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Bessis D, Bursztejn AC, Morice-Picard F, Capri Y, Barbarot S, Aubert H, Bodet D, Bourrat E, Chiaverini C, Poujade L, Willems M, Rouanet J, Dompmartin-Blanchère A, Geneviève D, Gerard M, Ginglinger E, Hadj-Rabia S, Martin L, Mazereeuw-Hautier J, Bibas N, Molinari N, Herman F, Phan A, Rod J, Roger H, Sigaudy S, Ziegler A, Vial Y, Verloes A, Cavé H, Lacombe D. Dermatological manifestations in Costello syndrome: A prospective multicentric study of 31 HRAS-positive variant patients. J Eur Acad Dermatol Venereol 2024. [PMID: 38595321 DOI: 10.1111/jdv.19996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Data on dermatological manifestations of Costello syndrome (CS) remain heterogeneous and lack in validated description. OBJECTIVES To describe the dermatological manifestations of CS; compare them with the literature findings; assess those discriminating CS from other RASopathies, including cardiofaciocutaneous syndrome (CFCS) and the main types of Noonan syndrome (NS); and test for dermatological phenotype-genotype correlations. METHODS We performed a 10-year, large, prospective, multicentric, collaborative dermatological and genetic study. RESULTS Thirty-one patients were enrolled. Hair abnormalities were ubiquitous, including wavy or curly hair and excessive eyebrows, respectively in 68% and 56%. Acral excessive skin (AES), papillomas and keratotic papules (PKP), acanthosis nigricans (AN), palmoplantar hyperkeratosis (PPHK) and 'cobblestone' papillomatous papules of the upper lip (CPPUL), were noted respectively in 84%, 61%, 65%, 55% and 32%. Excessive eyebrows, PKP, AN, CCPUL and AES best differentiated CS from CFCS and NS. Multiple melanocytic naevi (>50) may constitute a new marker of attenuated CS associated with intragenic duplication in HRAS. Oral acitretin may be highly beneficial for therapeutic management of PPHK. No significant dermatological phenotype-genotype correlation was determined between patients with and without HRAS c.34G>A (p.G12S). CONCLUSIONS AND RELEVANCE This validated phenotypic characterization of a large number of patients with CS will allow future researchers to make a positive diagnosis, and to differentiate CS from CFCS and NS.
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Affiliation(s)
- Didier Bessis
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- INSERM U1058, Montpellier, France
| | | | - Fanny Morice-Picard
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Paediatric Dermatology, Pellegrin University Hospital of Bordeaux, Bordeaux, France
| | - Yline Capri
- Department of Clinical Genetics, Robert-Debré Hospital, Paris, France
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
| | - Sébastien Barbarot
- Department of Dermatology, Hotel Dieu Hospital, University of Nantes, Nantes, France
| | - Hélène Aubert
- Department of Dermatology, Hotel Dieu Hospital, University of Nantes, Nantes, France
| | - Damien Bodet
- Department of Paediatric Haematology-Immunology-Oncology, Caen Normandie Hospital and University of Caen, Caen, France
| | - Emmanuelle Bourrat
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Paediatric Dermatology, Robert-Debré Hospital, AP-HP, Paris, France
| | - Christine Chiaverini
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Dermatology, l'Archet 2 Hospital, University of Nice, Nice, France
| | - Laura Poujade
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
| | - Marjolaine Willems
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Developmental Anomalies - and Malformative Syndromes Sud Ouest Occitanie, University hospital of Montpellier, Montpellier, France
| | - Jacques Rouanet
- Department of Dermatology, d'Estaing Hospital and University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | | | - David Geneviève
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Developmental Anomalies - and Malformative Syndromes Sud Ouest Occitanie, University hospital of Montpellier, Montpellier, France
| | - Marion Gerard
- Department of Clinical Genetics, Caen Normandie Hospital and University of Caen, Caen, France
| | | | - Smaïl Hadj-Rabia
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Paediatric Dermatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Ludovic Martin
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Dermatology, Angers Hospital University, Angers, France
| | - Juliette Mazereeuw-Hautier
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Dermatology, Larrey Hospital, University of Toulouse, Toulouse, France
| | - Nathalie Bibas
- Department of Dermatology, Larrey Hospital, University of Toulouse, Toulouse, France
| | - Nicolas Molinari
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - Fanchon Herman
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - Alice Phan
- Department of Paediatric Dermatology, Femme-Mère-Enfant Hospital-HCL, University of Lyon, Lyon, France
| | - Julien Rod
- Department of Paediatric Surgery, Caen Normandie Hospital and University of Caen, Caen, France
| | | | - Sabine Sigaudy
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
- Department of Clinical Genetics, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - Alban Ziegler
- Department of Clinical Genetics, Hospital and University of Angers, Angers, France
| | - Yoann Vial
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
- Department of Molecular Genetics, Robert-Debré Hospital, AP-HP, Paris, France
| | - Alain Verloes
- Department of Clinical Genetics, Robert-Debré Hospital, Paris, France
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
| | - Hélène Cavé
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
- Department of Molecular Genetics, Robert-Debré Hospital, AP-HP, Paris, France
| | - Didier Lacombe
- Department of Clinical Genetics, Pellegrin University Hospital of Bordeaux, Bordeaux, France
- French National Reference Centre for Developmental Anomalies - and Malformative Syndromes SOOR, University Hospital of Bordeaux, Bordeaux, France
- INSERM U1211, Bordeaux, France
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