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de Lima-Souza RA, Kimura TDC, Scarini JF, Lavareze L, Figueiredo-Maciel T, Chone CT, Egal ESA, Altemani A, Mariano FV. Solitary Angiokeratoma in the Oral Cavity: A Critical Literature Review and Report of a New Case. Indian J Otolaryngol Head Neck Surg 2024; 76:3604-3611. [PMID: 39130332 PMCID: PMC11306674 DOI: 10.1007/s12070-024-04631-w] [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: 12/04/2023] [Accepted: 03/08/2024] [Indexed: 08/13/2024] Open
Abstract
This study aimed to perform an integrative review of solitary angiokeratomas cases in the oral cavity and to report a new case in a 39-year-old man. A modified PECOS strategy was used using PubMed, Embase, Scopus, Web of Science databases, and the reference lists of the selected articles. Case reports of oral solitary angiokeratoma published in English, Portuguese, and Spanish languages with histopathological diagnosis without the presence of systemic disorders were included. Of the 51 articles identified, 18 met the eligibility criteria. Solitary angiokeratomas have a slight male predilection, with a peak incidence in the fourth decade of life. The tongue was the most common localization (77.7%), followed by buccal mucosa (11.1%), labial mucosa (5.6%), and tonsillar pillar (5.6%). The granulomatous appearance was the most frequent clinical aspect. Surgical excision was implemented in 94.4% of the cases. The lesion presented a good prognosis, with no recurrence in 3 to 24 months. In summary, solitary angiokeratoma is a rare lesion in the oral cavity. The professional making the oral diagnosis should be familiar with the clinical manifestation of angiokeratoma and be prepared to consider it in the differential diagnosis of pigmented lesions since these lesions may be part of systemic disorders. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-024-04631-w.
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Affiliation(s)
- Reydson Alcides de Lima-Souza
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo Brazil
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
| | - Talita de Carvalho Kimura
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo Brazil
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
| | - João Figueira Scarini
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo Brazil
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
| | - Luccas Lavareze
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo Brazil
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
| | - Tayná Figueiredo-Maciel
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo Brazil
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
| | - Carlos Takahiro Chone
- Department of Ophthalmology and Otorhinolaryngology, Faculdade de Ciências Médica, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo Brazil
| | - Erika Said Abu Egal
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
- Biorepository and Molecular Pathology, Huntsman Cancer Institute, University of Utah (UU), Salt Lake City, Utah United States of America
| | - Albina Altemani
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
| | - Fernanda Viviane Mariano
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, 13083-887 Campinas, São Paulo Brazil
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Benz K, Hahn P, Hanisch M, Lücke K, Lücke T, Jackowski J. Systematic review of oral and craniofacial findings in patients with Fabry disease or Pompe disease. Br J Oral Maxillofac Surg 2019; 57:831-838. [PMID: 31405600 DOI: 10.1016/j.bjoms.2019.07.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 07/20/2019] [Indexed: 12/21/2022]
Abstract
Fabry disease and Pompe disease are rare lysosomal storage disorders that belong to a heterogeneous group of more than 200 distinct inborn metabolic diseases. Mutations followed by loss of function of enzymes or transporters that are localised in the acidic environment of the lysosome may result in degradation of many substrates, such as glycosaminoglycans, glycosphingolipids, glycogen, cholesterol, oligosaccharides, glycoproteins, and peptides, or the excretion of the products degraded by the lysosome. Our aim was to identify the oral signs and symptoms of Fabry disease and Pompe disease from a systematic review made using MEDLINE/PubMed, and a hand search for relevant articles, following the PRISMA guidelines. Both diseases show various craniofacial and oral changes, including supernumerary teeth, dental agenesis, angiokeratoma, and telangiectases in Fabry disease; and macroglossia, teeth fusion, and taurodontism in Pompe disease. Common clinical signs of Fabry disease include hyposalivation, hypohidrosis, and xerophthalmia, and a generally reduced physical resilience was apparent in patients with Pompe disease. Oral and craniofacial changes in patients with both diseases extend over their entire lifetime and can be detected even in an infant. Lysosomal storage diseases should be taken into consideration in the differential diagnosis of relevant diverse symptoms, because treatment, when available, is most effective when started early. The main therapeutic concepts are enzymatic replacement for Pompe disease, whereas patients with Fabry disease require additional oral chaperone treatment or enzyme replacement.
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Affiliation(s)
- Korbinian Benz
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455 Witten, Germany.
| | - Philipp Hahn
- Clinic for Child and Adolescent Medicine, Faculty of Medicine, Ruhr-University Bochum, Alexandrinenstr. 5, 44791 Bochum, Germany
| | - Marcel Hanisch
- Department of Cranio-Maxillofacial Surgery, University Hospital Münster, Albert-Schweitzer-Straße 33, 48149 Münster, Germany
| | - Katrin Lücke
- Private Practice, Breddestr. 20, 58452 Witten, Germany
| | - Thomas Lücke
- Clinic for Child and Adolescent Medicine, Faculty of Medicine, Ruhr-University Bochum, Alexandrinenstr. 5, 44791 Bochum, Germany
| | - Jochen Jackowski
- Department of Oral Surgery and Dental Emergency Care, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455 Witten, Germany
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Kang E, Kim YM, Kim DH, Yoo HW, Lee BH. Life-threatening bleeding from gastric mucosal angiokeratomas during anticoagulation: A case report of Fabry disease. Medicine (Baltimore) 2017; 96:e6063. [PMID: 28178158 PMCID: PMC5313015 DOI: 10.1097/md.0000000000006063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
RATIONALE Angiokeratomas are the earliest manifestation of Fabry disease (FD), and the extent of their appearance is related to disease severity. Angiokeratomas are mostly found on cutaneous regions. PATIENT CONCERNS, DIAGNOSES, INTERVENTIONS, AND OUTCOMES Here we report an FD patient with widespread gastrointestinal angiokeratomas who developed life-threatening bleeding following anticoagulation for atrial fibrillation. LESSONS Careful observation for gastrointestinal bleeding is warranted for patients on anticoagulation with extensive cutaneous angiokeratomas. Furthermore, our experience suggests that surveillance is needed to assess the prevalence and extent of gastrointestinal angiokeratomas in patients with FD.
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Affiliation(s)
- Eungu Kang
- Department of Pediatrics, Asan Medical Center Children's Hospital
| | - Yoon-Myung Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital
| | - Dae-Hee Kim
- Division of Cardiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Han-Wook Yoo
- Department of Pediatrics, Asan Medical Center Children's Hospital
| | - Beom Hee Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital
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Luna PC, Boggio P, Larralde M. Dermatologic Aspects of Fabry Disease. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2016. [DOI: 10.1177/2326409816661353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Paula C. Luna
- Dermatology Department, Hospital Alemán, Buenos Aires, Argentina
- Dermatology Department, Hospital General de Agudos J. M. Ramos Mejia, Buenos Aires, Argentina
| | - Paula Boggio
- Dermatology Department, Hospital General de Agudos J. M. Ramos Mejia, Buenos Aires, Argentina
| | - Margarita Larralde
- Dermatology Department, Hospital Alemán, Buenos Aires, Argentina
- Dermatology Department, Hospital General de Agudos J. M. Ramos Mejia, Buenos Aires, Argentina
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Lubinsky M, Kantaputra PN. Syndromes with supernumerary teeth. Am J Med Genet A 2016; 170:2611-6. [DOI: 10.1002/ajmg.a.37763] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/12/2016] [Indexed: 01/24/2023]
Affiliation(s)
| | - Piranit Nik Kantaputra
- Center of Excellence in Medical Genetics Research; Chiang Mai University; Chiang Mai Thailand
- Division of Pediatric Dentistry; Faculty of Dentistry; Department of Orthodontics and Pediatric Dentistry; Chiang Mai University; Chiang Mai Thailand
- Dentaland Clinic; Chiang Mai Thailand
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Urrets-Zavalía JA, Espósito E, Garay I, Monti R, Ruiz-Lascano A, Correa L, Serra HM, Grzybowski A. The eye and the skin in nonendocrine metabolic disorders. Clin Dermatol 2015; 34:166-82. [PMID: 26903184 DOI: 10.1016/j.clindermatol.2015.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
As metabolism is controlled by the input of genes and the environment, metabolic disorders result from some disturbance in the interaction between genes and environmental factors. Many metabolic disorders consist in congenital enzyme deficiencies, also known as "inborn errors of metabolism," that may be disabling or cause severe illness and death and are predominantly inherited in an autosomal recessive fashion. The deposit in cells and tissues of storage substances from errors in metabolic processes may produce a wide variety of disorders affecting different organs and functions, with different degrees of severity, and often present around the time of birth or early childhood. Distinctive ocular and skin manifestations accompany many metabolic diseases and may provide clues for their diagnosis and evolution.
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Affiliation(s)
- Julio A Urrets-Zavalía
- Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina.
| | - Evangelina Espósito
- Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina.
| | - Iliana Garay
- Department of Dermatology, Hospital Privado Centro Médico de Córdoba, Naciones Unidas 346, Córdoba (5016), Argentina.
| | - Rodolfo Monti
- Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina.
| | - Alejandro Ruiz-Lascano
- Department of Dermatology, Hospital Privado Centro Médico de Córdoba, Naciones Unidas 346, Córdoba (5016), Argentina.
| | - Leandro Correa
- Department of Ophthalmology, University Clinic Reina Fabiola, Catholic University of Córdoba, Oncativo 1248, Córdoba (5000), Argentina.
| | - Horacio M Serra
- CIBICI-CONICET, Faculty of Chemical Sciences, National University of Córdoba, Haya de la Torre esquina Medina Allende sin número, Ciudad Universitaria, Córdoba (5000), Argentina.
| | - Andrzej Grzybowski
- Department of Ophthalmology, Poznań City Hospital, ul. Szwajcarska 3, 61-285 Poznań, Poland; Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.
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Subasioglu A, Savas S, Kucukyilmaz E, Kesim S, Yagci A, Dundar M. Genetic background of supernumerary teeth. Eur J Dent 2015; 9:153-158. [PMID: 25713500 PMCID: PMC4319293 DOI: 10.4103/1305-7456.149670] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula. This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate. Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico–Rhino–Phalangeal syndrome. ST can be an important component of a distinctive disorder and an important clue for early diagnosis. Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment. In this review, the genetic syndromes that are related with ST were discussed.
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Affiliation(s)
- Aslı Subasioglu
- Department of Medical Genetics, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - Selcuk Savas
- Department of Pedodontics, Dentistry Faculty, Izmir Katip Celebi University, Izmir, Turkiye
| | - Ebru Kucukyilmaz
- Department of Pedodontics, Dentistry Faculty, Izmir Katip Celebi University, Izmir, Turkiye
| | - Servet Kesim
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkiye
| | - Ahmet Yagci
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkiye
| | - Munis Dundar
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkiye
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8
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Nannini V. Metabolic and autoimmune syndromes. Atlas Oral Maxillofac Surg Clin North Am 2014; 22:123-34. [PMID: 25171994 DOI: 10.1016/j.cxom.2014.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Victor Nannini
- Private Practice, Long Island Oral and Maxillofacial Surgery, P.C., 134 Mineola Boulevard, Mineola, New York 11501, USA; Division of Oral and Maxillofacial Surgery, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, New York 11554, USA.
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9
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Katsoulas N, Tosios KI, Argyris P, Koutlas IG, Sklavounou A. Lymphangioma circumscriptum, angiokeratoma, or superficial vascular ectasia with epithelial hyperplasia? Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e53-7. [DOI: 10.1016/j.oooo.2013.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/16/2013] [Accepted: 12/01/2013] [Indexed: 10/25/2022]
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10
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Zampetti A, Orteu C, Antuzzi D, Bongiorno M, Manco S, Gnarra M, Morrone A, Cardinali G, Kovacs D, Aspite N, Linder D, Parini R, Feliciani C. Angiokeratoma: decision-making aid for the diagnosis of Fabry disease. Br J Dermatol 2012; 166:712-20. [DOI: 10.1111/j.1365-2133.2012.10742.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Kar HK, Gupta L. A case of angiokeratoma circumscriptum of the tongue: response with carbon dioxide and pulsed dye laser. J Cutan Aesthet Surg 2012; 4:205-7. [PMID: 22279389 PMCID: PMC3263134 DOI: 10.4103/0974-2077.91255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Solitary angiokeratoma circumscriptum (AC) of the tongue is a rare entity. We present a case of solitary AC over the ventral surface of the tongue present for 3 years. The patient was treated with a combination of carbon dioxide (CO2) and pulsed dye laser (PDL). There was more than 75% improvement in the lesion after treating with alternate sessions of CO2 and PDL.
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Affiliation(s)
- Hemanta Kumar Kar
- Departments of Dermatology, STD and Leprosy, Dr. RML Hospital and PGIMER, New Delhi, India
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12
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Affiliation(s)
- Avinash S Bidra
- Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT 06030, USA.
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13
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Abstract
A doença de Fabry é enfermidade de armazenamento lisossômico rara, ligada ao cromossomo-X, causada pela deficiência parcial ou completa da enzima alfagalactosidase A. O defeito resulta no acúmulo de globotriaosilceramida no endotélio vascular e tecidos viscerais, sendo a pele, o coração, os rins e o sistema nervoso central os mais afetados. As autoras realizam revisão da literatura relacionada a essa afecção e ressaltam que o reconhecimento precoce dos angioqueratomas e da hipoidrose constitui sinal-chave no diagnóstico dessa doença grave. Destacam também a necessidade de esses doentes serem avaliados por equipe multidisciplinar.
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Affiliation(s)
- Paula Boggio
- Hospital General de Agudos J.M. Ramos Mejía, Argentina
| | | | | | - Margarita Larralde
- Universidade de Buenos Aires; Hospital de Agudos J.M. Ramos Mejía, Argentina; Hospital Alemán, Argentina
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14
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Abstract
Fabry disease, an X-linked disorder of glycosphingolipids that is caused by the deficiency of alpha-galactosidase A, is associated with dysfunction of many cell types and includes a systemic vasculopathy. As a result, patients have a markedly increased risk of developing small-fiber peripheral neuropathy, stroke, myriad cardiac manifestations and chronic renal disease. Virtually all complications of Fabry disease are non-specific in nature and clinically indistinguishable from similar abnormalities that occur in the context of more common disorders in the general population. Although Fabry disease was originally thought to be very rare, recent studies have found a much higher incidence of mutations of the GLA gene, suggesting that this disorder is under-diagnosed. Although the etiology of Fabry disease has been known for many years, the mechanism by which the accumulating alpha-D-galactosyl moieties cause this multi-organ disorder has only recently been studied and is yet to be completely elucidated. Specific therapy for Fabry disease has been developed in the last few years but its role in the management of the disorder is still being investigated. Fortunately, standard 'non-specific' medical and surgical therapy is effective in slowing deterioration or compensating for organ failure in patients with Fabry disease. All these aspects are discussed in detail in the present review.
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Affiliation(s)
- Raphael Schiffmann
- Institute of Metabolic Disease, Baylor Research Institute, 3812 Elm Street, Dallas, TX 75226, USA.
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Ergun S, Mete O, Yeşil S, Tanyeri H. Solitary angiokeratoma of the tongue treated with diode laser. Lasers Med Sci 2007; 24:123-5. [PMID: 18057978 DOI: 10.1007/s10103-007-0525-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 11/02/2007] [Indexed: 11/28/2022]
Abstract
Angiokeratoma is a muco-cutaneous disorder that is usually associated with a number of metabolic disorders. Involvement of the tongue with solitary angiokeratoma, without a systemic or metabolic disease, is very rare. To the best of our knowledge, we report the second case of solitary angiokeratoma of the tongue arising in a 16-year-old woman who was treated with diode laser (810 nm) in our department.
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Affiliation(s)
- Sertan Ergun
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey.
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Cox-Brinkman J, Vedder A, Hollak C, Richfield L, Mehta A, Orteu K, Wijburg F, Hammond P. Three-dimensional face shape in Fabry disease. Eur J Hum Genet 2007; 15:535-42. [PMID: 17327876 DOI: 10.1038/sj.ejhg.5201798] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Facial dysmorphology is an important feature in several lysosomal storage disorders. Although in Fabry disease facial dysmorphism is not a prominent sign, minor facial abnormalities have been previously reported. By analysing three-dimensional images of faces, we quantified facial dysmorphology in a cohort of both male and female Fabry patients. Morphometric analysis of different regions of the face revealed significant differences in face shape in male patients and to a lesser extent in female patients. In male patients, the most prominent abnormalities were located in the peri-orbital region. Pattern recognition techniques achieved a discrimination accuracy of up to 85% for male patients compared with healthy controls. The discrimination accuracy in female patients achieved only 67%. This objective method for facial dysmorphology assessment provided evidence for significant differences in face shape in both male and female Fabry patients compared with controls. However, because discrimination from healthy controls is too low, no key role in the diagnostic process can be expected.
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Affiliation(s)
- Josanne Cox-Brinkman
- Department of Paediatrics, Academic Medical Center, University Hospital of Amsterdam, Amsterdam, The Netherlands
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Abstract
Angiokeratoma is a rare, cutaneous vascular disorder that can occur in several clinically distinct conditions. It usually presents as multiple, red to blue or black, asymptomatic papules on the skin. Oral mucosal involvement is common in the systemic form, but very rare in the localized forms of angiokeratomas. We report the second case of a solitary papular angiokeratoma of the oral cavity.
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Affiliation(s)
- Maria Siponen
- Department of Diagnostics and Oral Medicine, Oulu University Hospital, Finland
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18
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Ries M, Moore DF, Robinson CJ, Tifft CJ, Rosenbaum KN, Brady RO, Schiffmann R, Krasnewich D. Quantitative dysmorphology assessment in Fabry disease. Genet Med 2006; 8:96-101. [PMID: 16481892 DOI: 10.1097/01.gim.0000200950.25118.dd] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE 1) To identify morphometric characteristics in hemizygous patients with Fabry disease a treatable lysosomal storage disorder caused by the deficiency of alpha-galactosidase A where morphological abnormalities have occasionally been mentioned, but have never been investigated systematically. 2) To devise a quantitative method to evaluate dysmorphic abnormalities in Fabry disease. METHOD Cross-sectional, single center, independent dysmorphology assessment by a panel of three clinical geneticists, based on standardized medical photography. POPULATION consecutive hemizygous patients with Fabry disease (N = 38) unselected for the features assessed, mean age 38 +/- 10.8 years (range: 10-60), recruited for neuropathic pain into enzyme replacement therapy trials. RESULTS The following dysmorphic features were identified (in order of descending frequency): periorbital fullness, prominent lobules of the ears, bushy eyebrows, recessed forehead, pronounced nasal angle, generous nose/bulbous nasal tip, prominent supraorbital ridges, shallow midface, full lips, prominent nasal bridge, broad alar base, coarse features, posteriorly rotated ears, and prognathism. Extremity features included broad fingertips, short fingers, prominent superficial vessels of hands, 5 digit brachydactyly, and 5 digit clinodactyly. Narrow anterior-posterior chest diameter was noted. Ten core features were statistically defined. Cronbach's alpha measuring internal consistency was 0.62. Light's kappa for global inter-rater variability was 0.26 while Cohen's kappa allowing pair-wise rater comparison varied between 0.08-0.48. CONCLUSIONS Patients with Fabry disease share common morphological characteristics of the face, trunk, and extremities. Some of these features are subtle as documented by the inter-rater variability. Awareness of these features may facilitate the diagnosis of patients with Fabry disease, and identification of affected family members.
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Affiliation(s)
- Markus Ries
- Developmental and Metabolic Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1260, USA
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Ries M, Bettis KEB, Choyke P, Kopp JB, Austin HA, Brady RO, Schiffmann R. Parapelvic kidney cysts: A distinguishing feature with high prevalence in Fabry disease. Kidney Int 2004; 66:978-82. [PMID: 15327390 DOI: 10.1111/j.1523-1755.2004.00846.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fabry disease is an X-linked generalized progressive debilitating lysosomal storage disorder. The disease usually manifests in childhood, but the diagnosis is often made following the occurrence of late-stage complications such as progressive kidney failure. In order to identify key novel renal diagnostic imaging features of Fabry disease, we conducted a cross sectional case-control study of kidney involvement in patients with Fabry disease. METHODS Twenty-four patients (mean age 36.1 +/- 8.1 years, median 37 years, range 20 to 48 years) with chronic neuropathic pain who were enrolled in an enzyme replacement trial underwent prospective renal imaging evaluation with magnetic resonance imaging (MRI) and computed tomography (CT) at the National Institutes of Health, Bethesda, Maryland. We concurrently enrolled 19 age-matched healthy controls (mean age 34.6 +/- 12.0 years, median 33 years, range 18 to 61 years). The presence and localization of kidney cysts as well as the ratio of the signal intensity between medulla and cortex were determined. RESULTS Fifty percent of the Fabry disease patients had renal sinus cysts, compared to one individual (7%) in the control group. The ratio of the signal intensity between medulla and cortex on T2-weighted scans in Fabry disease patients with sinus cysts was elevated compared with Fabry disease patients without cysts (P= 0.0083), and elevated in Fabry disease patients without cysts compared with normal controls without cysts (P= 0.0173). CONCLUSION The finding of multiple renal sinus cysts in the workup of a patient with kidney disease patient should strongly suggest the consideration of Fabry disease in the differential diagnosis. The cause of such cysts in Fabry disease remains to be elaborated.
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Affiliation(s)
- Markus Ries
- Developmental and Metabolic Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1260, USA.
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Thyagarajan T, Totey S, Danton MJS, Kulkarni AB. Genetically altered mouse models: the good, the bad, and the ugly. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 14:154-74. [PMID: 12799320 DOI: 10.1177/154411130301400302] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Targeted gene disruption in mice is a powerful tool for generating murine models for human development and disease. While the human genome program has helped to generate numerous candidate genes, few genes have been characterized for their precise in vivo functions. Gene targeting has had an enormous impact on our ability to delineate the functional roles of these genes. Many gene knockout mouse models faithfully mimic the phenotypes of the human diseases. Because some models display an unexpected or no phenotype, controversy has arisen about the value of gene-targeting strategies. We argue in favor of gene-targeting strategies, provided they are used with caution, particularly in interpreting phenotypes in craniofacial and oral biology, where many genes have pleiotropic roles. The potential pitfalls are outweighed by the unique opportunities for developing and testing different therapeutic strategies before they are introduced into the clinic. In the future, we believe that genetically engineered animal models will be indispensable for gaining important insights into the molecular mechanisms underlying development, as well as disease pathogenesis, diagnosis, prevention, and treatment.
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Affiliation(s)
- Tamizchelvi Thyagarajan
- Functional Genomics Unit and Gene Targeting Facility, National Institute of Dental and Craniofacial Research, National Institutes of Health, Building 30, Room 527, 30 Convent Drive, Bethesda, MD 20892, USA
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