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Pan C, Ge H, Zheng L, Cao Q, Zhang C, Wang Y, Zhao A, He W, Li G, Liu H, Yang Y, Wei R, Wang H, Tan Y, Wang B, Cheng W, Sun Z, Wang X, Li M. Exploring Th17-related inflammation in AP1B1-associated KIDAR syndrome and potential therapeutic implications of secukinumab. J Eur Acad Dermatol Venereol 2024. [PMID: 38641987 DOI: 10.1111/jdv.20033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/30/2024] [Indexed: 04/21/2024]
Affiliation(s)
- Chaolan Pan
- Department of Dermatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongsong Ge
- Department of Dermatology, Anhui Provincial Children's Hospital, Hefei, China
| | - Luyao Zheng
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiaoyu Cao
- Department of Dermatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Cheng Zhang
- Department of Dermatology, Anhui Provincial Children's Hospital, Hefei, China
| | - Yumeng Wang
- Department of Dermatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Anqi Zhao
- Department of Dermatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei He
- Department of Dermatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Guofang Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haifei Liu
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yijun Yang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruoqu Wei
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haoyu Wang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yidong Tan
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bing Wang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenjie Cheng
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhe Sun
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoxiao Wang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ming Li
- Department of Dermatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
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Van Oosterwyck R, Loos E, Willaert A. Otological problems in ichthyosis: A literature review. Int J Pediatr Otorhinolaryngol 2023; 173:111714. [PMID: 37714023 DOI: 10.1016/j.ijporl.2023.111714] [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: 03/05/2023] [Revised: 07/29/2023] [Accepted: 08/27/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Ichthyoses are a rare group of keratinization disorders characterized by scaling of the skin due to an impaired barrier function. Few studies have addressed ear involvement in patients with ichthyosis, although it is a probably underestimated aspect of the disease. OBJECTIVE This study aims to provide an overview of the otological manifestations in ichthyosis and propose specific treatment options. METHODS Articles were collected using PubMed, EMBASE, and Web of Science. A total of 53 articles were included in this literature review. RESULTS The most common ear problem in patients with ichthyosis is scale accumulation in the ear canals, which can lead to conductive hearing loss and increases the risk of ear infections. Furthermore, some types of ichthyosis are associated with outer ear malformations. Lastly, sensorineural hearing loss is common in syndromic forms of ichthyosis. CONCLUSIONS Otological problems are present in all types of ichthyoses and their treatment is challenging. The involvement of ear, nose, and throat specialists in the routine care of ichthyosis patients is essential for early identification and treatment of these manifestations. More research is needed to provide more insight into the otological problems in ichthyosis and to ameliorate treatment options.
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Affiliation(s)
- R Van Oosterwyck
- University Hospitals Leuven, Department of Otorhinolaryngology-Head and Neck Surgery, Herestraat 49, B-3000, Leuven, Belgium
| | - E Loos
- University Hospitals Leuven, Department of Otorhinolaryngology-Head and Neck Surgery, Herestraat 49, B-3000, Leuven, Belgium; KU Leuven, University of Leuven, Department of Neurosciences, Research Group ExpORL, Leuven, Belgium.
| | - A Willaert
- University Hospitals Leuven, Department of Otorhinolaryngology-Head and Neck Surgery, Herestraat 49, B-3000, Leuven, Belgium
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3
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Serra G, Memo L, Cavicchioli P, Cutrone M, Giuffrè M, La Torre ML, Schierz IAM, Corsello G. Novel mutations of the ABCA12, KRT1 and ST14 genes in three unrelated newborns showing congenital ichthyosis. Ital J Pediatr 2022; 48:145. [PMID: 35964051 PMCID: PMC9375412 DOI: 10.1186/s13052-022-01336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Congenital ichthyosis (CI) is a heterogeneous group of genetic disorders characterized by generalized dry skin, scaling and hyperkeratosis, often associated to erythroderma. They are rare diseases, with overall incidence of 6.7 in 100,000. Clinical manifestations are due to mutations in genes mostly involved in skin barrier formation. Based on clinical presentation, CI is distinguished in non-syndromic and syndromic forms. To date, mutations of more than 50 genes have been associated to different types of CI. Cases presentation We report on three Italian unrelated newborns showing clinical signs compatible with different forms of CI of variable severity, namely Harlequin ichtyosis (HI), epidermolytic ichtyosis (EI) and autosomal recessive ichtyosis with hypotrichosis (ARIH). Target next generation sequencing (NGS) analysis identified three novel mutations of the ABCA12, KRT1 and ST14 genes, respectively associated to such congenital ichtyoses, not reported in literature. Genomic investigation allowed to provide the more appropriate management to each patient, based on an individualized approach. Conclusions Our report highlights the wide genetic heterogeneity and phenotypic variability of CI. It expands the current knowledge on such diseases, widening their genomic database, and providing a better clinical characterization. Furthermore, it underlines the clinical relevance of NGS, which is essential to address the management of patients. Indeed, it may guide towards the most adequate approach, preventing clinical obstinacy for subjects with more severe forms and unfavorable outcomes (together with the support, in such situations, of bioethicists included within the multidisciplinary care team), as well as reassuring families in those with milder course and favorable evolution.
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Affiliation(s)
- Gregorio Serra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
| | - Luigi Memo
- Clinical Genetics Outpatient Service, Serenissima Unit of Health and Social Services 3, Venice, Italy
| | - Paola Cavicchioli
- Pediatrics and Neonatal Intensive Care Unit, Angel Hospital, Mestre, Venice, Italy
| | - Mario Cutrone
- Pediatric Dermatology Outpatient Service, Angel Hospital, Mestre, Venice, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Maria Laura La Torre
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Ingrid Anne Mandy Schierz
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
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Joosten MDW, Clabbers JMK, Jonca N, Mazereeuw-Hautier J, Gostyński AH. New developments in the molecular treatment of ichthyosis: review of the literature. Orphanet J Rare Dis 2022; 17:269. [PMID: 35840979 PMCID: PMC9287901 DOI: 10.1186/s13023-022-02430-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022] Open
Abstract
Ichthyosis covers a wide spectrum of diseases affecting the cornification of the skin. In recent years, new advances in understanding the pathophysiology of ichthyosis have been made. This knowledge, combined with constant development of pathogenesis-based therapies, such as protein replacement therapy and gene therapy, are rather promising for patients with inherited skin diseases. Several ongoing trials are investigating the potency of these new approaches and various studies have already been published. Furthermore, a lot of case series report that biological therapeutics are effective treatment options, mainly for Netherton syndrome and autosomal recessive congenital ichthyosis. It is expected that some of these new therapies will prove their efficacy and will be incorporated in the treatment of ichthyosis.
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Affiliation(s)
- M D W Joosten
- Department of Dermatology, The Netherlands and European Reference Network - Skin, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands
| | - J M K Clabbers
- Department of Dermatology, The Netherlands and European Reference Network - Skin, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.,Department of Dermatology, Haga Hospital, The Hague, The Netherlands
| | - N Jonca
- Cell Biology and Cytology Laboratory, CNRS, Inserm, UPS, European Reference Network - Skin, University Hospital Center of Toulouse and Infinity, Federal Biology Institute, Toulouse University, Toulouse, France
| | - J Mazereeuw-Hautier
- Department of Dermatology, European Reference Network - Skin, University Hospital Center of Toulouse, Toulouse, France
| | - A H Gostyński
- Department of Dermatology, The Netherlands and European Reference Network - Skin, Maastricht University Medical Center, Maastricht, The Netherlands. .,GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, The Netherlands.
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5
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Daae E, Feragen KB, Sitek JC, von der Lippe C. It's more than just lubrication of the skin: parents' experiences of caring for a child with ichthyosis. Health Psychol Behav Med 2022; 10:335-356. [PMID: 35402085 PMCID: PMC8986293 DOI: 10.1080/21642850.2022.2053685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The ichthyoses are a group of genetic skin disorders, characterized by excessive amounts of dry, thickened skin, which may be fragile, inelastic and prone to fissures and infection. Skin care is time consuming and demanding, and, usually performed by the parents. Methods: We aimed to explore parental experience of caring for a child with ichthyosis, and collected data using semistructured interview, and thematic analysis. Results: Our analysis revealed four main themes: Parents' and others' reactions to the child's difference, Experiences with healthcare services, It's all skin care, and Impact on relationships. Conclusion: After birth of a child with severe ichthyosis, the parents experienced emotional distress and stigmatization due to the different appearance of the skin and healthcare professionals' lack of knowledge. Skin care caused pain in the child, was time consuming, and caused financial burdens. This study can guide healthcare professionals on where to focus future efforts in meeting the clinical and psychological needs of parents caring for a child with ichthyosis.
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Affiliation(s)
- Elisabeth Daae
- Center for Rare Disorders, Oslo University Hospital HF, Oslo, Norway
| | | | - Jan C Sitek
- Department of Dermatology, Oslo University Hospital HF, Oslo, Norway
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6
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Cuperus E, Bygum A, Boeckmann L, Bodemer C, Bolling MC, Caproni M, Diociaiuti A, Emmert S, Fischer J, Gostynski A, Guez S, van Gijn ME, Hannulla-Jouppi K, Has C, Hernández-Martín A, Martinez AE, Mazereeuw-Hautier J, Medvecz M, Neri I, Sigurdsson V, Suessmuth K, Traupe H, Oji V, Pasmans SGMA. Proposal for a 6-step-approach for differential diagnosis of neonatal erythroderma. J Eur Acad Dermatol Venereol 2022; 36:973-986. [PMID: 35238435 PMCID: PMC9310754 DOI: 10.1111/jdv.18043] [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: 05/12/2021] [Revised: 12/15/2021] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
The broad differential diagnosis of neonatal erythroderma often poses a diagnostic challenge. Mortality of neonatal erythroderma is high due to complications of the erythroderma itself and the occasionally severe and life-threatening underlying disease. Early correct recognition of the underlying cause leads to better treatment and prognosis. Currently, neonatal erythroderma is approached by a case by case basis. The purpose of this scoping review was to develop a diagnostic approach in neonatal erythroderma. After a systematic literature search in Embase (January 1990 - May 2020, 74 cases of neonatal erythroderma were identified, and 50+ diagnoses could be extracted. Main causes were the ichthyoses (40%) and primary immunodeficiencies (35%). Congenital erythroderma was present in 64% (47/74) of the cases, predominantly with congenital ichthyosis (11/11; 100%), Netherton syndrome (12/14, 86%), and Omenn syndrome (11/23, 48%). Time until diagnosis ranged from 102 days to 116 days for cases of non-congenital erythroderma and congenital erythroderma respectively. Among the 74 identified cases a total of 17 patients (23%) died within a mean of 158 days and were related to Omenn syndrome (35%), graft versus host disease (67%), and Netherton syndrome (18%). Disease history and physical examination are summarized in this paper. Age of onset and a collodion membrane can help to narrow the differential diagnoses. Investigations of blood, histology, hair analysis, genetic analysis and clinical imaging are summarized and discussed. A standard blood investigation is proposed and the need for skin biopsies with Lympho-Epithelial Kazal-Type related Inhibitor-staining is highlighted. Overall, this review shows that diagnostic procedures narrow the differential diagnosis in neonatal erythroderma. A 6-step flowchart for the diagnostic approach for neonatal erythroderma during the first month of life is proposed. The approach was made with the support of expert leaders from international multidisciplinary collaborations in the European Reference Network Skin-subthematic group Ichthyosis.
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Affiliation(s)
- E Cuperus
- Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Department of Dermatology, Center of Pediatric Dermatology, The Netherlands
| | - A Bygum
- University of Southern Denmark, Clinical Institute, Denmark & Odense University Hospital, Department of Clinical Genetics, Denmark
| | - L Boeckmann
- University Medical Center Rostock. Clinic and Policlinic for Dermatology and Venereology. Rostock, Germany
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker-Enfants Malades Hospital (AP-HP5), Paris-Centre University, Imagine Institute, INSERM, Paris, France
| | - M C Bolling
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Groningen, the Netherlands
| | - M Caproni
- Department of Health Sciences, Section of Dermatology, USL Toscana Centro, Rare Diseases Unit, University of Florence, Florence, Italy
| | - A Diociaiuti
- Dermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Emmert
- University Medical Center Rostock. Clinic and Policlinic for Dermatology and Venereology. Rostock, Germany
| | - J Fischer
- Institute of Human Genetics, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - A Gostynski
- Department of Dermatology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - S Guez
- Pediatrics Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - M E van Gijn
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - K Hannulla-Jouppi
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, HUS, Helsinki, Finland
| | - C Has
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - A E Martinez
- Pediatric Dermatology, NHS Foundation Trust, Great Ormond Street, London, UK
| | - J Mazereeuw-Hautier
- Dermatology Department, Reference Center for Rare Skin Diseases, Toulouse, France
| | - M Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - I Neri
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater, Studiorum University of Bologna, Bologna, Italy
| | - V Sigurdsson
- University Medical Center Utrecht and Utrecht University, Department of Dermatology, Utrecht, The Netherlands
| | - K Suessmuth
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - S G M A Pasmans
- Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Department of Dermatology, Center of Pediatric Dermatology, The Netherlands
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7
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Navarro‐Navarro I, Jiménez‐Gallo D, Varga‐Martínez R, Villegas‐Romero I, Mora‐López F, Linares‐Barrios M, Youssefian L, Vahidnezhad H, Uitto J. Novel splice mutation in cdsn gene causing type B peeling skin syndrome. J Eur Acad Dermatol Venereol 2022; 36:e456-e460. [DOI: 10.1111/jdv.17949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/21/2021] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Irene Navarro‐Navarro
- Unidad de Gestión Clínica de Dermatología Médico‐Quirúrgica y Venereología Hospital Universitario Puerta del Mar Cádiz Spain
| | - David Jiménez‐Gallo
- Unidad de Gestión Clínica de Dermatología Médico‐Quirúrgica y Venereología Hospital Universitario Puerta del Mar Cádiz Spain
| | - Raquel Varga‐Martínez
- Servicio de Inmunología Unidad de Gestión Clínica de Hematología Inmunología y Genética Hospital Universitario Puerta del Mar Cádiz España
| | - Isabel Villegas‐Romero
- Unidad de Gestión Clínica de Dermatología Médico‐Quirúrgica y Venereología Hospital Universitario Puerta del Mar Cádiz Spain
| | - Francisco Mora‐López
- Servicio de Inmunología Unidad de Gestión Clínica de Hematología Inmunología y Genética Hospital Universitario Puerta del Mar Cádiz España
| | - Mario Linares‐Barrios
- Unidad de Gestión Clínica de Dermatología Médico‐Quirúrgica y Venereología Hospital Universitario Puerta del Mar Cádiz Spain
| | - Leila Youssefian
- Department of Dermatology and Cutaneous Biology Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology Sidney Kimmel Medical College Thomas Jefferson University Philadelphia PA USA
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8
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Sánchez-Espino LF, Gil-Téllez CI, Cantú-Reyna C, Martínez-Longoria CA. Ichthyosiform Erythroderma, a Multifaceted Syndromic Entity. Pediatr Rev 2021; 42:112-117. [PMID: 34470889 DOI: 10.1542/pir.2018-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Luis F Sánchez-Espino
- Instituto de Seguridad Social para los trabajadores del Estado de Nuevo León (ISSSTELEON), Hospital San José del Tecnológico de Monterrey, Mexico.,Department of Pediatrics, Tecnológico de Monterrey, School of Medicine and Health Science, Mexico
| | - Claudia I Gil-Téllez
- Instituto de Seguridad Social para los trabajadores del Estado de Nuevo León (ISSSTELEON), Hospital San José del Tecnológico de Monterrey, Mexico
| | - Consuelo Cantú-Reyna
- Instituto de Seguridad Social para los trabajadores del Estado de Nuevo León (ISSSTELEON), Hospital San José del Tecnológico de Monterrey, Mexico
| | - César A Martínez-Longoria
- Instituto de Seguridad Social para los trabajadores del Estado de Nuevo León (ISSSTELEON), Hospital San José del Tecnológico de Monterrey, Mexico
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9
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Trinh TT, Blasco H, Maillot F, Bakhos D. Hearing loss in inherited metabolic disorders: A systematic review. Metabolism 2021; 122:154841. [PMID: 34333001 DOI: 10.1016/j.metabol.2021.154841] [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: 05/02/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
Inherited metabolic disorders (IMDs) have been observed in individuals with hearing loss (HL), but IMDs are rarely the cause of syndromic HL. With early diagnosis, management of HL is more effective and cortical reorganization is possible with hearing aids or cochlear implants. This review describes relationships between IMDs and HL in terms of incidence, etiology of HL, pathophysiology, and treatment. Forty types of IMDs are described in the literature, mainly in case reports. Management and prognosis are noted where existing. We also describe IMDs with HL given age of occurrence of HL. Reviewing the main IMDs that are associated with HL may provide an additional clinical tool with which to better diagnose syndromic HL.
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Affiliation(s)
- T-T Trinh
- CHRU de Tours, service ORL et Chirurgie Cervico-Faciale, Tours, France.
| | - H Blasco
- Laboratoire de Biochimie et Biologie Moléculaire, Tours, France; Université François Rabelais, Tours, France; INSERM U1253, Tours, France
| | - F Maillot
- Université François Rabelais, Tours, France; INSERM U1253, Tours, France; CHU de Tours, service de Médecine Interne, Tours, France
| | - D Bakhos
- CHRU de Tours, service ORL et Chirurgie Cervico-Faciale, Tours, France; Université François Rabelais, Tours, France; INSERM U1253, Tours, France
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10
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hiPSC-Derived Epidermal Keratinocytes from Ichthyosis Patients Show Altered Expression of Cornification Markers. Int J Mol Sci 2021; 22:ijms22041785. [PMID: 33670118 PMCID: PMC7916893 DOI: 10.3390/ijms22041785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Inherited ichthyoses represent a large heterogeneous group of skin disorders characterised by impaired epidermal barrier function and disturbed cornification. Current knowledge about disease mechanisms has been uncovered mainly through the use of mouse models or human skin organotypic models. However, most mouse lines suffer from severe epidermal barrier defects causing neonatal death and human keratinocytes have very limited proliferation ability in vitro. Therefore, the development of disease models based on patient derived human induced pluripotent stem cells (hiPSCs) is highly relevant. For this purpose, we have generated hiPSCs from patients with congenital ichthyosis, either non-syndromic autosomal recessive congenital ichthyosis (ARCI) or the ichthyosis syndrome trichothiodystrophy (TTD). hiPSCs were successfully differentiated into basal keratinocyte-like cells (hiPSC-bKs), with high expression of epidermal keratins. In the presence of higher calcium concentrations, terminal differentiation of hiPSC-bKs was induced and markers KRT1 and IVL expressed. TTD1 hiPSC-bKs showed reduced expression of FLG, SPRR2B and lipoxygenase genes. ARCI hiPSC-bKs showed more severe defects, with downregulation of several cornification genes. The application of hiPSC technology to TTD1 and ARCI demonstrates the successful generation of in vitro models mimicking the disease phenotypes, proving a valuable system both for further molecular investigations and drug development for ichthyosis patients.
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TROIANO GIANMARCO, LAZZERI GIACOMO. A review of quality of life of patients suffering from ichthyosis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E374-E378. [PMID: 33150225 PMCID: PMC7595076 DOI: 10.15167/2421-4248/jpmh2020.61.3.1450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
Introduction Ichthyoses include a heterogeneous group of skin diseases often characterized by persistent scaling and hyperkeratosis with variable erythema, pruritus, and sweating impairment. The aim of our review was to assess the quality of life in patients with ichthyosis. Methods In July 2018 we performed a systematic search in the electronic database PubMed (MEDLINE). The MESH term “quality of life” was combined, through the Boolean operator AND with the key word “ichthyosis”. We considered eligible for the systematic review studies written in English. Results The literature search yielded 63 publications, but 7 studies were included in the review. Studies were published in 2003-2014 and involved a minimum of 10 and a maximum of 235 patients. Authors used 5 types of tools: Dermatology Life Quality Index (DLQI), Dermatitis Family Impact Questionnaire (DFI), Nottingham Health Profile (NHP) questionnaire, Short Form Questionnaire 36 and 12 (SF-36, SF-12). Many patients reported worse scores than general population. Patients referred physical problems related to pain (which negatively influenced the mobility). Conclusions Ichthyosis considerably impaired the QoL, especially for paediatric patients. Further studies and efforts should be done to manage and treat the pain.
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Affiliation(s)
- GIANMARCO TROIANO
- Correspondence: Gianmarco Troiano, Department of Molecular & Developmental Medicine, University of Siena, Italy - E-mail:
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12
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Kloska A, Węsierska M, Malinowska M, Gabig-Cimińska M, Jakóbkiewicz-Banecka J. Lipophagy and Lipolysis Status in Lipid Storage and Lipid Metabolism Diseases. Int J Mol Sci 2020; 21:E6113. [PMID: 32854299 PMCID: PMC7504288 DOI: 10.3390/ijms21176113] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 12/15/2022] Open
Abstract
This review discusses how lipophagy and cytosolic lipolysis degrade cellular lipids, as well as how these pathway ys communicate, how they affect lipid metabolism and energy homeostasis in cells and how their dysfunction affects the pathogenesis of lipid storage and lipid metabolism diseases. Answers to these questions will likely uncover novel strategies for the treatment of aforementioned human diseases, but, above all, will avoid destructive effects of high concentrations of lipids-referred to as lipotoxicity-resulting in cellular dysfunction and cell death.
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Affiliation(s)
- Anna Kloska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
| | - Magdalena Węsierska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
| | - Marcelina Malinowska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
| | - Magdalena Gabig-Cimińska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
- Laboratory of Molecular Biology, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Kładki 24, 80-822 Gdańsk, Poland
| | - Joanna Jakóbkiewicz-Banecka
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
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13
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Akiyama M. Acylceramide is a key player in skin barrier function: insight into the molecular mechanisms of skin barrier formation and ichthyosis pathogenesis. FEBS J 2020. [DOI: 10.1111/febs.15497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Masashi Akiyama
- Department of Dermatology Nagoya University Graduate School of Medicine Nagoya Japan
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14
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Mohamad J, Nanda A, Pavlovsky M, Peled A, Malchin N, Malovitski K, Pramanik R, Weissglas-Volkov D, Shomron N, McGrath J, Sprecher E, Sarig O. Phenotypic suppression of acral peeling skin syndrome in a patient with autosomal recessive congenital ichthyosis. Exp Dermatol 2020; 29:742-748. [PMID: 32618001 DOI: 10.1111/exd.14140] [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: 02/02/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/01/2022]
Abstract
Autosomal recessive congenital ichthyosis (ARCI) manifests with generalized scaling often associated with generalized erythema. Mutations in at least 13 different genes have been reported to cause ARCI. Acral peeling skin syndrome (APSS) is a rare autosomal recessive disorder manifesting with peeling over the distal limbs and dorsal surfaces of hands and feet. APSS is mostly due to mutations in TGM5, encoding transglutaminase 5. Both ARCI and APSS are fully penetrant genetic traits. Here, we describe a consanguineous family in which one patient with mild ARCI was found to carry a homozygous mutation in ALOXE3 (c.1238G > A; p.Gly413Asp). The patient was also found to carry a known pathogenic homozygous mutation in TGM5 (c.1335G > C; p.Lys445Asn) but did not display acral peeling skin. Her uncle carried the same homozygous mutation in TGM5 but carried the ALOXE3 mutation in a heterozygous state and showed clinical features typical of APSS. Taken collectively, these observations suggested that the ALOXE3 mutation suppresses the clinical expression of the TGM5 variant. We hypothesized that ALOXE3 deficiency may affect the expression of a protein capable of compensating for the lack of TGM5 expression. Downregulation of ALOXE3 in primary human keratinocytes resulted in increased levels of corneodesmosin, which plays a critical role in the maintenance of cell-cell adhesion in the upper epidermal layers. Accordingly, ectopic corneodesmosin expression rescued the cell-cell adhesion defect caused by TGM5 deficiency in keratinocytes as ascertained by the dispase dissociation assay. The present data thus provide evidence for phenotypic suppression in a human hereditary skin disorder.
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Affiliation(s)
- Janan Mohamad
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arti Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - Mor Pavlovsky
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Alon Peled
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Natalia Malchin
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Kiril Malovitski
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rashida Pramanik
- St John's Institute of Dermatology, King's College London, London, UK
| | - Daphna Weissglas-Volkov
- Department of Cell and Developmental Biology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noam Shomron
- Department of Cell and Developmental Biology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - John McGrath
- St John's Institute of Dermatology, King's College London, London, UK
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Sarig
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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15
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Cammarata-Scalisi F, Willoughby CE, Cárdenas Tadich A, Labrador N, Herrera A, Callea M. Clinical, etiopathogenic, and therapeutic aspects of KID syndrome. Dermatol Ther 2020; 33:e13507. [PMID: 32367610 DOI: 10.1111/dth.13507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/20/2020] [Accepted: 04/28/2020] [Indexed: 11/26/2022]
Abstract
Keratitis-ichthyosis-deafness (KID syndrome) is a syndromes ichthyoses that is clinically and genetically heterogeneous requiring early and long-term multidisciplinary monitoring of affected individuals. A review of the clinical, etiopathogenic and therapeutic aspects is presented of this rare congenital ectodermal disorder.
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Affiliation(s)
| | | | | | | | - Adriana Herrera
- Ophthalmology Unit, University of Los Andes, Mérida, Venezuela
| | - Michele Callea
- Unit of Dentistry, Bambino Gesù Children' Hospital, IRCCS, Rome, Italy
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16
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Rodríguez-Manchón S, Pedrón-Giner C, Cañedo-Villarroya E, Muñoz-Codoceo RA, Hernández-Martín Á. Malnutrition in children with ichthyosis: Recommendations for monitoring from a multidisciplinary clinic experience. J Am Acad Dermatol 2020; 85:144-151. [PMID: 32585277 DOI: 10.1016/j.jaad.2020.06.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/27/2020] [Accepted: 06/17/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Short stature has been reported in congenital ichthyoses (CI), but few data exist on patients' nutritional status. OBJECTIVE To describe the nutritional status at the first evaluation of children and young adults with CI. METHODS Prospective observational study of patients assessed at a multidisciplinary clinic. Clinical variables and ichthyosis severity were collected. Anthropometric assessment was made by measuring weight and height, and nutritional status was classified based on the World Health Organization definitions for malnutrition. Analytical assessment included markers of nutritional status, fat-soluble vitamins, and micronutrients. RESULTS We included 50 patients with a median age of 5 years (IQR, 1.6-10.3). Undernutrition was found in 32% of patients, and 75% of the undernourished children presented growth impairment. Younger children and those with severe ichthyoses were the most affected. Micronutrient deficiencies were found in 60% of patients. Deficiencies of selenium (34%), iron (28%), vitamin D (22%), and zinc (4%) were the most frequent findings. LIMITATIONS Our small sample includes a heterogeneous group of ichthyoses. CONCLUSION Children with CI appear to be at risk of undernutrition, especially at younger ages. Nutritional deficiencies are common and should be monitored. Growth failure in children with ichthyosis could be caused by undernutrition and aggravated by nutritional deficiencies.
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Affiliation(s)
- Silvia Rodríguez-Manchón
- Section of Paediatric Gastroenterology and Nutrition, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
| | - Consuelo Pedrón-Giner
- Section of Paediatric Gastroenterology and Nutrition, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Elvira Cañedo-Villarroya
- Section of Paediatric Gastroenterology and Nutrition, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Rosa Ana Muñoz-Codoceo
- Section of Paediatric Gastroenterology and Nutrition, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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17
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Non-invasive methods for evaluation of skin manifestations in patients with ichthyosis. Arch Dermatol Res 2019; 312:231-236. [DOI: 10.1007/s00403-019-01987-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/24/2019] [Accepted: 09/25/2019] [Indexed: 12/15/2022]
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18
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Cortés H, Del Prado-Audelo ML, Urbán-Morlán Z, Alcalá-Alcalá S, González-Torres M, Reyes-Hernández OD, González-Del Carmen M, Leyva-Gómez G. Pharmacological treatments for cutaneous manifestations of inherited ichthyoses. Arch Dermatol Res 2019; 312:237-248. [DOI: 10.1007/s00403-019-01994-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/26/2019] [Accepted: 10/03/2019] [Indexed: 12/11/2022]
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19
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Peter Rout D, Nair A, Gupta A, Kumar P. Epidermolytic hyperkeratosis: clinical update. Clin Cosmet Investig Dermatol 2019; 12:333-344. [PMID: 31190940 PMCID: PMC6512611 DOI: 10.2147/ccid.s166849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 04/01/2019] [Indexed: 12/29/2022]
Abstract
Epidermolytic hyperkeratosis (EHK), earlier termed as bullous congenital ichthyosiform erythroderma is a skin disorder characterized as an autosomal dominant and rare disorder which has been observed to affect 1 in over 200,000 infants as a consequence of a significant mutation in the genes responsible for the keratin proteins, mostly keratin 1 and 10. The features present at birth include erythema and blistering. In adults, the hallmarks include hyperkeratosis, erosions, and blisters. The major symptoms including xerosis, pruritus, and painful fissuring lead not only to cosmetic problems but also stress, inferiority complex and other psychological conditions. While clinical inspection followed by confirmatory tests including histopathology and electron microscopic assessment is used for diagnosis, treatment modalities can be further improved for better diagnosis. This article reviews subtypes of ichthyosis, with a focus on EHK, genetics behind the disease, recently reported mutations, the existing diagnostics and treatments for the same and potential of new modalities in diagnosis/treatment.
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Affiliation(s)
- Denice Peter Rout
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
| | - Anushka Nair
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
| | - Anand Gupta
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
| | - Piyush Kumar
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
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20
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Zhang H, Ericsson M, Weström S, Vahlquist A, Virtanen M, Törmä H. Patients with congenital ichthyosis and TGM1 mutations overexpress other ARCI genes in the skin: Part of a barrier repair response? Exp Dermatol 2018; 28:1164-1171. [PMID: 30372788 PMCID: PMC7379499 DOI: 10.1111/exd.13813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/16/2018] [Accepted: 10/22/2018] [Indexed: 12/14/2022]
Abstract
Autosomal recessive congenital ichthyosis (ARCI) is a group of monogenic skin disorders caused by mutations in any of at least 12 different genes, many of which are involved in the epidermal synthesis of ω-O-acylceramides (acylCer). AcylCer are essential precursors of the corneocyte lipid envelope crosslinked by transglutaminase-1 (TGm-1), or a yet unidentified enzyme, for normal skin barrier formation. We hypothesized that inactivating TGM1 mutations will lead to a compensatory overexpression of the transcripts involved in skin barrier repair, including many other ARCI-causing genes. Using microarray, we examined the global mRNA expression profile in skin biopsies from five ARCI patients with TGM1 mutations and four healthy controls. There were a total of 599 significantly differentially expressed genes (adjusted P < 0.05), out of which 272 showed more than 1.5 log2fold-change (FC) up- or down-regulation. Functional classification of the latter group of transcripts showed enrichment of mRNA encoding proteins mainly associated with biological pathways involved in keratinocyte differentiation and immune response. Moreover, the expression of seven out of twelve ARCI-causing genes was significantly increased (FC = 0.98-2.05). Also, many of the genes involved in keratinocyte differentiation (cornified envelope formation) and immune response (antimicrobial peptides and proinflammatory cytokines) were upregulated. The results from the microarray analysis were also verified for selected genes at the mRNA level by qPCR and at the protein level by semi-quantitative immunofluorescence. The upregulation of these genes might reflect a compensatory induction of acylCer biosynthesis as a part of a global barrier repair response in the patient's epidermis.
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Affiliation(s)
- Hanqian Zhang
- Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden
| | - Maja Ericsson
- Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden
| | - Simone Weström
- Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden
| | - Anders Vahlquist
- Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden
| | - Marie Virtanen
- Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden
| | - Hans Törmä
- Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden
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21
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Murase C, Takeichi T, Shibata A, Nakatochi M, Kinoshita F, Kubo A, Nakajima K, Ishii N, Amano H, Masuda K, Kawakami H, Kanekura T, Washio K, Asano M, Teramura K, Akasaka E, Tohyama M, Hatano Y, Ochiai T, Moriwaki S, Sato T, Ishida-Yamamoto A, Seishima M, Kurosawa M, Ikeda S, Akiyama M. Cross-sectional survey on disease severity in Japanese patients with harlequin ichthyosis/ichthyosis: Syndromic forms and quality-of-life analysis in a subgroup. J Dermatol Sci 2018; 92:127-133. [PMID: 30241690 DOI: 10.1016/j.jdermsci.2018.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/16/2018] [Accepted: 08/26/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Congenital ichthyoses (CIs) adversely affect quality of life (QOL) in patients. However, the effects of CIs on patient QOL have not been studied sufficiently. OBJECTIVE To investigate the association between disease severity and QOL in patients with harlequin ichthyosis (HI) and ichthyosis: syndromic forms (ISFs) METHODS: Clinical information of patients with HI and ISFs from 2010 to 2015 were obtained from 100 dermatology departments/divisions of principal institutes/hospitals throughout Japan. We examined the relationship between disease severity and QOL in patients with HI and ISFs. Patients who were aged 8 years or older and participated in a multicenter retrospective questionnaire survey in Japan were assessed by dermatology life quality index (DLQI, range of 0-30) and clinical ichthyosis score (range of 0-100). RESULTS Netherton syndrome patients had a significantly higher risk of allergy to food or environmental allergens than patients with other phenotypes. Keratitis-ichthyosis-deafness (KID) syndrome patients showed a significantly higher risk of skin infections than patients with other phenotypes. Complete data on DLQI were obtained from 13 patients, whose median age was 21 (8-71) years. Nine patients were male, and 4 were female. Systemic retinoids were administrated to 2 of the 3 HI patients. The Spearman's correlation coefficient between the clinical ichthyosis score and DLQI was 0.611 (P < 0.05). CONCLUSION We confirmed that Netherton syndrome and KID syndrome patients have a higher risk of allergy to food or environmental allergens and of skin infections, respectively. QOL impairment correlates with disease severity in HI and ISFs patients.
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Affiliation(s)
- Chiaki Murase
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Akitaka Shibata
- Department of Dermatology, Gifu Prefectural Tajimi Hospital, 161-5 Maehata-cho, Tajimi 507-8522, Japan
| | - Masahiro Nakatochi
- Statistical Analysis Section, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Fumie Kinoshita
- Statistical Analysis Section, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Akiharu Kubo
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Kimiko Nakajima
- Department of Dermatology, Kochi Medical School, 185-1 Kohasu, Okoh-cho, Nanakoku, Kochi 783-8505, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Hiroo Amano
- Department of Dermatology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Koji Masuda
- Department of Dermatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroshi Kawakami
- Department of Dermatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8520, Japan
| | - Ken Washio
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Masayuki Asano
- Department of Dermatology, Tohoku University Graduate School of Medicine, Seiryoumachi 1-1, Aoba-ku, Sendai 980-8574, Japan
| | - Kazuya Teramura
- Department of Dermatology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga 520-2192, Japan
| | - Eijiro Akasaka
- Department of Dermatology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan
| | - Mikiko Tohyama
- Department of Dermatology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon-shi, Ehime 791-0295, Japan
| | - Yutaka Hatano
- Department of Dermatology, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan
| | - Toyoko Ochiai
- Department of Dermatology, Nihon University Hospital, 1-6 Kanda Surugadai, Chiyoda-Ku, Tokyo, 101-8309, Japan
| | - Shinichi Moriwaki
- Department of Dermatology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Tomotaka Sato
- Department of Dermatology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara 299-0111, Japan
| | - Akemi Ishida-Yamamoto
- Department of Dermatology, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahi-kawa, Hokkaido 078-8510, Japan
| | - Mariko Seishima
- Department of Dermatology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Gifu 501-1194, Japan
| | - Michiko Kurosawa
- Departments of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shigaku Ikeda
- Departments of Dermatology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan.
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Schepis C, Failla P, Siragusa M, Vinci M, Calì F. Novel SPINK5 variants in a patient with Netherton syndrome and intellectual disability. The diagnostic value of trichoscopy. GIORN ITAL DERMAT V 2018; 155:239-240. [PMID: 29781262 DOI: 10.23736/s0392-0488.18.05931-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Carmelo Schepis
- Unit of Dermatology, Oasi Research Institute-IRCCS, Troina, Enna, Italy -
| | - Pinella Failla
- Unit of Pediatrics and Medical Genetics, Oasi Research Institute-IRCCS, Troina, Enna, Italy
| | | | - Mirella Vinci
- Laboratory of Molecular Genetics, Oasi Research Institute-IRCCS, Troina, Enna, Italy
| | - Francesco Calì
- Laboratory of Molecular Genetics, Oasi Research Institute-IRCCS, Troina, Enna, Italy
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23
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Yu K, Reid AT, Chen SJT, Patel RM, Donn SM, Gudjonsson JE, Lowe L. Dystrophic calcifications point the way-Unusual and early diagnostic clue of Conradi-Hünermann-Happle syndrome. JAAD Case Rep 2018; 4:333-336. [PMID: 29693062 PMCID: PMC5911813 DOI: 10.1016/j.jdcr.2017.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Kenneth Yu
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Rajiv M Patel
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan.,Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Steven M Donn
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | | | - Lori Lowe
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan.,Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
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24
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Sitek JC, Kulseth MA, Rypdal KB, Skodje T, Sheng Y, Retterstøl L. Whole-exome sequencing for diagnosis of hereditary ichthyosis. J Eur Acad Dermatol Venereol 2018; 32:1022-1027. [PMID: 29444371 DOI: 10.1111/jdv.14870] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/29/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Hereditary ichthyosis constitutes a diverse group of cornification disorders. Identification of the molecular cause facilitates optimal patient care. OBJECTIVE We wanted to estimate the diagnostic yield of applying whole-exome sequencing (WES) in the routine genetic workup of inherited ichthyosis. METHODS During a 3-year-period, all ichthyosis patients, except X-linked and mild vulgar ichthyosis, consecutively admitted to a university hospital clinic were offered WES with subsequent analysis of ichthyosis-related genes as a first-line genetic investigation. Clinical and molecular data have been collected retrospectively. RESULTS Genetic variants causative for the ichthyosis were identified in 27 of 34 investigated patients (79.4%). In all, 31 causative mutations across 13 genes were disclosed, including 12 novel variants. TGM1 was the most frequently mutated gene, accounting for 43.7% of patients suffering from autosomal recessive congenital ichthyosis (ARCI). CONCLUSION Whole-exome sequencing appears an effective tool in disclosing the molecular cause of patients with hereditary ichthyosis seen in clinical practice and should be considered a first-tier genetic test in these patients.
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Affiliation(s)
- J C Sitek
- Department of Dermatology, Oslo University Hospital, Oslo, Norway.,Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - M A Kulseth
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - K B Rypdal
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - T Skodje
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Y Sheng
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - L Retterstøl
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
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25
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Ahrens-Nicklas R, Schlotawa L, Ballabio A, Brunetti-Pierri N, De Castro M, Dierks T, Eichler F, Ficicioglu C, Finglas A, Gaertner J, Kirmse B, Klepper J, Lee M, Olsen A, Parenti G, Vossough A, Vanderver A, Adang LA. Complex care of individuals with multiple sulfatase deficiency: Clinical cases and consensus statement. Mol Genet Metab 2018; 123:337-346. [PMID: 29397290 PMCID: PMC6856873 DOI: 10.1016/j.ymgme.2018.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 12/11/2022]
Abstract
Multiple sulfatase deficiency (MSD) is an ultra-rare neurodegenerative disorder that results in defective sulfatase post-translational modification. Sulfatases in the body are activated by a unique protein, formylglycine-generating enzyme (FGE) that is encoded by SUMF1. When FGE is absent or insufficient, all 17 known human sulfatases are affected, including the enzymes associated with metachromatic leukodystrophy (MLD), several mucopolysaccharidoses (MPS II, IIIA, IIID, IVA, VI), chondrodysplasia punctata, and X-linked ichthyosis. As such, individuals demonstrate a complex and severe clinical phenotype that has not been fully characterized to date. In this report, we describe two individuals with distinct clinical presentations of MSD. Also, we detail a comprehensive systems-based approach to the management of individuals with MSD, from the initial diagnostic evaluation to unique multisystem issues and potential management options. As there have been no natural history studies to date, the recommendations within this report are based on published studies and consensus opinion and underscore the need for future research on evidence-based outcomes to improve management of children with MSD.
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Affiliation(s)
- Rebecca Ahrens-Nicklas
- Division of Human Genetics and Metabolism, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Lars Schlotawa
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK; Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen, Germany.
| | - Andrea Ballabio
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Nicola Brunetti-Pierri
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy; Department of Translational Medicine, Federico II University of Naples, Italy
| | - Mauricio De Castro
- United States Air Force Medical Genetics Center, 81st Medical Group, Keesler AFB, MS, USA
| | - Thomas Dierks
- Faculty of Chemistry, Biochemistry I, Bielefeld University, Bielefeld, Germany
| | - Florian Eichler
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Can Ficicioglu
- Division of Human Genetics and Metabolism, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jutta Gaertner
- Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen, Germany
| | - Brian Kirmse
- Department of Pediatrics, Genetic and Metabolism, University of Mississippi Medical Center, USA
| | - Joerg Klepper
- Department of Pediatrics and Neuropediatrics, Children's Hospital, Klinikum Aschaffenburg-Alzenau, Germany
| | - Marcus Lee
- Division of Pediatric Neurology, Children's of Mississippi, University of Mississippi Medical Center, Biloxi, MS, USA
| | | | - Giancarlo Parenti
- Telethon Institute of Genetics and Medicine, Pozzuoli, Italy; Department of Translational Medicine, Federico II University of Naples, Italy
| | - Arastoo Vossough
- Division of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Adeline Vanderver
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Laura A Adang
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
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26
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Akiyama M. Corneocyte lipid envelope (CLE), the key structure for skin barrier function and ichthyosis pathogenesis. J Dermatol Sci 2017. [DOI: 10.1016/j.jdermsci.2017.06.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Cho KH, Shim SH, Kim M. Clinical, biochemical, and genetic aspects of Sjögren-Larsson syndrome. Clin Genet 2017; 93:721-730. [PMID: 28543186 DOI: 10.1111/cge.13058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/14/2017] [Accepted: 05/18/2017] [Indexed: 11/26/2022]
Abstract
Sjögren-Larsson syndrome (SLS) is caused by an autosomal recessive mutation in ALDH3A2, which encodes the fatty aldehyde dehydrogenase responsible for the metabolism of long-chain aliphatic aldehydes and alcohols. The pathophysiologic accumulation of aldehydes in various organs, including the skin, brain, and eyes, leads to characteristic features of ichthyosis, intellectual disability, spastic di-/quadriplegia, and low visual acuity with photophobia. The severity of the clinical manifestations thereof can vary greatly, although most patients are bound to a wheelchair due to contractures. To date, correlations between genotype and phenotype have proven difficult to document due to low disease incidence and high heterogenetic variability in mutations. This review summarizes the clinical characteristics of SLS that have been found to contribute to the prognosis thereof, as well as recent updates from genetic and brain imaging studies. In addition, the differential diagnoses of SLS are briefly illustrated, covering cerebral palsy and other genetic or neurocutaneous syndromes mimicking the syndrome.
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Affiliation(s)
- K H Cho
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - S H Shim
- Genetics Laboratory, Fertility Center, CHA Gangnam Medical Center, CHA University, Seoul, Korea
| | - M Kim
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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28
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Rasheed M, Shahzad S, Zaeem A, Afzal I, Gul A, Khalid S. Updated strategies for the management, pathogenesis and molecular genetics of different forms of ichthyosis syndromes with prominent hair abnormalities. Arch Dermatol Res 2017; 309:773-785. [PMID: 28913623 DOI: 10.1007/s00403-017-1780-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/12/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
Abstract
Syndromic ichthyosis is rare inherited disorders of cornification with varied disease complications. This disorder appears in seventeen subtypes associated with severe systematic manifestations along with medical, cosmetic and social problems. Syndromic ichthyosis with prominent hair abnormalities covers five major subtypes: Netherton syndrome, trichothiodystrophy, ichthyosis hypotrichosis syndrome, ichthyosis hypotrichosis sclerosing cholangitis and ichthyosis follicularis atrichia photophobia syndrome. These syndromes mostly prevail in high consanguinity states, with distinctive clinical features. The known pathogenic molecules involved in ichthyosis syndromes with prominent hair abnormalities include SPINK5, ERCC2, ERCC3, GTF2H5, MPLKIP, ST14, CLDN1 and MBTPS2. Despite underlying genetic origin, most of the health professionals solely rely on phenotypic expression of these disorders that leads to improper management of patients, hence making these patients living an orphanage life. After dermal features, association of other systems such as nervous system, skeletal system, hair abnormalities or liver problems may sometimes give clues for diagnosis but still leaving place for molecular screening for efficient diagnosis. In this paper, we have presented a review of ichthyosis syndrome with prominent hair abnormalities, with special emphasis on their updated genetic consequences and disease management. Additionally, we aim to update health professionals about the practice of molecular screening in ichthyosis syndromes for appropriate diagnosis and treatment.
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Affiliation(s)
- Madiha Rasheed
- Department of Bioinformatics and Biotechnology, Maryum Block, International Islamic University Islamabad, H-10, Islamabad, 44000, Pakistan
| | - Shaheen Shahzad
- Department of Bioinformatics and Biotechnology, Maryum Block, International Islamic University Islamabad, H-10, Islamabad, 44000, Pakistan.
| | - Afifa Zaeem
- Department of Bioinformatics and Biotechnology, Maryum Block, International Islamic University Islamabad, H-10, Islamabad, 44000, Pakistan
| | - Imran Afzal
- Department of Biology, Lahore Garrison University, Lahore, Pakistan
| | - Asma Gul
- Department of Bioinformatics and Biotechnology, Maryum Block, International Islamic University Islamabad, H-10, Islamabad, 44000, Pakistan
| | - Sumbal Khalid
- Department of Bioinformatics and Biotechnology, Maryum Block, International Islamic University Islamabad, H-10, Islamabad, 44000, Pakistan
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29
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Dev T, Raman Kumar M, Sethuraman G. Ichthyosis linearis circumflexa with bamboo hair: challenges in the diagnosis and management. BMJ Case Rep 2017; 2017:bcr-2017-220227. [PMID: 28554884 DOI: 10.1136/bcr-2017-220227] [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: 11/04/2022] Open
Abstract
A 15-year-old boy had persistent and refractory erythroderma since early childhood. His parents noticed polycyclic skin lesions and hair fragility around the age of 5 years. He was treated by a local untrained practitioner for more than 3 years without any significant improvement, and he developed weight gain, thinning of skin, muscle weakness and growth retardation. He was evaluated in 2015 and found to have iatrogenic Cushing's disease with severe skeletal complications and pituitary-adrenal-gonadal suppression, which persisted despite gradual withdrawal of steroids.
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Affiliation(s)
- Tanvi Dev
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Marwaha Raman Kumar
- Senior Consultant Endocrinology and Scientific Advisor (Projects), International Life Sciences Institute (ILSI), New Delhi, India
| | - Gomathy Sethuraman
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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30
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Alkatan HM, Aljebreen MA, Alsuhaibani AH. Long term follow up of mucous membrane grafting for cicatricial ectropion in Ichthyosis: A case report. Int J Surg Case Rep 2017; 33:21-23. [PMID: 28314226 PMCID: PMC5361770 DOI: 10.1016/j.ijscr.2017.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 11/18/2022] Open
Abstract
In this case report we highlight briefly the unique entities of Icthyosis, the commonest ophthalmological manifestation and the reported modalities of surgical therapy, which includes Mucous Membrane Graft (MMG). Up to our knowledge this is the first reported long term follow up of MMG offered for Ichthyosis-related cicatricial ectropion. Thus we believe that this case has a value in using MMG as the standard therapy for a generalized condition, which is not peculiar only to ophthalmologists.
Introduction Ichthyosis is a group of keratinizing diseases characterized by scaly and dry skin. One of the ocular complications associated with ichthyosis is cicatricial ectropion which often results in exposure keratopathy and eventually corneal scarring. Presentation of case In this report we are presenting a 21-year-old female who is known to have ichthyosis-related bilateral lower lid cicatricial ectropion, which was managed with Mucous Membrane Grafting (MMG) six years ago. Discussion Despite the serious complications of ichthyosis-related eyelid malposition such as cicatricial ectropion, until present no single way has been standardized to treat the ectropion in these patients. MMG has been previously described, but up to our knowledge this is the first reported long term follow up of MMG offered for ichthyosis-related cicatricial ectropion. Conclusion We strongly recommend MMG as a promising surgical treatment option offered for ichthyosis patients with cicatricial ectropion providing good outcome and acceptable cosmetic results.
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Affiliation(s)
- Hind Manaa Alkatan
- Departments of Ophthalmology and Pathology, King Saud University Medical City, Riyadh, Saudi Arabia.
| | | | - Adel H Alsuhaibani
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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31
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Xu M, Tang Z, Han Y, Xiong H, Li C, Guo Q. Rare case of Netherton syndrome with generalized lentigines. J Dermatol 2016; 44:1413-1414. [PMID: 27988933 DOI: 10.1111/1346-8138.13708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Min Xu
- Department of Dermatology; Sun Yat-sen Memorial Hospital; Sun Yat-sen University; Guangzhou China
| | - Zengqi Tang
- Department of Dermatology; Sun Yat-sen Memorial Hospital; Sun Yat-sen University; Guangzhou China
| | - Yanfang Han
- Department of Dermatology; Sun Yat-sen Memorial Hospital; Sun Yat-sen University; Guangzhou China
| | - Hui Xiong
- Department of Dermatology; Sun Yat-sen Memorial Hospital; Sun Yat-sen University; Guangzhou China
| | - Chijun Li
- Department of Dermatology; Sun Yat-sen Memorial Hospital; Sun Yat-sen University; Guangzhou China
| | - Qing Guo
- Department of Dermatology; Sun Yat-sen Memorial Hospital; Sun Yat-sen University; Guangzhou China
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