NAPD, Serafini F, Marchiori J, Moro JGD. [Do you know this syndrome? Bart's syndrome]. An Bras Dermatol 2010; 85:119-21. [PMID: 20464103 DOI: 10.1590/s0365-05962010000100023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Bart's syndrome is characterized by three clinical manifestations: epidermolysis bullosa, congenital absence of skin, and nail abnormalities. It is believed that congenital skin absence follows the patterns of Blaschko's lines. Treatment seeks to prevent secondary infection. Prognosis is favorable and depends upon the healing of lesions.
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14
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Casanova JM, Martí RM, Baradad M, Egido R, Mascaró JM. [Bart syndrome associated to lethal junctional epidermolysis bullosa (Herlitz form)]. ACTAS DERMO-SIFILIOGRAFICAS 2007; 97:658-61. [PMID: 17173830 DOI: 10.1016/s0001-7310(06)73489-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We present the case of a newborn with congenital absence of skin in the anterior part of the left leg that shortly after developed bulla and erosions in hands, feet, ears, buttocks and mouth. The cutaneous biopsy and ultrastructural and immunohistochemical studies showed a subepidermal bulla in the lamina lucida, absence of hemidesmosomes and marked decrease of laminin 5, thus establishing the diagnosis of Bart syndrome associated to the Herlitz form of lethal junctional epidermolysis bullosa. Bart syndrome consists of congenital and localized absence of skin, nail abnormalities and mucoc-cutaneous bullae. It is usually associated to dystrophic epidermolysis bullosa. The Herlitz form of junctional epidermolysis bullosa is a rare variant, usually lethal that is produced by mutations in the genes coding for the anchor protein laminin 5. To our knowledge this is the second case that reports an association between Bart syndrome and lethal junctional epidermolysis bullosa and the first in which the results of immunofluorescence mapping are published.
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Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova de Lleida, Spain.
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15
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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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16
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García-Alix Pérez A, de Lucas Laguna R, Quero Jiménez J. [The skin as an expression of neurological alterations in the neonate]. An Pediatr (Barc) 2005; 62:548-63. [PMID: 15927121 DOI: 10.1157/13075548] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The skin is involved in many different genetic syndromes and diseases with multiple organ involvement. Neurodevelopmental disorders appear in many of these entities and knowledge of these cutaneous alterations may provide clues to their diagnosis. Recognizing these skin disorders in the newborn allows early identification of neonates with a biological risk of epilepsy and motor and/or cognitive disorders and enables them to be followed up. This helps to plan the management of these patients and, in many entities, to predict their natural history and provide genetic counseling to the family. This review examines the cutaneous signs that may provide important clues in the neonate that help to identify entities that carry a risk of neurodevelopmental disorders in the neonate.
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Affiliation(s)
- A García-Alix Pérez
- Departamento de Pediatría, Servicio de Neonatología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, 28036 Madrid, España.
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Cham PMH, Drolet BA, Segura AD, Esterly NB. Congenital Volkmann ischaemic contracture: a case report and review. Br J Dermatol 2004; 150:357-63. [PMID: 14996111 DOI: 10.1111/j.1365-2133.2004.05817.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Congenital Volkmann ischaemic contracture or neonatal compartment syndrome has rarely been discussed in the literature of dermatology. The condition often involves the upper extremity with cutaneous lesions, contractures and neuropathy. Because the lesions can be mistaken for other entities including necrotizing fasciitis, neonatal gangrene, congenital varicella, aplasia cutis congenita, amniotic band syndrome, subcutaneous fat necrosis and epidermolysis bullosa, dermatologists play a significant role in the diagnosis and, consequently, the treatment of the patient. We describe a premature newborn who had a unilateral, well-demarcated necrotic plaque with a central pallor at birth. The plaque extended circumferentially over the left forearm from the wrist to the elbow. Left wrist oedema, bullae over the fingers and flaccid paralysis at the wrist were also noted.
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Affiliation(s)
- P M H Cham
- Department of Dermatology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA
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18
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Síndrome de Bart. ACTAS DERMO-SIFILIOGRAFICAS 2001. [DOI: 10.1016/s0001-7310(01)76525-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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