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Lu Q, Xu Y, Zhang Z, Li S, Zhang Z. Primary hypertrophic osteoarthropathy: genetics, clinical features and management. Front Endocrinol (Lausanne) 2023; 14:1235040. [PMID: 37705574 PMCID: PMC10497106 DOI: 10.3389/fendo.2023.1235040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/31/2023] [Indexed: 09/15/2023] Open
Abstract
Primary hypertrophic osteoarthropathy (PHO) is a genetic disorder mainly characterized by clubbing fingers, pachydermia and periostosis. Mutations in the HPGD or SLCO2A1 gene lead to impaired prostaglandin E2 (PGE2) degradation, thus elevating PGE2 levels. The identification of the causative genes has provided a better understanding of the underlying mechanisms. PHO can be divided into three subtypes according to its pathogenic gene and inheritance patterns. The onset age, sex ratio and clinical features differ among subtypes. The synthesis and signaling pathways of PGE2 are outlined in this review. Cyclooxygenase-2 (COX-2) is the key enzyme that acts as the rate-limiting step for prostaglandin production, thus COX-2 inhibitors have been used to treat this disease. Although this treatment showed effective results, it has side effects that restrain its use. Here, we reviewed the genetics, clinical features, differential diagnosis and current treatment options of PHO according to our many years of clinical research on the disease. We also discussed probable treatment that may be an option in the future.
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Affiliation(s)
- Qi Lu
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yang Xu
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Zeng Zhang
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Shanshan Li
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Zhenlin Zhang
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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2
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Komatsu-Fujii T, de Jesus CS, Nomura T, Kabashima K. Non-invasive visualization of epidermal hypertrophy of pachydermoperiostosis. J Eur Acad Dermatol Venereol 2023; 37:e344-e345. [PMID: 36226402 DOI: 10.1111/jdv.18654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/06/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Takashi Nomura
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Drug Discovery for Intractable Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Singapore Immunology Network (SIgN) and Institute of Medical Biology, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
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3
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Kartal Baykan E, Türkyılmaz A. Differential Diagnosis of Acromegaly: Pachydermoperiostosis Two New Cases from Turkey. J Clin Res Pediatr Endocrinol 2022; 14:350-355. [PMID: 34027406 PMCID: PMC9422917 DOI: 10.4274/jcrpe.galenos.2021.2020.0301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/29/2021] [Indexed: 12/01/2022] Open
Abstract
Pachydermoperiostosis (PDP), also known as primary hypertrophic osteoarthropathy, is a rare genetic disorder characterized by pachyderma and periostosis. Acromegaly is a condition caused by excessive secretion of growth hormone (GH) leading to elevated insulin-like growth factor 1 levels, and is characterised by somatic overgrowth and physical disfigurement, notably affecting hands and feet. We present two cases referred with an initial diagnosis of acromegaly that were ultimately diagnosed as PDP. Case 1: A 17 year-old boy presented with enlargement in both feet and hands, finger clubbing, swelling in knee joints, knee pain, coarsening of facial skin lines and forehead skin, and excessive sweating which increased gradually over five years. There were prominent skin folds on the forehead, face, and eyelids. Also, there was an enlargement in both hands and clubbing of the fingers. There was marked swelling in the knee joints and ankles. Genetic analysis revealed a novel homozygous variant NM_005630: c.31C>T (p.Q11*) in the SLCO2A1 gene. Case 2: A 16 year-old boy presented with coarsening of forehead skin and scalp, excessive sweating, and pain in the elbow and knee over three years. Skin folds were prominent on the forehead and scalp. Genetic analysis revealed a homozygous variant NM_005630.2:c.86delG (p.G29Afs*48) in the SLCO2A1 gene. Such clinical presentation contemporaneous with normal GH level and prominent radiological abnormalities prompted the diagnosis of PDP. In conclusion, PDP is a very rare osteoarthrodermopathic disorder with clinical and radiographic presentation that may mimic acromegaly. In the evaluation of patients with acromegaloid appearance, PDP should be considered as a differential diagnosis.
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Affiliation(s)
- Emine Kartal Baykan
- Erzurum Regional Training and Research Hospital, Clinic of Endocrinology and Metabolic Diseases, Erzurum, Turkey
| | - Ayberk Türkyılmaz
- Karadeniz Technical University Faculty of Medicine, Department of Medical Genetics, Trabzon, Turkey
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4
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Xu Y, Zhang Z, Yue H, Li S, Zhang Z. Monoallelic mutations in SLCO2A1 cause autosomal dominant primary hypertrophic osteoarthropathy. J Bone Miner Res 2021; 36:1459-1468. [PMID: 33852188 DOI: 10.1002/jbmr.4310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 11/08/2022]
Abstract
Primary hypertrophic osteoarthropathy (PHO) is a rare disease inherited as a recessive or irregular dominant trait and characterized by digital clubbing, pachydermia, and periostosis. Biallelic mutations in HPGD and SLCO2A1, disturbing prostaglandin E2 (PGE2 ) catabolism and leading to increased circulating PGE2 level, cause PHO autosomal recessive 1 (PHOAR1) and PHO autosomal recessive 2 (PHOAR2), respectively. However, no causative genes have been reported for PHO autosomal dominant (PHOAD). Here, we performed Sanger sequencing and whole-genome sequencing (WGS) on DNA samples from seven Chinese PHOAD families; after excluding other single-nucleotide variants (SNVs), structural variations (SVs), and copy number variations (CNVs) in the genomes, we reported six SLCO2A1 monoallelic mutations (c.1660G>A [p.G554R], c.664G>A [p.G222R], c.1106G>A [p.G369D], c.1065dupA [p.Q356TfsX77], c.1293delT [p.S432AfsX48], and c.1807C>T [p.R603X]) in the probands and affected family members. Then, in five other PHO families with probands carrying SLCO2A1 biallelic mutations, we verified that parents with SLCO2A1 monoallelic mutations also displayed PHO manifestations, which further confirmed the pathogenicity of SLCO2A1 monoallelic mutations and illustrated the allelic nature of PHOAD and PHOAR2. Subsequently, through comparison of seven PHOAD probands and 50 PHOAR2 patients, we found onset age in puberty and skewed penetrance rate were similar in both PHO types, but symptoms and signs of PHOAD were milder, including less severe pachydermia (p = .027) and periostosis (p = .005), and less frequent cutis verticis gyrata (p = .011), acne (p = .005), arthralgia (p = .037), and anemia (p = .023). The median urinary PGE2 level in PHOAD probands was almost half that in PHOAR2 patients (PHOAD 277.58 ng/mmoL creatinine, PHOAR2 473.19 ng/mmoL creatinine; p = .038). Moreover, through the 3-month trial of oral administration of etoricoxib, an effective response similar to that we reported previously in PHOAR2 patients was observed in PHOAD probands. In conclusion, our findings confirm that SLCO2A1 monoallelic mutations are the cause of PHOAD and broaden phenotypic spectrum of PHO. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Yang Xu
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zeng Zhang
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hua Yue
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Shanshan Li
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhenlin Zhang
- Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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5
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Oiwa T, Ishibashi M, Okuno T, Ohba M, Endo Y, Uozumi R, Ghazawi FM, Yoshida K, Niizeki H, Yokomizo T, Nomura T, Kabashima K. Eicosanoid profiling in patients with complete form of pachydermoperiostosis carrying SLCO2A1 mutations. J Dermatol 2021; 48:1442-1446. [PMID: 34114674 DOI: 10.1111/1346-8138.16012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/08/2021] [Accepted: 05/14/2021] [Indexed: 11/29/2022]
Abstract
Pachydermoperiostosis (PDP) is a genetic disease characterized by digital clubbing, periostosis, and pachydermia caused by mutated HPGD or SLCO2A1. Plasma prostaglandin (PG)E2 levels are increased in these patients. However, other eicosanoids have not been quantitated. We aimed to quantitate plasma eicosanoid levels in four patients carrying SLCO2A1 mutations by high-performance liquid chromatography-tandem mass spectrometry. PGE2 level was elevated in all patients; PGD2 and 11β-PGF2 α levels were also increased in some patients, whereas eicosapentaenoic acid, docosahexaenoic acid, and arachidonic acid levels were decreased in all patients. Our data indicate a dysfunctional eicosanoid homeostasis and varied levels of PG in patients with a complete form of PDP carrying SLCO2A1 mutations. PGE2 levels seem to mostly affect the symptoms, with other eicosanoids possibly having a minor effect.
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Affiliation(s)
- Tomohiro Oiwa
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mami Ishibashi
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Dermatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Toshiaki Okuno
- Department of Biochemistry (I), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mai Ohba
- Department of Biochemistry (I), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuichiro Endo
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryuji Uozumi
- Institute for Advancement of Clinical and Translational Science (iACT), Koto University Hospital, Kyoto, Japan
| | - Feras M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, Canada
| | - Kazue Yoshida
- Division of Dermatology, Department of Surgical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hironori Niizeki
- Division of Dermatology, Department of Surgical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Takehiko Yokomizo
- Department of Biochemistry (I), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takashi Nomura
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,A*STAR Singapore Immunology Network (SIgN)/Skin Research Institute of Singapore (SRIS), Singapore, Singapore
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6
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Role of Prostaglandin E-Major Urinary Metabolite Levels in Identifying the Phenotype of Pachydermoperiostosis. J Invest Dermatol 2021; 141:2973-2975. [PMID: 34089722 DOI: 10.1016/j.jid.2021.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 11/21/2022]
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7
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Anansiripun P, Suchonwanit P. A Case of Progressive Thickening and Furrowing of Facial Skin and Scalp with Scarring Alopecia. Skin Appendage Disord 2021; 7:237-242. [PMID: 34055917 DOI: 10.1159/000513792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Pimsiri Anansiripun
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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8
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Li X, Chen L, Xu J, Xiong X, Deng Y. A case of cutis verticis gyrata related to pregnancy. Indian J Dermatol Venereol Leprol 2021; 87:533-534. [PMID: 33969669 DOI: 10.25259/ijdvl_751_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 02/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Xulin Li
- Department of Dermatology, Affifiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Lingna Chen
- Department of Dermatology, Affifiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Jixiang Xu
- Department of Dermatology, Affifiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xia Xiong
- Department of Dermatology, Affifiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Yongqiong Deng
- Department of Dermatology, Affifiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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9
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Ishizuka T, Fujioka K, Mori I, Takeda T, Fuwa M, Ikeda T, Taguchi K, Morita H, Nakabayashi K, Niizeki H. Primary hypertrophic osteoarthropathy with severe arthralgia identified by gene mutation of SLCO2A1. Mod Rheumatol Case Rep 2021; 5:404-408. [PMID: 33308032 DOI: 10.1080/24725625.2020.1861744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Male, 41 years old (yo) had been complaining of severe arthralgia. Past History indicated obstruction of intestinal tract at 12 yo and gastric ulcer at 13 yo. He had been suffered from polyarthralgia especially at PIP and MP joints of both hands from 38 yo. Finally, he complained severe arthralgia at PIP and MP joints with clubbed fingers without swelling. Biochemical finding indicated negative rheumatoid factor and anti-CCP antibody and normal MMP-3 level, but slightly increased CRP and ESR levels. Radiological finding indicated periostosis of long bone without bone erosion and osteoporosis. His facial appearance was acromegalic with cutaneous manifestation of pachydermia and cutis vertices gyrate without abnormal growth hormone response. Histological findings of skin indicated oedema and hyperplasia of sebaceous glands with infiltration of lymphocytes around small blood vessels compatible with pachydermoperiostosis. In this case mutation of SLCO2A1 gene, which coded prostaglandin transport protein, was identified. The mutation c.940 + 1G > A of SLCO2A1 gene results in deletion of exon 7 and truncation of PG transporter (p.Arg288Glyfs*7). We suggest that severe arthralgia was originated from over production of prostaglandin E2. Further studies will be required.
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Affiliation(s)
- Tatsuo Ishizuka
- Center of General Internal Medicine and Rheumatology, Gifu Municipal Hospital, Gifu, Japan
| | - Kei Fujioka
- Center of General Internal Medicine and Rheumatology, Gifu Municipal Hospital, Gifu, Japan
| | - Ichiro Mori
- Center of General Internal Medicine and Rheumatology, Gifu Municipal Hospital, Gifu, Japan
| | - Tomofumi Takeda
- Center of General Internal Medicine and Rheumatology, Gifu Municipal Hospital, Gifu, Japan
| | - Masayuki Fuwa
- Center of General Internal Medicine and Rheumatology, Gifu Municipal Hospital, Gifu, Japan
| | - Takahide Ikeda
- Department of General Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Koichiro Taguchi
- Department of General Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroyuki Morita
- Department of General Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Center for Child Health and Development, Tokyo, Japan.,Department of Dermatology, National Center for Child Health and Development, Tokyo, Japan
| | - Hironori Niizeki
- Department of Maternal-Fetal Biology, National Center for Child Health and Development, Tokyo, Japan.,Department of Dermatology, National Center for Child Health and Development, Tokyo, Japan
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10
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Zouboulis CC, Yoshida GJ, Wu Y, Xia L, Schneider MR. Sebaceous gland: Milestones of 30‐year modelling research dedicated to the “brain of the skin”. Exp Dermatol 2020; 29:1069-1079. [DOI: 10.1111/exd.14184] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Christos C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodore Fontane and Faculty of Health Sciences Brandenburg Dessau Germany
| | - Go J. Yoshida
- Department of Immunological Diagnosis Juntendo University School of Medicine Bunkyo‐ku, Tokyo Japan
| | - Yaojiong Wu
- Shenzhen Key Laboratory of Health Sciences and Technology Tsinghua Shenzhen International Graduate School and Tsinghua‐Berkeley Shenzhen Institute Tsinghua University Beijing China
| | - Longqing Xia
- Department of Dermatology Renji Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - Marlon R. Schneider
- German Federal Institute for Risk Assessment (BfR) German Centre for the Protection of Laboratory Animals (Bf3R) Berlin Germany
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11
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Akaranuchat N, Limsuvan P. Touraine-Solente-Gole syndrome: Clinical manifestation with bilateral true eyelid ptosis. JPRAS Open 2020; 21:6-13. [PMID: 32158879 PMCID: PMC7061552 DOI: 10.1016/j.jpra.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 04/16/2019] [Indexed: 11/03/2022] Open
Abstract
Touraine-Solente-Gole syndrome (pachydermoperiostosis [PDP] or primary idiopathic hypertrophic osteoarthropathy [HOA]) is a rare hereditary disorder that is characterized by a triad of manifestations that consists of skin changes (pachydermia), abnormal bone and joint manifestations (periostosis and/or artritis), and digital clubbing (acropachia). Here, we report the case of 24-year-old male who presented with severe bilateral true eyelid ptosis. Physical examination revealed severe ptosis with poor function of the levator palpabrae superioris muscle, thickening of and deep grooves in facial skin (especially at the frontal region), and abnormal appearance of the scalp with accentuating folds and deep furrows (cutis verticis gyrata). Abnormal bone enlargement of the hands, knees, and feet was also observed. Frontal rhytidectomy and levator resection and advancement were performed to alleviate symptoms. At the short-term follow-up, the patient described being satisfied with the outcome of treatment. This patient will be routinely followed over the long term to evaluate disease progression. Although the cause of ptosis in most PDP is mechanical process or dysfunction, this case of PDP had bilateral true eyelid ptosis due to poor levator palpabrae superioris muscle excursion with coexisting signs and symptoms of complete form PDP. This finding highlights the need to investigate for bilateral true eyelid ptosis caused by abnormal levator palpabrae superioris muscle function in patients diagnosed with PDP.
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Affiliation(s)
- Nutthawut Akaranuchat
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
| | - Papassorn Limsuvan
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
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12
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Mengana Medina M, Frómeta Guerra A, Fuentes Liens EE, Sánchez Figueredo SA. Touraine-Solente-Gole Syndrome. (Primary paquidermoperiostosis). Two case report. BIONATURA 2020. [DOI: 10.21931/rb/2020.05.01.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Two cases occur in the same family (siblings) of 30 and 16 years of age with a diagnosis of primary pachydermoperiostosis or Touraine-Solente-Goulé Syndrome (TSG), an uncommon condition, characterized by pachydermia, periostosis and pachydactyly, which can be idiopathic, with onset at puberty, of genetic origin, autosomal dominant transmission.
These brothers come to the internal medicine office of the Carlos Manuel de Céspedes hospital complaining of joint pain with skin and osteoarticular manifestations, consulting with the dermatology service considering the diagnosis of this rare syndrome and conducting relevant studies and after its conclusion makes the clinical report for publication because it is the first case reported in our province.
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Affiliation(s)
- Martha Mengana Medina
- Especialista de 1er grado en Dermatología y Profesora Asistente. Hospital General Universitario “Carlos Manuel de Céspedes”. Granma Cuba
| | - Adonis Frómeta Guerra
- Especialista de 2do grado en medicina interna y Profesor Auxiliar. Hospital General Universitario “Carlos Manuel de Céspedes”. Granma Cuba
| | - Eduardo Enrique Fuentes Liens
- Especialista de 1er grado en Medicina General Integral, Especialista de 1er grado en Otorrinolaringología. Profesor Asistente. Hospital General Universitario “Carlos Manuel de Céspedes”. Granma Cuba
| | - Sandra Amalia Sánchez Figueredo
- Especialista de primer grado en medicina intensiva. Profesor asistente Hospital General Universitario “Carlos Manuel de Céspedes”. Granma Cuba
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13
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Tabatabaei SA, Masoomi A, Soleimani M, Rafizadeh SM, Salabati M, Ahmadraji A, Bohrani B, Ghahvechian H, Nozarian Z. Pachydermoperiostosis: A clinicopathological description. J Curr Ophthalmol 2019; 31:450-453. [PMID: 31844800 PMCID: PMC6896461 DOI: 10.1016/j.joco.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/24/2019] [Accepted: 03/04/2019] [Indexed: 11/27/2022] Open
Abstract
Purpose To report a case of pachydermoperiostosis (PDP) and a review of the literature. Methods A 32-year-old man was referred to our clinic with bilateral eyelid swelling and blepharoptosis. On examination, marked blepharoptosis was noted, and his eyelids were found to be floppy. Systemic examination was significant for clubbing of digits, coarse acromegalic facial features, and furrowing and oiliness of the skin of scalp and forehead. Results The patient was diagnosed as a case of PDP. On the brain MRI, the pituitary gland was enlarged, and the border of clivus was irregular. Pituitary and thyroid hormone levels were normal. He underwent bilateral lateral tarsal strip (LTS) procedure to address the eyelid laxity. Histopathologic examination revealed marked sebaceous gland hyperplasia with mucin deposition in the dermis. Conclusion Floppy eyelid syndrome, clubbing, and acromegaloid face are main features that could lead to the diagnosis of PDP.
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Affiliation(s)
- Seyed Ali Tabatabaei
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoomi
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohsen Rafizadeh
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mirataollah Salabati
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliasghar Ahmadraji
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Bohrani
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ghahvechian
- Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Nozarian
- Pathology Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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14
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Neurosurgical and Scalp Reconstructive Challenges During Craniotomy in the Setting of Cutis Verticis Gyrata. World Neurosurg 2019; 125:392-397. [PMID: 30763753 DOI: 10.1016/j.wneu.2019.01.217] [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] [Received: 12/12/2018] [Accepted: 01/22/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cutis verticis gyrata (CVG) is a rare condition of the scalp in which thickening of the dermis induces rigid folds and furrows resembling the cerebral cortex. Two forms of primary CVG exist: essential, in which CVG is the only presenting problem, and nonessential, in which the scalp condition occurs along with neuropsychiatric ailments. CVG can also occur secondary to a variety of causes including inflammatory, neoplastic, and metabolic conditions or drug use. A review of the available literature, including description of the epidemiology, pathophysiology, histology, and typical management of CVG, is provided. However, we identified no literature describing the complications of CVG in the setting of a craniotomy. CASE REPORT The patient presented here is a 54-year-old man with CVG who presented with occlusion of the M2/M2 branches of the middle cerebral artery, resulting in malignant cerebral edema, requiring emergent management via decompressive craniectomy. Because of the thickening of the scalp, skin incision was complicated by bleeding and difficulty in achieving hemostasis using Raney clips. Plastic surgery was consulted intraoperatively for assistance with complex closure of the wound in a multilayered fashion. Despite this, the patient's postoperative course was complicated by cerebrospinal fluid leakage due to difficulty in approximating the incision during closure. Subsequent cranioplasty was performed jointly between neurosurgery and plastic surgery. CONCLUSIONS Despite its rarity, CVG is an important issue for neurosurgeons to understand as it can present complications in performing craniotomy, most notably during the scalp exposure and closure. CVG may also complicate the postoperative course if adequate approximation of the tissues cannot be achieved, resulting in wound infection and/or cerebrospinal fluid leak. The presented patient benefited from a combined neurosurgical and plastic surgical approach that was implemented intraoperatively and continued through the postoperative stages and the subsequent cranioplasty.
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15
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Pachydermoperiostosis in a 19-year-old Taiwanese man. DERMATOL SIN 2018. [DOI: 10.1016/j.dsi.2018.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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16
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Alessandrella A, Della Casa R, Alessio M, Puente Prieto J, Strisciuglio P, Melis D. A novel homozygous mutation in the
SLCO2A1
gene causing pachydermoperiostosis: Efficacy of hydroxychloroquine treatment. Am J Med Genet A 2018; 176:1253-1257. [DOI: 10.1002/ajmg.a.38677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 01/28/2018] [Accepted: 02/22/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Annalisa Alessandrella
- Department of Translational Medical SciencesSection of Pediatrics, Federico II UniversityNaples Italy
| | - Roberto Della Casa
- Department of Translational Medical SciencesSection of Pediatrics, Federico II UniversityNaples Italy
| | - Maria Alessio
- Department of Translational Medical SciencesSection of Pediatrics, Federico II UniversityNaples Italy
| | | | - Pietro Strisciuglio
- Department of Translational Medical SciencesSection of Pediatrics, Federico II UniversityNaples Italy
| | - Daniela Melis
- Department of Translational Medical SciencesSection of Pediatrics, Federico II UniversityNaples Italy
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17
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Wen X, Li Y, Hamblin MR, Jiang X. Facial Manifestations of Pachydermoperiostosis Treated with Botulinum Toxin Type-A: Report of 3 Cases. Acta Derm Venereol 2017; 97:761-762. [PMID: 28224169 PMCID: PMC5475399 DOI: 10.2340/00015555-2645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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18
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Tanese K, Niizeki H, Seki A, Nakabayashi K, Nakazawa S, Tokura Y, Kawashima Y, Kubo A, Ishiko A. Infiltration of mast cells in pachydermia of pachydermoperiostosis. J Dermatol 2017; 44:1320-1321. [PMID: 28191660 PMCID: PMC5697663 DOI: 10.1111/1346-8138.13770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Keiji Tanese
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Hironori Niizeki
- Department of Dermatology, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuhito Seki
- Department of Orthopedics, National Center for Child Health and Development, Tokyo, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Shinsuke Nakazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yuhei Kawashima
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Akiharu Kubo
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Akira Ishiko
- Department of Dermatology, Toho University School of Medicine, Tokyo, Japan
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19
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Nakazawa S, Mori T, Niizeki H, Nakabayashi K, Tokura Y. Complete type of pachydermoperiostosis with a novel mutation c.510G>A of the SLCO2A1 gene. J Dermatol 2016; 44:1411-1412. [PMID: 28026033 DOI: 10.1111/1346-8138.13728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Shinsuke Nakazawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Division of Dermatology, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Tatsuyoshi Mori
- Division of Dermatology, Fujinomiya City General Hospital, Fujinomiya, Japan.,Mori Clinic, Mishima, Japan
| | - Hironori Niizeki
- Department of Dermatology, National Center for Child Health and Development, Tokyo, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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