1
|
Michelerio A, Greco A, Tomasini D, Tomasini C. Galli-Galli Disease: A Comprehensive Literature Review. Dermatopathology (Basel) 2024; 11:79-100. [PMID: 38390850 PMCID: PMC10885078 DOI: 10.3390/dermatopathology11010008] [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: 11/21/2023] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
Galli-Galli disease (GGD) is a rare genodermatosis that exhibits autosomal dominant inheritance with variable penetrance. GGD typically manifests with erythematous macules, papules, and reticulate hyperpigmentation in flexural areas. A distinct atypical variant exists, which features brown macules predominantly on the trunk, lower limbs, and extremities, with a notable absence of the hallmark reticulated hyperpigmentation in flexural areas. This review includes a detailed literature search and examines cases since GGD's first description in 1982. It aims to synthesize the current knowledge on GGD, covering its etiology, clinical presentation, histopathology, diagnosis, and treatment. A significant aspect of this review is the exploration of the genetic, histopathological, and clinical parallels between GGD and Dowling-Degos disease (DDD), which is another rare autosomal dominant genodermatosis, particularly focusing on their shared mutations in the KRT5 and POGLUT1 genes. This supports the hypothesis that GGD and DDD may be different phenotypic expressions of the same pathological condition, although they have traditionally been recognized as separate entities, with suprabasal acantholysis being a distinctive feature of GGD. Lastly, this review discusses the existing treatment approaches, underscoring the absence of established guidelines and the limited effectiveness of various treatments.
Collapse
Affiliation(s)
- Andrea Michelerio
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Dermatology Unit, Ospedale Cardinal Massaia, 14100 Asti, Italy
| | - Antonio Greco
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Dario Tomasini
- Dermatology Unit, ASST Valle Olona, 21052 Busto Arsizio, Italy
| | - Carlo Tomasini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Dermatology Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| |
Collapse
|
2
|
Vișan MA, Căruntu C, Costache RS, Tiplica G, Costache DO. Hidradenitis suppurativa: Detangling phenotypes and identifying common denominators. J Eur Acad Dermatol Venereol 2024; 38:62-76. [PMID: 37641875 DOI: 10.1111/jdv.19481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a severe impact on patients' quality of life through its recurrent and painful nature, as well as its comorbidity burden. The shift in the pathogenic paradigm from a condition of the apocrine glands to an autoinflammatory disease associated with follicular destruction has rendered its understanding difficult, as there are still large gaps in pinpointing the underlying mechanisms, which cannot currently explain the existing clinical variation and as a result, translate into suboptimal therapy. Multifactorial involvement is hypothesized, with an implication of genetic mutations, microbiome dysbiosis, cytokine upregulation and environmental factors. Clinical observation is fundamental for diagnosis, however, the marked heterogeneity in presentation leads to delays in detection and challenges in treatment selection, showcasing clear limits in defining the link between genetic aspects of HS, the role of epigenetic factors and its pathogenic pathways. There have been attempts to formulate phenotypes that could aid in prognostication and management, however, current classification schemata show significant overlap and no validation through longitudinal studies. In this context, nomenclature poses a great challenge due to the lack of global agreement in the definition of lesions, which should be addressed by future research to enable simplified recognition and allow for more precise severity scoring. This could be complemented by the addition of extra dermatologic findings or paraclinical assessment in constructing phenotypes. The development of valid, predictive and reliable classifications of HS may lead to an improvement in comprehending its pathophysiology, favouring a more personalized approach in management. This could be achieved through consensus in the characterization of clinical features and data gathering, as well as validation attempts for described phenotypes. Ultimately, the genotype-endotype-phenotype correlation in HS requires targeted, systematic inquiries and should be addressed more largely to broaden the perspective on this debilitating entity.
Collapse
Affiliation(s)
- Maria-Alexandra Vișan
- Department of Dermatology, Dr. Carol Davila University Central Military Emergency Hospital, Bucharest, Romania
| | - Constantin Căruntu
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Dermatology, 'Prof. N.C. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania
| | - Raluca Simona Costache
- Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - George Tiplica
- Dermatology Clinic, Colentina Clinical Hospital, Bucharest, Romania
- Dermatology Discipline, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Daniel Octavian Costache
- Department of Dermatology, Dr. Carol Davila University Central Military Emergency Hospital, Bucharest, Romania
- Dermatology Discipline, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| |
Collapse
|
3
|
de Oliveira ASLE, de Siqueira RC, Nait-Meddour C, Tricarico PM, Moura R, Agrelli A, d'Adamo AP, Jamain S, Crovella S, de Fátima Medeiros Brito M, Boniotto M, Brandão LAC. A loss-of-function NCSTN mutation associated with familial Dowling Degos disease and hidradenitis suppurativa. Exp Dermatol 2023; 32:1935-1945. [PMID: 37665193 DOI: 10.1111/exd.14919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/26/2023] [Accepted: 08/06/2023] [Indexed: 09/05/2023]
Abstract
Dowling Degos disease (DDD) is a rare autosomal dominant genodermatosis characterized by acquired, slowly progressive reticulated pigmented lesions primarily involving flexural skin areas. Mutations in KRT5, POGLUT-1 and POFUT-1 genes have been associated with DDD, and loss-of-function mutations in PSENEN, a subunit of the gamma-secretase complex, were found in patients presenting with DDD or DDD comorbid with hidradenitis suppurativa (HS). A nonsense mutation in NCSTN, another subunit of the gamma-secretase, was already described in a patient suffering from HS and DDD but whether NCSTN could be considered a novel gene for DDD is still debated. Here, we enrolled a four-generation family with HS and DDD. Through Whole Exome Sequencing (WES) we identified a novel nonsense mutation in the NCSTN gene in all the affected family members. To study the impact of this variant, we isolated outer root sheath cells from patients' hair follicles. We showed that this variant leads to a premature stop codon, activates a nonsense-mediated mRNA decay, and causes NCSTN haploinsufficiency in affected individuals. In fact, cells treated with gentamicin, a readthrough agent, had the NCSTN levels corrected. Moreover, we observed that this haploinsufficiency also affects other subunits of the gamma-secretase complex, possibly causing DDD. Our findings clearly support NCSTN as a novel DDD gene and suggest carefully investigating this co-occurrence in HS patients carrying a mutation in the NCSTN gene.
Collapse
Affiliation(s)
| | | | - Cécile Nait-Meddour
- Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Créteil, France
| | - Paola Maura Tricarico
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Department of Advanced Diagnostics, Trieste, Italy
| | - Ronald Moura
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Department of Advanced Diagnostics, Trieste, Italy
| | - Almerinda Agrelli
- Laboratory of Nanostructured Materials (LMNANO), Center for Strategic Technologies Northeastern (CETENE), Recife, Brazil
| | - Adamo Pio d'Adamo
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Department of Advanced Diagnostics, Trieste, Italy
- University of Trieste, Department of Medical Surgical and Health Sciences, Trieste, Italy
| | - Stéphane Jamain
- Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Créteil, France
| | - Sergio Crovella
- LARC Laboratory Animal Research Center, University of Qatar, Doha, Qatar
| | | | - Michele Boniotto
- Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Créteil, France
| | - Lucas André Cavalcanti Brandão
- Keizo Asami Institute-iLIKA, Federal University of Pernambuco, Recife, Brazil
- Department of Pathology, Federal University of Pernambuco, Recife, Brazil
| |
Collapse
|
4
|
Balić A, Marinović B, Bukvić Mokos Z. The genetic aspects of hidradenitis suppurativa. Clin Dermatol 2023; 41:551-563. [PMID: 37652193 DOI: 10.1016/j.clindermatol.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Genetic aspects have a substantial role in hidradenitis suppurativa (HS) pathogenesis. A positive family history of HS occurs in about one-third of HS cases and is significantly higher in patients with early onset of the disease. Recent twin studies have shown a high heritability in HS, fortifying the importance of genetic factors in disease pathogenesis. Based on existing knowledge on the genomics of HS, the disease can be categorized as familial HS, sporadic, syndromic HS, and "HS plus" associated with other syndromes. In familial HS, autosomal dominant transmission is proposed, and monogenic inheritance is rare. This monogenic trait is related to mutations of γ-secretase component genes and Notch signaling or defects in inflammasome function. With newly discovered gene mutations, such as those related to innate and adaptive immunity, skin microbiome, inflammasome, epidermal homeostasis, and keratinization pathway, we can define HS as a polygenic, multifactorial, autoinflammatory disease. To fully elucidate the genetic aspects of HS, we need extensive, long-term global collaborations.
Collapse
Affiliation(s)
- Anamaria Balić
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, European Reference Network (ERN) - Skin Reference Centre, Zagreb, Croatia
| | - Branka Marinović
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, European Reference Network (ERN) - Skin Reference Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zrinka Bukvić Mokos
- Department of Dermatology and Venereology, University Hospital Centre Zagreb, European Reference Network (ERN) - Skin Reference Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| |
Collapse
|
5
|
Dupont M, Parent M, Vanhooteghem O. About a Rare Association Between Vulvar Dowling Degos Disease and HS. Int J Womens Health 2023; 15:355-359. [PMID: 36923583 PMCID: PMC10010119 DOI: 10.2147/ijwh.s398604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
Dowling Degos disease (DDD) is a rare genodermatosis that manifests itself as acquired, reticulated hyperpigmentation of the folds. We report the case of a 45-year-old woman who presented since the age of 30 with hyperpigmented macules of reticulated appearance of vulvar, perianal and bilateral axillary location associated with hidradenitis suppurativa (HS) at Hurley stage 2 of later onset. DDD is classically described in the flexural folds and, to our knowledge; less than a dozen cases of vulvar location are published in the literature. We postulate that DDD is responsible for the development of HS in susceptible patients. Indeed, this association seems to be explained by a common pathophysiological mechanism, targeting the Notch signalling pathway, involved in the proliferation and differentiation of epidermal cells that can induce the development of HS. DDD should be considered as a comorbid factor of HS.
Collapse
Affiliation(s)
- Manon Dupont
- Dermatology Department, CHU UCL Namur, Site Sainte Elisabeth, Namur, 5000, Belgium
| | - Muriel Parent
- Department of Pathology, Institute of Pathology and Genetics (IPG), Gosselies, 6041, Belgium
| | - Olivier Vanhooteghem
- Dermatology Department, CHU UCL Namur, Site Sainte Elisabeth, Namur, 5000, Belgium
| |
Collapse
|
6
|
de Oliveira ASLE, Bloise G, Moltrasio C, Coelho A, Agrelli A, Moura R, Tricarico PM, Jamain S, Marzano AV, Crovella S, Cavalcanti Brandão LA. Transcriptome Meta-Analysis Confirms the Hidradenitis Suppurativa Pathogenic Triad: Upregulated Inflammation, Altered Epithelial Organization, and Dysregulated Metabolic Signaling. Biomolecules 2022; 12:1371. [PMID: 36291580 PMCID: PMC9599370 DOI: 10.3390/biom12101371] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Hidradenitis suppurativa (HS) is an inflammatory skin condition clinically characterized by recurrent painful deep-seated nodules, abscesses, and sinus tracks in areas bearing apocrine glands, such as axillae, breasts, groins, and buttocks. Despite many recent advances, the pathophysiological landscape of HS still demands further clarification. To elucidate HS pathogenesis, we performed a meta-analysis, set analysis, and a variant calling on selected RNA-Sequencing (RNA-Seq) studies on HS skin. Our findings corroborate the HS triad composed of upregulated inflammation, altered epithelial differentiation, and dysregulated metabolism signaling. Upregulation of specific genes, such as KRT6, KRT16, serpin-family genes, and SPRR3 confirms the early involvement of hair follicles and the impairment of barrier function in HS lesioned skin. In addition, our results suggest that adipokines could be regarded as biomarkers of HS and metabolic-related disorders. Finally, the RNA-Seq variant calling identified several mutations in HS patients, suggesting potential new HS-related genes associated with the sporadic form of this disease. Overall, this study provides insights into the molecular pathways involved in HS and identifies potential HS-related biomarkers.
Collapse
Affiliation(s)
| | - Giovanna Bloise
- Department of Pathology, Federal University of Pernambuco, Recife 50670-901, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Medical Surgical and Health Sciences, University of Trieste, 34137 Trieste, Italy
| | - Antonio Coelho
- Hospital Israelita Albert Einstein, São Paulo 05652-000, Brazil
| | - Almerinda Agrelli
- Laboratory of Nanostructured Materials (LMNANO), Center for Strategic Technologies Northeastern (CETENE), Av. Prof. Luís Freire, 1-Cidade Universitária, Recife 50740-545, Brazil
| | - Ronald Moura
- Department of Advanced Diagnostics, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Paola Maura Tricarico
- Department of Advanced Diagnostics, Institute for Maternal and Child Health-IRCCS “Burlo Garofolo”, 34137 Trieste, Italy
| | - Stéphane Jamain
- Translational Neuropsychiatry, Univ. Paris Est Créteil, Inserm, IMRB, 94010 Créteil, France
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Sergio Crovella
- Biological Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, University of Qatar, Doha 2713, Qatar
| | | |
Collapse
|
7
|
Chen K, Liang B, Ma W, Wan G, Chen B, Lu C, Luo Y, Gu X. Immunological and prognostic analysis of PSENEN in low-grade gliomas: An immune infiltration-related prognostic biomarker. Front Mol Neurosci 2022; 15:933855. [PMID: 35966015 PMCID: PMC9366120 DOI: 10.3389/fnmol.2022.933855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022] Open
Abstract
Metformin is widely used in the treatment of type 2 diabetes (T2D) and plays a role in antitumor and antiobesity processes. A recent study identified its direct molecular target, PEN2 (PSENEN). PSENEN is the minimal subunit of the multiprotein complex γ-secretase, which promotes the differentiation of oligodendrocyte progenitors into astrocytes in the central nervous system. This study was mainly based on gene expression data and clinical data from the TCGA and CGGA databases. Analysis of differential expression of PSENEN between tissues from 31 cancers and paracancerous tissues revealed that it had high expression levels in most cancers except 2 cancers. Using univariate Cox regression analysis and Kaplan-Meier survival analysis, a high expression level of PSENEN was shown to be a risk factor in low-grade gliomas (LGG). Gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analyses indicated that PSENEN is widely involved in immune-related signaling pathways in LGG. PSENEN expression level was significantly associated with TMB, MSI, tumor stemness index, and the expression levels of immunomodulatory genes in LGG. Finally, immune infiltration analysis revealed that PSENEN level was associated with the presence of various immune infiltrating cells, among which PSENEN was strongly associated with the presence of M2 macrophages and played a synergistic pro-cancer role. In conclusion, PSENEN may partially influence prognosis by modulating immune infiltration in patients with LGG, and PSENEN may be a candidate prognostic biomarker for determining prognosis associated with immune infiltration in LGG.
Collapse
Affiliation(s)
- Kaijie Chen
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
| | - Beibei Liang
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
- School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Wenhao Ma
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
| | - Guoqing Wan
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Bing Chen
- Department of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Changlian Lu
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Changlian Lu,
| | - Yuzhou Luo
- Business School, Guilin University of Technology, Guilin, China
- Yuzhou Luo,
| | - Xuefeng Gu
- Shanghai Key Laboratory of Molecular Imaging, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health Science and Engineering, The University of Shanghai for Science and Technology, Shanghai, China
- School of Pharmacy, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Xuefeng Gu,
| |
Collapse
|
8
|
Tricarico PM, Moltrasio C, Gradišek A, Marzano AV, Flacher V, Boufenghour W, von Stebut E, Schmuth M, Jaschke W, Gams M, Boniotto M, Crovella S. Holistic health record for Hidradenitis suppurativa patients. Sci Rep 2022; 12:8415. [PMID: 35589750 PMCID: PMC9120068 DOI: 10.1038/s41598-022-11910-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a recurrent inflammatory skin disease with a complex etiopathogenesis whose treatment poses a challenge in the clinical practice. Here, we present a novel integrated pipeline produced by the European consortium BATMAN (Biomolecular Analysis for Tailored Medicine in Acne iNversa) aimed at investigating the molecular pathways involved in HS by developing new diagnosis algorithms and building cellular models to pave the way for personalized treatments. The objectives of our european Consortium are the following: (1) identify genetic variants and alterations in biological pathways associated with HS susceptibility, severity and response to treatment; (2) design in vitro two-dimensional epithelial cell and tri-dimensional skin models to unravel the HS molecular mechanisms; and (3) produce holistic health records HHR to complement medical observations by developing a smartphone application to monitor patients remotely. Dermatologists, geneticists, immunologists, molecular cell biologists, and computer science experts constitute the BATMAN consortium. Using a highly integrated approach, the BATMAN international team will identify novel biomarkers for HS diagnosis and generate new biological and technological tools to be used by the clinical community to assess HS severity, choose the most suitable therapy and follow the outcome.
Collapse
Affiliation(s)
- Paola Maura Tricarico
- Department of Advanced Diagnostics, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Anton Gradišek
- Department of Intelligent System, Jožef Stefan Institute, Jamova Cesta 39, 1000, Ljubljana, Slovenia
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano, Milan, Italy
| | - Vincent Flacher
- Laboratory CNRS I2CT/UPR3572 Immunology, Immunopathology and Therapeutic Chemistry, Strasbourg Drug Discovery and Development Institute (IMS), Institut de Biologie Moléculaire Et Cellulaire, University of Strasbourg, Strasbourg, France
| | - Wacym Boufenghour
- Laboratory CNRS I2CT/UPR3572 Immunology, Immunopathology and Therapeutic Chemistry, Strasbourg Drug Discovery and Development Institute (IMS), Institut de Biologie Moléculaire Et Cellulaire, University of Strasbourg, Strasbourg, France
| | - Esther von Stebut
- Department of Dermatology, University of Cologne, Kerpenerstr. 62, 50935, Cologne, Germany
| | - Matthias Schmuth
- Department of Dermatology, Venereology and Allergy, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - Wolfram Jaschke
- Department of Dermatology, Venereology and Allergy, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - Matjaž Gams
- Department of Intelligent System, Jožef Stefan Institute, Jamova Cesta 39, 1000, Ljubljana, Slovenia
| | - Michele Boniotto
- INSERM, IMRB, Translational Neuropsychiatry, F-94010, University Paris Est Créteil, Créteil, France
| | - Sergio Crovella
- Biological Sciences Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, University of Qatar, Doha, Qatar
| |
Collapse
|
9
|
Haywood S, Barker R, Blakeway-Manning E, Walton S. An unusual case of comedones. Clin Exp Dermatol 2022; 47:1210-1213. [PMID: 35538888 DOI: 10.1111/ced.15159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 11/30/2022]
Abstract
We present the case of a 71-year-old woman with widespread comedones since adolescence. Histological examination revealed branching hyperpigmented rete ridges and cystically dilated follicular infundibulum containing laminated keratinous debris. We explore the differential diagnosis in the context of other reticulate hyperpigmentation disorders.
Collapse
Affiliation(s)
- Sophia Haywood
- Department of Dermatology, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | | | | | - Shernaz Walton
- Department of Dermatology, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Hull, UK.,Hull York Medical School, Hull, UK
| |
Collapse
|
10
|
Chang CH, Wu RW, Weng HY, Huang WP, Lin YF, Liu YM, Tsai SF. Protein O-fucosyltransferase-1 mutation in familial Dowling-Degos Disease concomitant with atopic dermatitis. DERMATOL SIN 2022. [DOI: 10.4103/1027-8117.359341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
|
11
|
Amat-Samaranch V, Agut-Busquet E, Vilarrasa E, Puig L. New perspectives on the treatment of hidradenitis suppurativa. Ther Adv Chronic Dis 2021; 12:20406223211055920. [PMID: 34840709 PMCID: PMC8613896 DOI: 10.1177/20406223211055920] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/08/2021] [Indexed: 12/25/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the presence of painful nodules, abscesses, chronically draining fistulas, and scarring in apocrine gland-bearing areas of the body. The exact pathogenesis of HS is not yet well understood, but there is a consensus in considering HS a multifactorial disease with a genetic predisposition, an inflammatory dysregulation, and an influence of environmental modifying factors. Therapeutic approach of HS is challenging due to the wide clinical manifestations of the disease and the complex pathogenesis. This review describes evidence for effectiveness of current and emerging HS therapies. Topical therapy, systemic treatments, biological agents, surgery, and light therapy have been used for HS with variable results. Adalimumab is the only US Food and Drug Administration (FDA) approved biologic agent for moderate-to-severe HS, but new therapeutic options are being studied, targeting different specific cytokines involved in HS pathogenesis. Comparing treatment outcomes between therapies is difficult due to the lack of randomized controlled trials. Treatment strategy should be selected in concordance to disease severity and requires combination of treatments in most cases.
Collapse
Affiliation(s)
- Victoria Amat-Samaranch
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041, Barcelona, Spain
| | - Eugènia Agut-Busquet
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041, Barcelona, Spain
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041, Barcelona, Spain
| | - Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas 90, 08041 Barcelona, Spain
| |
Collapse
|
12
|
Dowling-Degos Disease Presenting With Associated Epidermal Inclusion Cysts: A Case Report and Review of the Literature. Am J Dermatopathol 2021; 44:e29-e32. [PMID: 34816802 DOI: 10.1097/dad.0000000000002103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Dowling-Degos Disease (DDD) is a rare and disfiguring autosomal dominant genodermatosis characterized by reticulate hyperpigmented macules or follicular comedone-like papules in the intertriginous areas that typically presents in the third or fourth decade of life. It is a progressive disease that is often treatment-resistant. Although its association with hidradenitis suppurativa has been well described, DDD has also been less commonly reported in conjunction with other dermatologic diseases with unknown etiologic associations. Herein, we present a case of DDD with associated epidermal inclusion cysts and conduct a literature review of dermatologic conditions reported in association with DDD.
Collapse
|
13
|
Vellaichamy G, Dimitrion P, Zhou L, Ozog D, Lim HW, Liao W, Hamzavi IH, Mi QS. Insights from γ-Secretase: Functional Genetics of Hidradenitis Suppurativa. J Invest Dermatol 2021; 141:1888-1896. [PMID: 33836848 PMCID: PMC8316262 DOI: 10.1016/j.jid.2021.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/18/2021] [Accepted: 01/31/2021] [Indexed: 01/09/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, relapsing, and remitting inflammatory disease of the skin with significant heritability and racial disposition. The pathogenesis of HS remains enigmatic, but occlusion of the terminal hair follicle and dysregulation of the local innate immune response may contribute to pathogenesis. Genetic predisposition might also contribute to disease susceptibility and phenotypic heterogeneity because mutations in γ-secretase have been found to underlie a minor but characteristic subset of patients with HS. In this review, we synthesized the current data on γ-secretase in HS, evaluated its importance in the context of disease pathobiology, and discussed avenues of future studies.
Collapse
Affiliation(s)
- Gautham Vellaichamy
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA; Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA
| | - Peter Dimitrion
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA; Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA; Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Li Zhou
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA; Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA; Wayne State University School of Medicine, Detroit, Michigan, USA; Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - David Ozog
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Henry W Lim
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Iltefat H Hamzavi
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA
| | - Qing-Sheng Mi
- Center for Cutaneous Biology and Immunology Research, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA; Immunology Research Program, Henry Ford Cancer Institute, Henry Ford Health System, Detroit, Michigan, USA; Wayne State University School of Medicine, Detroit, Michigan, USA; Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA.
| |
Collapse
|
14
|
Fletcher J, Posso-De Los Rios C, Jambrosic J, Alavi A. Coexistence of Hidradenitis Suppurativa and Steatocystoma Multiplex; Is It a New Variant of Hidradenitis Suppurativa? J Cutan Med Surg 2021; 25:586-590. [PMID: 33908804 PMCID: PMC8637365 DOI: 10.1177/12034754211010145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Hidradenitis suppurativa and steatocystoma multiplex may coexist in the same
patient. The overlap of these 2 conditions could be suggestive of an
unrecognized defect in follicular proliferation mutual in the pathogenesis of
both conditions. Here we present 5 patients with both hidradenitis suppurativa
and steatocystoma multiplex. Recognizing the overlap between these 2 conditions
is important for accurate diagnosis, management, and identification of potential
surgical candidates, as well as future basic science research.
Collapse
Affiliation(s)
- Joshua Fletcher
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Bldg, Toronto, Canada
| | | | | | - Afsaneh Alavi
- 12366 Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
15
|
Theut Riis P, Loft I, Yazdanyar S, Kjærsgaard Andersen R, Pedersen O, Ring H, Huber R, Sultan M, Loesche C, Saunte D, Jemec G. Full exome sequencing of 11 families with Hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2021; 35:1203-1211. [DOI: 10.1111/jdv.17095] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/01/2020] [Indexed: 12/25/2022]
Affiliation(s)
- P. Theut Riis
- Department of Dermatology Zealand University Hospital Roskilde Denmark
| | - I.C. Loft
- Department of Clinical Immunology Naestved Hospital Naestved Denmark
| | - S. Yazdanyar
- Department of Dermatology Zealand University Hospital Roskilde Denmark
| | | | - O.B. Pedersen
- Department of Clinical Immunology Naestved Hospital Naestved Denmark
| | - H.C. Ring
- Department of Dermatology Zealand University Hospital Roskilde Denmark
| | - R. Huber
- Novartis Institutes for BioMedical Research Basel Switzerland
| | - M. Sultan
- Novartis Institutes for BioMedical Research Basel Switzerland
| | - C. Loesche
- Novartis Institutes for BioMedical Research Basel Switzerland
| | - D.M.L. Saunte
- Department of Dermatology Zealand University Hospital Roskilde Denmark
- Department of Clinical Medicine Health Sciences Faculty University of Copenhagen Copenhagen Denmark
| | - G.B.E. Jemec
- Department of Dermatology Zealand University Hospital Roskilde Denmark
- Department of Clinical Medicine Health Sciences Faculty University of Copenhagen Copenhagen Denmark
| |
Collapse
|
16
|
Stephan C, Kurban M, Abbas O. Dowling-Degos disease: a review. Int J Dermatol 2020; 60:944-950. [PMID: 33368260 DOI: 10.1111/ijd.15385] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/30/2020] [Accepted: 12/02/2020] [Indexed: 12/19/2022]
Abstract
Dowling-Degos disease is a rare autosomal dominant genodermatosis. It is characterized by acquired reticulate hyperpigmentation over the flexures, comedone-like follicular papules, and pitted perioral scars that usually develop during adulthood. Mutations in genes affecting melanosome transfer, and melanocyte and keratinocyte differentiation have been implicated in the pathogenesis of this disease. These genes include KRT5, POFUT1, POGLUT1 and, most recently, PSENEN. Dowling-Degos disease can be found in isolation or with other associated findings, most notably hidradenitis suppurativa. This condition belongs to a spectrum of conditions that all result in reticulate hyperpigmentation that at times are hard to distinguish from each other. The most closely linked entity is Galli-Galli, which is clinically indistinguishable from Dowling-Degos disease and can only be distinguished by the presence of acantholysis on microscopy. Unfortunately, Dowling-Degos disease is generally progressive and recalcitrant to treatment.
Collapse
Affiliation(s)
- Carla Stephan
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
17
|
Wang Z, Yan Y, Wang B. γ-Secretase Genetics of Hidradenitis Suppurativa: A Systematic Literature Review. Dermatology 2020; 237:698-704. [PMID: 33333507 PMCID: PMC8491499 DOI: 10.1159/000512455] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acne inversa/hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory disease of the skin that can significantly affect patients' quality of life. The etiology and pathogenesis of HS are unclear and gene mutations might play a role. SUMMARY The primary focus of the review is on aggregating the gene mutations reported, summarizing the structure of γ-secretase and analyzing and speculating about the mechanism and the underlying relations between gene mutation and functional changes of protein. The systematic literature review was done by searching the PubMed, Embase, and Web of Science databases. γ-Secretase is an intramembrane protease complex responsible for the intramembranous cleavage of more than 30 type-1 transmembrane proteins including amyloid precursor protein and Notch receptors. The protein complex consists of four hydrophobic proteins: presenilin, presenilin enhancer-2 (PSENEN), nicastrin, and anterior pharynx defective 1 (APH1). To date, 57 mutations of γ-secretase genes have been reported in 70 patients or families worldwide, including 39 in NCSTN, 14 in PSENEN, and 4 in PSEN1, of which 17 are frameshifts, 15 result in nonsense mutations, 13 in missense mutations, and 12 are splice site mutations. Given the structure of γ-secretase and analysis of related mutation loci of NCSTN, PSENEN, and PSEN1, mutations in γ-secretase genes could affect activation of presenilin, prevent substrate binding, and hinder intramembrane cleavage of select proteins.
Collapse
Affiliation(s)
- Zhongshuai Wang
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Yan
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Baoxi Wang
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
| |
Collapse
|
18
|
Zouboulis CC, Benhadou F, Byrd AS, Chandran NS, Giamarellos‐Bourboulis EJ, Fabbrocini G, Frew JW, Fujita H, González‐López MA, Guillem P, Gulliver WPF, Hamzavi I, Hayran Y, Hórvath B, Hüe S, Hunger RE, Ingram JR, Jemec GB, Ju Q, Kimball AB, Kirby JS, Konstantinou MP, Lowes MA, MacLeod AS, Martorell A, Marzano AV, Matusiak Ł, Nassif A, Nikiphorou E, Nikolakis G, Nogueira da Costa A, Okun MM, Orenstein LA, Pascual JC, Paus R, Perin B, Prens EP, Röhn TA, Szegedi A, Szepietowski JC, Tzellos T, Wang B, van der Zee HH. What causes hidradenitis suppurativa ?—15 years after. Exp Dermatol 2020; 29:1154-1170. [DOI: 10.1111/exd.14214] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Christos C. Zouboulis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg Dessau Germany
| | - Farida Benhadou
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Hôpital Erasme Universite Libre de Bruxelles Bruxelles Belgium
| | - Angel S. Byrd
- Department of Dermatology Howard University College of Medicine Washington DC USA
| | - Nisha S. Chandran
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Division of Dermatology Department of Medicine National University Hospital Singapore
| | - Evangelos J. Giamarellos‐Bourboulis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- 4th Department of Internal Medicine National and Kapodistrian University of Athens Medical School Athens Greece
| | - Gabriella Fabbrocini
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Section of Dermatology Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | | | - Hideki Fujita
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Marcos A. González‐López
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Division of Dermatology Hospital Universitario Marqués de Valdecilla University of Cantabria IDIVAL Santander Spain
| | - Philippe Guillem
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Surgery Clinique du Val d’Ouest (Lyon), ResoVerneuil (Paris) and Groupe de Recherche en Proctologie de la Société Nationale Française de ColoProctologie Paris France
| | - Wayne P. F. Gulliver
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Faculty of Medicine Memorial University of Newfoundland, and NewLab Clinical Research Inc St. John's Canada
| | - Iltefat Hamzavi
- Department of Dermatology Henry Ford Hospital Wayne State University Detroit MI USA
| | - Yildiz Hayran
- Department of Dermatology Ankara Numune Training and Research Hospital Ankara Turkey
| | - Barbara Hórvath
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology University Medical Centre Groningen University of Groningen Groningen The Netherlands
| | | | - Robert E. Hunger
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology, Inselspital Bern University Hospital Bern Switzerland
| | - John R. Ingram
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology & Academic Wound Healing Division of Infection and Immunity Cardiff University Cardiff UK
| | - Gregor B.E. Jemec
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Zealand University Hospital Roskilde Denmark
| | - Qiang Ju
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology RenJi Hospital School of Medicine Shanghai Jiaotong University Shanghai China
| | - Alexa B. Kimball
- Department of Dermatology Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA
| | - Joslyn S. Kirby
- Department of Dermatology Penn State Milton S. Hershey Medical Center Hershey PA USA
| | - Maria P. Konstantinou
- Dermatology Department Paul Sabatier University University Hospital of Toulouse Toulouse France
| | | | - Amanda S. MacLeod
- Department of Dermatology Department of Immunology Department of Molecular Genetics and Microbiology Duke University Durham NC USA
| | - Antonio Martorell
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Hospital of Manises Valencia Spain
| | - Angelo V. Marzano
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Dermatology Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
- Department of Pathophysiology and Transplantation Università degli Studi di Milano Milan Italy
| | - Łukasz Matusiak
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology, Venereology and Allergology Wrocław Medical University Wrocław Poland
| | - Aude Nassif
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Institut Pasteur Paris France
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases King’s College London, and Department of Rheumatology King’s College Hospital London UK
| | - Georgios Nikolakis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg Dessau Germany
| | - André Nogueira da Costa
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Translational Science and Experimental Medicine Early Respiratory and Immunology Biopharmaceuticals R&D AstraZeneca Gothenburg Sweden
| | | | | | - José Carlos Pascual
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Alicante University General Hospital Alicante Institute for Health and Biomedical Research (ISABIAL‐FISABIO Foundation) Alicante Spain
| | - Ralf Paus
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - Benjamin Perin
- Division of Dermatology University of Washington Seattle WA USA
| | - Errol P. Prens
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Erasmus University Medical Center Rotterdam The Netherlands
| | - Till A. Röhn
- Autoimmunity, Transplantation and Inflammation Novartis Institutes for BioMedical Research Novartis Pharma AG Basel Switzerland
| | - Andrea Szegedi
- Division of Dermatological Allergology Department of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Jacek C. Szepietowski
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology, Venereology and Allergology Wrocław Medical University Wrocław Poland
| | - Thrasyvoulos Tzellos
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Nordland Hospital Trust Bodø Norway
| | - Baoxi Wang
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Plastic Surgery Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Hessel H. van der Zee
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Erasmus University Medical Center Rotterdam The Netherlands
| |
Collapse
|
19
|
Garcovich S, Genovese G, Moltrasio C, Malvaso D, Marzano AV. PASH, PAPASH, PsAPASH, and PASS: The autoinflammatory syndromes of hidradenitis suppurativa. Clin Dermatol 2020; 39:240-247. [PMID: 34272017 DOI: 10.1016/j.clindermatol.2020.10.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease usually involving the major skin folds characterized by a multifactorial pathogenesis and a wide spectrum of clinical manifestations. It can also rarely present in association with other diseases as complex clinical syndromes, causing additional diagnostic and therapeutic challenges. Different etiopathologic factors contribute to follicular inflammation and suppurative lesions of syndromic HS, including follicular hyperkeratinization and plugging, as well as activation of autoinflammatory pathways. Patients with syndromic HS frequently have a severe disease course, presenting with atypical skin involvement, signs of systemic inflammation, and resistance to conventional treatments. Systematic classification of syndromic HS is based on clinical, pathogenetic, and genetic factors, but it is constantly evolving due to increased disease awareness. Treatment of syndromic HS is difficult and should be personalized on a case-by-case basis. Investigating syndromic HS can lead to useful insights on genetics and pathogenesis, translating into new clinical approaches for sporadic hidradenitis. We review the classification, clinical presentation, disease associations, and therapeutic management of syndromic HS, focusing mainly on its autoinflammatory syndromes PASH, PAPASH, PsAPASH, and PASS.
Collapse
Affiliation(s)
- Simone Garcovich
- Institute of Dermatology, F. Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Advanced Diagnostics, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Trieste, Italy
| | - Dalma Malvaso
- Institute of Dermatology, F. Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| |
Collapse
|
20
|
Garcovich S, Tricarico P, Nait‐Meddour C, Giovanardi G, Peris K, Crovella S, Boniotto M. Novel nicastrin mutation in hidradenitis suppurativa-Dowling-Degos disease clinical phenotype: more than just clinical overlap? Br J Dermatol 2020; 183:758-759. [PMID: 32282940 PMCID: PMC7586838 DOI: 10.1111/bjd.19121] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- S. Garcovich
- UOC DermatologiaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Università Cattolica del Sacro CuoreRomeItaly
| | - P.M. Tricarico
- Department of Advanced DiagnosticsInstitute for Maternal and Child Health–IRCCS ‘Burlo Garofolo’TriesteItaly
| | - C. Nait‐Meddour
- University of Paris Est–CréteilCréteilFrance
- Institut Mondor for Biomedical Research INSERM U955 Team 16CréteilFrance
| | - G. Giovanardi
- UOC DermatologiaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Università Cattolica del Sacro CuoreRomeItaly
| | - K. Peris
- UOC DermatologiaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Università Cattolica del Sacro CuoreRomeItaly
| | - S. Crovella
- Department of Advanced DiagnosticsInstitute for Maternal and Child Health–IRCCS ‘Burlo Garofolo’TriesteItaly
- Department of MedicalSurgical and Health SciencesUniversity of TriesteTriesteItaly
| | - M. Boniotto
- University of Paris Est–CréteilCréteilFrance
- Institut Mondor for Biomedical Research INSERM U955 Team 16CréteilFrance
| |
Collapse
|
21
|
García-Gil MF, Monte Serrano J, Ramirez-Lluch M, Valero Torres A, López-Giménez MT, Lezcano Biosca V. A novel mutation in POFUT1 gene associated with Dowling-Degos disease and hidradenitis suppurativa. Int J Dermatol 2020; 60:e25-e27. [PMID: 32767357 DOI: 10.1111/ijd.15092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
| | - Juan Monte Serrano
- Department of Dermatology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
| | - Mar Ramirez-Lluch
- Department of Dermatology, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
| | | | | | | |
Collapse
|
22
|
Nguyen T, Damiani G, Orenstein L, Hamzavi I, Jemec G. Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J Eur Acad Dermatol Venereol 2020; 35:50-61. [DOI: 10.1111/jdv.16677] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/03/2020] [Indexed: 12/11/2022]
Affiliation(s)
- T.V. Nguyen
- Bellevue Dermatology Clinic & Clinical Research Center Bellevue WA USA
| | - G. Damiani
- Department of Dermatology Emory University School of Medicine Atlanta GA USA
| | - L.A.V. Orenstein
- Dipartimento di Fisiopatologia Medico‐Chirurgica e dei Trapianti Università degli Studi di Milano Unità Operativa di Dermatologia IRCCS Fondazione Ca' GrandaOspedale Maggiore Policlinico Milano Italy
| | - I. Hamzavi
- Department of Dermatology Henry Ford Hospital Detroit MI USA
| | - G.B. Jemec
- Department of Dermatology Zealand University Hospital Roskilde Denmark
| |
Collapse
|
23
|
Supekar BB, Rambhia KD, Singh RP, Mukhi JI. Dowling-Degos Disease with Follicular Involvement Associated with Hidradenitis Suppurativa: A Manifestation of Follicular Occlusion Phenomenon? Indian J Dermatol 2020; 65:295-298. [PMID: 32831371 PMCID: PMC7423233 DOI: 10.4103/ijd.ijd_392_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 30-year-old female patient presented with progressive reticulate pigmentation of the neck, upper chest, back, cubital fossa, and axillae since the age of 15 years. The patient also complained of recurrent multiple tender nodules and plaques associated with sinuses and pus discharge over the axillae, groins, and buttocks which healed with scarring for 4 years. There were multiple pitted scars and hyperpigmented macules over the perioral area and cheeks. Scattered comedo-like lesions were present over the upper back, chest, cubital fossae, and buttocks. Histopathology from the pigmented lesion revealed thinning of the suprapapillary epidermis, epidermal hyperplasia with finger-like elongation of the rete ridges, and increased pigmentation of their lower part, suggestive of Dowling-Degos disease (DDD). Biopsy section from comedonal lesion showed dilated infundibulum and antler-like rete ridges suggestive of follicular DDD. We report a case of DDD with follicular involvement and hidradenitis suppurativa (HS) which is a rare association and can be explained on the basis of single underlying defect in follicular epithelial proliferation. DDD-HS has been shown to result from mutations in PSENEN, encoding a critical component of the γ-secretase complex.
Collapse
Affiliation(s)
- Bhagyashree Babanrao Supekar
- From the Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, India
| | - Kinjal Deepak Rambhia
- Department of Dermatology, Venereology and Leprosy, HBTMC and Dr. R.N. Cooper Hospital, Mumbai, Maharashtra, India
| | - Rajesh Pratap Singh
- From the Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, India
| | - Jayesh Ishwardas Mukhi
- From the Department of Dermatology, Venereology and Leprosy, Government Medical College and Hospital, Nagpur, India
| |
Collapse
|
24
|
Ren J, Zeng LY. Scrotal Dowling-Degos disease caused by a novel frameshift variant in gamma-secretase subunit presenile enhancer gene. Australas J Dermatol 2020; 61:e399-e402. [PMID: 32478413 DOI: 10.1111/ajd.13316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We reported a Chinese pedigree with scrotal Dowling-Degos disease and evaluated the phenotypic and genotypic characteristics. In affected cases, pigmented macules were identified on the scrotum. The rashes increased, and the colour deepened progressively. No pain or pruritus were noticed, and no other skin folds were involved. Skin histopathology showed characteristic features of Dowling-Degos disease. A heterozygous PSENEN frameshift variant c.292delC(p.L98Wfs*47) was identified in affected cases. The variant was not found in dbSNP, 1000 Genomes project database and the ExAC Browser. The p.L98 and adjacent amino acids are highly conserved among species. Our cases expand the phenotypic and genotypic spectrum of PSENEN-related Dowling-Degos disease.
Collapse
Affiliation(s)
- Jun Ren
- Department of Dermatology, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| | - Li-Yue Zeng
- Department of Dermatology, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China
| |
Collapse
|
25
|
Nomura T. Hidradenitis Suppurativa as a Potential Subtype of Autoinflammatory Keratinization Disease. Front Immunol 2020; 11:847. [PMID: 32508815 PMCID: PMC7251184 DOI: 10.3389/fimmu.2020.00847] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/14/2020] [Indexed: 12/11/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition, clinically characterized by boiled cysts, comedones, abscesses, hypertrophic scars, and/or sinus tracts typically in the apocrine-gland-rich areas such as the axillae, groin, and/or buttocks. Although its precise pathogenic mechanisms remain unknown, I herein emphasize the importance of the following three recent discoveries in the pathogenesis of HS: First, heterozygous loss-of-function mutations in the genes encoding γ-secretase, including NCSTN, PSENEN, and PSEN1, have been identified in some patients with HS. Such genetic alterations result in hyperkeratosis, dysregulated hair follicle differentiation, and cyst formation via aberrant Notch signaling. Furthermore, Psen1-/Psen2-, Psen1-, Ncstn+/-, and Notch1-/Notch2- mice share common phenotypes of human HS, suggesting a role of aberrant keratinization in the development of HS. Second, upregulation of interleukin 1β, interleukin-36, caspase-1, and NLRP3 and dysregulation of the Th17:Treg cell axis have been demonstrated in HS samples, suggesting that autoinflammation is a key event in the pathophysiology of the disease. Notably, HS may be complicated with other autoinflammatory diseases such as inflammatory bowel diseases and pyoderma gangrenosum, again highlighting the importance of autoinflammation in HS. Last, biologics such as adalimumab, infliximab, anakinra, ustekinumab, and secukinumab are reportedly effective for moderate-to-severe HS. These findings collectively suggest that HS is closely linked with aberrant keratinization and autoinflammation, raising the question whether it represents an autoinflammatory keratinization disease, a recently proposed disease entity. In this mini review, I introduce the concept of autoinflammatory keratinization disease and attempt to address this clinically important question.
Collapse
Affiliation(s)
- Toshifumi Nomura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
26
|
George A, George R, Mathew AJ, Telugu RB. Dowling-Degos Disease with Hidradenitis Suppurativa and Inflammatory Arthritis in Two Generations. Indian Dermatol Online J 2020; 11:413-415. [PMID: 32695705 PMCID: PMC7367576 DOI: 10.4103/idoj.idoj_337_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/27/2019] [Accepted: 09/05/2019] [Indexed: 11/23/2022] Open
Abstract
Dowling–Degos disease (DDD) is a rare autosomal dominant genodermatosis characterized by reticulate brown-to-black pigmentation of the flexures, pitted perioral acneiform scars, and comedo-like follicular papules on the flexures. The diagnosis is based on characteristic clinical and histopathological features. DDD has been found to occur in association with hidradenitis suppurativa (HS), arthritis, epidermoid cysts, keratoacanthomas, and squamous cell carcinoma. To date, there is only one report of DDD associated with HS and polyarticular arthritis.
Collapse
Affiliation(s)
- Anju George
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Renu George
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ashish J Mathew
- Department of Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ramesh B Telugu
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| |
Collapse
|
27
|
Low Prevalence of GSC Gene Mutations in a Large Cohort of Predominantly Caucasian Patients with Hidradenitis Suppurativa. J Invest Dermatol 2020; 140:2085-2088.e14. [PMID: 32142795 DOI: 10.1016/j.jid.2019.10.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/23/2019] [Accepted: 10/01/2019] [Indexed: 11/21/2022]
|
28
|
Atzmony L, Zaki TD, Antaya RJ, Choate KA. Phenotypic expansion of POFUT1 loss of function mutations in a disorder featuring segmental dyspigmentation with eczematous and folliculo-centric lesions. Am J Med Genet A 2019; 179:2469-2473. [PMID: 31566882 DOI: 10.1002/ajmg.a.61362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/06/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022]
Abstract
Appearance of mosaic disorders in thin Blaschko lines suggests that somatic mutations in keratinocyte precursors underlie their pathogenesis. Germline heterozygous mutations in POFUT1 gene cause Dowling-Degos disease (DDD), a skin disease that features flexural reticulated hyperpigmentation and follicular-based lesions. POFUT1 mosaicism has not been described to date. Here, we describe a 9-year-old female with segmental hyper- and hypopigmented patches with overlying eczematous plaques and follicular papules. Employing paired whole exome sequencing of saliva and keratinocytes isolated from affected skin, we found a novel germline heterozygous POFUT1 deletion causing frameshift and premature codon termination and somatic copy-neutral loss of heterozygosity on chromosome 20 encompassing POFUT1. Expression levels of POFUT1 as well as other key regulators of the notch signaling pathway-NOTCH1, NOTCH2, and HES1-were reduced in affected keratinocytes compared with normal keratinocytes. Our findings provide the first evidence of POFUT1 postzygotic mutation and a phenotypic expansion of POFUT1 loss of function mutations. We show that a recessive loss of function mutation in POFUT1 produces a distinct clinical presentation with features (e.g., dermatitis) that are absent in the generalized form of DDD. This study demonstrates how analysis of mosaic disorders can reveal unexpected phenotypes for known genes.
Collapse
Affiliation(s)
- Lihi Atzmony
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Theodore D Zaki
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Richard J Antaya
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
29
|
Manfredini M, Giuliani AL, Ruina G, Gafà R, Bosi C, Zoppas E, Di Virgilio F, Bettoli V. The P2X7 Receptor Is Overexpressed in the Lesional Skin of Subjects Affected by Hidradenitis Suppurativa: A Preliminary Study. Dermatology 2019; 237:111-118. [PMID: 31454821 DOI: 10.1159/000502026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/09/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND P2X receptors (P2XRs) are plasma membrane channels involved in the modulation of immune responses. The role of the P2X7 receptor (P2X7R) has never been investigated in hidradenitis suppurativa (HS), which is a recurrent skin disease characterized by inflammatory nodules, scarring, and suppuration. OBJECTIVE Our aim was to investigate by immunohistochemistry (IHC) P2X7R, NLRP3 (NOD-like receptor family, pyrin domain-containing 3), and interleukin-1β (IL-1β) expression in HS lesions compared to healthy control (HC) skin. METHOD The intensity of IHC immunostaining was semi-quantitatively graded for keratinocytes, neutrophils, lymphocytes, and monocytes. Statistical significance was assessed by the Mann-Whitney U test, Cohen's κ coefficient, and χ2 test. RESULTS A total of 59 samples, 31 from HS and 28 from HC, were collected and analysed. In skin keratinocytes, lymphocytes, and monocytes, but not in neutrophils, P2X7R and NLRP3 protein expression was significantly increased in HS versus the HC group. IL-1β protein expression was also higher in HS versus the HC group both in skin keratinocytes and in the inflammatory infiltrate. Cohen's κ correlation coefficients for the expression of P2X7R versus NLRP3 or IL-1β in skin keratinocytes were significant (κ = 0.43 and 0.34, respectively). The same association between P2X7R and NLRP3 or IL-1β was confirmed by χ2 tests. CONCLUSION P2X7R, NLRP3, and IL-1β are overexpressed, and therefore the entire P2X7R/NLRP3/IL-1β pro-inflammatory axis is likely overactive in the skin of HS patients. This observation might provide clues to the pathogenesis of this disease and suggest novel therapies and markers of disease activity.
Collapse
Affiliation(s)
- Marco Manfredini
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy, .,Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy,
| | - Anna Lisa Giuliani
- Oncology and Experimental Biology Section, Department of Morphology, Surgery and Experimental Medicine, Pathology, University of Ferrara, Ferrara, Italy
| | - Giulia Ruina
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Roberta Gafà
- Pathological Anatomy Section, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Cristina Bosi
- Pathological Anatomy Section, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Elisabetta Zoppas
- Oncology and Experimental Biology Section, Department of Morphology, Surgery and Experimental Medicine, Pathology, University of Ferrara, Ferrara, Italy
| | - Francesco Di Virgilio
- Oncology and Experimental Biology Section, Department of Morphology, Surgery and Experimental Medicine, Pathology, University of Ferrara, Ferrara, Italy
| | - Vincenzo Bettoli
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy
| |
Collapse
|
30
|
Li X, Jiang L, Huang Y, Ren Z, Liang X, Wang P. A gene dysfunction module reveals the underlying pathogenesis of hidradenitis suppurativa: An update. Australas J Dermatol 2019; 61:e10-e14. [PMID: 31266094 DOI: 10.1111/ajd.13107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/29/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Xueli Li
- Department of Aesthetic, Plastic, and Burn Surgery Yuhuangding Hospital Affiliated Hospital of Qingdao University Yantai City Shandong Province China
| | - Lei Jiang
- Department of Aesthetic, Plastic, and Burn Surgery Yuhuangding Hospital Affiliated Hospital of Qingdao University Yantai City Shandong Province China
| | - Yong Huang
- Department of Aesthetic, Plastic, and Burn Surgery Yuhuangding Hospital Affiliated Hospital of Qingdao University Yantai City Shandong Province China
| | - Zhilong Ren
- Department of Aesthetic, Plastic, and Burn Surgery Yuhuangding Hospital Affiliated Hospital of Qingdao University Yantai City Shandong Province China
| | - Xiaoqin Liang
- Department of Aesthetic, Plastic, and Burn Surgery Yuhuangding Hospital Affiliated Hospital of Qingdao University Yantai City Shandong Province China
| | - Peng Wang
- Department of Aesthetic, Plastic, and Burn Surgery Yuhuangding Hospital Affiliated Hospital of Qingdao University Yantai City Shandong Province China
| |
Collapse
|
31
|
Jfri AH, O’Brien EA, Litvinov IV, Alavi A, Netchiporouk E. Hidradenitis Suppurativa: Comprehensive Review of Predisposing Genetic Mutations and Changes. J Cutan Med Surg 2019; 23:519-527. [DOI: 10.1177/1203475419852049] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder. A genetic component in the pathogenesis is highly likely considering that ~30% to 40% of patients with HS report a family history of the disease. The genetic mutations related to HS that have been reported to date suggest HS can be inherited as a monogenic trait because of a defect in either the Notch signaling pathway or inflammasome function, or as a polygenic disorder resulting from defects in genes regulating epidermal proliferation, ceramide production, or in immune system function. This review provides a summary of genetic mutations reported in patients diagnosed with HS and discusses the mechanisms by which these genes are involved in its pathogenesis.
Collapse
Affiliation(s)
- Abdulhadi H. Jfri
- Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada
| | | | - Ivan V. Litvinov
- Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada
| | - Afsaneh Alavi
- Division of Dermatology, University of Toronto, Women’s College Hospital, ON, Canada
| | - Elena Netchiporouk
- Division of Dermatology, McGill University Health Centre, Montreal, QC, Canada
| |
Collapse
|
32
|
Tricarico PM, Boniotto M, Genovese G, Zouboulis CC, Marzano AV, Crovella S. An Integrated Approach to Unravel Hidradenitis Suppurativa Etiopathogenesis. Front Immunol 2019; 10:892. [PMID: 31105704 PMCID: PMC6494959 DOI: 10.3389/fimmu.2019.00892] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022] Open
Abstract
Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory disease involving hair follicles that presents with painful nodules, abscesses, fistulae, and hypertrophic scars, typically occurring in apocrine gland bearing skin. Establishing a diagnosis of HS may take up to 7 years after disease onset. HS severely impairs the quality of life of patients and its high frequency causes significant costs for health care system. HS patients have an increased risk of developing associated diseases, such as inflammatory bowel diseases and spondyloarthropathies, thereby suggesting a common pathophysiological mechanism. Familial cases, which are around 35% of HS patients, have allowed the identification of susceptibility genes. HS is perceived as a complex disease where environmental factors trigger chronic inflammation in the skin of genetically predisposed individuals. Despite the efforts made to understand HS etiopathogenesis, the exact mechanisms at the basis of the disease need to be still unraveled. In this review, we considered all OMICs studies performed on HS and observed that OMICs contribution in the context of HS appeared as not clear enough and/or rich of useful clinical information. Indeed, most studies focused only on one aspect—genome, transcriptome, or proteome—of the disease, enrolling small numbers of patients. This is quite limiting for the genetic studies, from different geographical areas and looking at a few aspects of HS pathogenesis without any integration of the findings obtained or a comparison among different studies. A strong need for an integrated approach using OMICs tools is required to discover novel actors involved in HS etiopathogenesis. Moreover, we suggest the constitution of consortia to enroll a higher number of patients to be analyzed following common and consensus OMICs strategies. Comparison and integration with the findings present in the OMICs repositories are mandatory. In a theoretic pipeline, the Skin-OMICs profile obtained from each HS patient should be compared and integrated with repositories and literature data by using appropriate InterOMICs approach. The final goal is not only to improve the knowledge of HS etiopathogenesis but also to provide novel tools to the clinicians with the eventual aim of offering a tailored treatment for HS patients.
Collapse
Affiliation(s)
- Paola M Tricarico
- Department of Advanced Diagnostics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Michele Boniotto
- University of Paris Est-Créteil and INSERM U955/IMRB-Team 16, Créteil, France
| | - Giovanni Genovese
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Fisiopatologia Medico-Chirurgica e Dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Angelo V Marzano
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Fisiopatologia Medico-Chirurgica e Dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Sergio Crovella
- Department of Advanced Diagnostics, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| |
Collapse
|
33
|
Frew JW, Hawkes JE, Sullivan-Whalen M, Gilleaudeau P, Krueger JG. Inter-rater reliability of phenotypes and exploratory genotype-phenotype analysis in inherited hidradenitis suppurativa. Br J Dermatol 2019; 181:566-571. [PMID: 30693478 DOI: 10.1111/bjd.17695] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Genotype-phenotype correlation measures the correlation between the presence of a physical trait with a group of similar mutations but is dependent on reliable phenotyping. It can provide information on disease pathogenesis, future disease progression, severity or activity. Such indicators would be valuable in hidradenitis suppurativa (HS). OBJECTIVES To assess inter-rater reliability (IRR) of HS clinical phenotypes and perform exploratory genotype-phenotype correlation in cases of HS with identified sequence variants. METHODS Linkage disequilibrium between variants was assessed. Genotype-phenotype correlations were explored using Spearman correlation coefficients. IRR was calculated using Cohen's κ. Correlation between phenotype classifications was assessed using the χ2 statistic. RESULTS Forty-three sequence variants with clinical information were identified. Clinical phenotypes were classified as LC2 (n = 29; 67%), scarring folliculitis (n = 18; 42%), atypical (n = 38; 88%) and nodular (n = 26; 60%). LC1 phenotype was associated with regular (χ2 = 41·289, P < 0·001) and typical (χ2 = 29·013, P < 0·001) phenotypes. Cohen's κ was highest for van der Zee and Jemec (0·815), followed by Martorell-Calatayud et al. (0·813), Naasan and Affleck (0·774) and Canoui-Poitrine et al. (0·435) classifications. High linkage disequilibrium was seen between variants of Han Chinese pedigrees. No significant genotype-phenotype correlations were identified. CONCLUSIONS These findings may be influenced by selection, publication bias and the assumption that HS is a monogenic disorder. The poor IRR of existing phenotype measures suggests limited utility of existing measures. Further investigations into the correlation of clinical phenotypes with inflammatory biomarkers may aid in prognostic efforts for this disease. What's already known about this topic? Genotype-phenotype correlation can provide information regarding disease pathogenesis and predictions for future disease progression, severity or activity. The identification of such indicators in hidradenitis suppurativa (HS) would be valuable for patients and clinicians alike, given the lack of biomarkers or clinical predictors of disease. What does this study add? Sixty-five sequence variants across 20 separate genes were identified. There was no significant correlation between phenotype classification in four separate classification schema and gene, mutation type or impact on Notch signalling. Utility of current phenotype measurements are limited. The lack of genotype-phenotype correlation in HS is suggestive that the underlying assumption of inherited HS as a monogenic disorder may need revision.
Collapse
Affiliation(s)
- J W Frew
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, U.S.A
| | - J E Hawkes
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, U.S.A
| | - M Sullivan-Whalen
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, U.S.A
| | - P Gilleaudeau
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, U.S.A
| | - J G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, U.S.A
| |
Collapse
|
34
|
Li A, Peng Y, Taiclet LM, Tanzi RE. Analysis of hidradenitis suppurativa-linked mutations in four genes and the effects of PSEN1-P242LfsX11 on cytokine and chemokine expression in macrophages. Hum Mol Genet 2019; 28:1173-1182. [PMID: 30544224 PMCID: PMC6423421 DOI: 10.1093/hmg/ddy414] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/25/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
Hidradenitis suppurativa (HS), or acne inversa, is a chronic inflammatory skin disorder characterized clinically with acne-like lesions in apocrine gland-bearing skin, follicular occlusion and recurrent inflammation. Thirty-four unique mutations in patients with HS have been found in three genes encoding the γ-secretase complex: nicastrin (NCSTN), presenilin 1 (PSEN1), presenilin enhancer 2 (PSENEN) and in POGLUT1, an endoplasmic reticulum O-glucosyltransferase involved in Notch signaling. We have carried out a system review and have performed a functional analysis of the 34 unique reported HS-linked mutations in NCSTN, PSEN1, PSENEN and POGLUT1. We have also examined the effects of the HS-linked PSEN1-P242LfsX11 mutation on cytokine and chemokine expression in macrophages. Mutations in NCSTN are predicted to cause loss of function, to result in loss of transmembrane (TM) domain, to affect NCSTN substrate recruitment sites, to cause loss or creation of new ligand binging sites and to alter post-translational modifications and disulfide bonds. PSEN1-P242LfsX11 occurs at the opposite side of TM5 from Alzheimer's disease-linked PSEN1 mutations. All of the PSENEN mutations occur on TM regions that are predicted to disrupt membrane function. POGLUT1 mutations lead to an early termination of protein synthesis and are predicted to affect ligand binding function. In addition, PSEN1-P242LfsX11 mediates cytokine and chemokine expression and prolongs tumor necrosis factor α production on the inflammatory processes in THP-1 cells and phorbol-12-myristate-13-acetate-differentiated macrophages in response to lipopolysaccharide stimulation. These in silico analyses are instructive for functional studies of the HS-linked mutations. The PSEN1-P242LfsX11 mutation mediates cytokine and chemokine expression in macrophages.
Collapse
Affiliation(s)
- Airong Li
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital, MassGeneral Institute for Neurodegenerative Diseases, Harvard Medical School, Charlestown, USA
| | - Yang Peng
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital, MassGeneral Institute for Neurodegenerative Diseases, Harvard Medical School, Charlestown, USA
| | - Lauren M Taiclet
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital, MassGeneral Institute for Neurodegenerative Diseases, Harvard Medical School, Charlestown, USA
| | - Rudolph E Tanzi
- Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital, MassGeneral Institute for Neurodegenerative Diseases, Harvard Medical School, Charlestown, USA
| |
Collapse
|
35
|
Common J, Barker J, Steensel M. What does acne genetics teach us about disease pathogenesis? Br J Dermatol 2019; 181:665-676. [DOI: 10.1111/bjd.17721] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 12/18/2022]
Affiliation(s)
- J.E.A. Common
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR) Singapore
| | - J.N. Barker
- St John's Institute of Dermatology Faculty of Life Sciences and Medicine King's College London London U.K
| | - M.A.M. Steensel
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR) Singapore
- Lee Kong Chian School of Medicine Nanyang Technological University Clinical Sciences Building Novena Singapore
| |
Collapse
|
36
|
McGrath JA. Concurrent hidradenitis suppurativa and Dowling-Degos disease taken down a 'Notch'. Br J Dermatol 2018; 178:328. [PMID: 29441533 DOI: 10.1111/bjd.16068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J A McGrath
- St John's Institute of Dermatology, King's College London, London, U.K
| |
Collapse
|
37
|
Ralser DJ, Takeuchi H, Fritz G, Basmanav FB, Effern M, Sivalingam S, El-Shabrawi-Caelen L, Degirmentepe EN, Kocatürk E, Singh M, Booken N, Spierings NMK, Schnabel V, Heineke A, Knuever J, Wolf S, Wehner M, Tronnier M, Leverkus M, Tantcheva-Poór I, Wenzel J, Oji V, Has C, Hölzel M, Frank J, Haltiwanger RS, Betz RC. Altered Notch Signaling in Dowling-Degos Disease: Additional Mutations in POGLUT1 and Further Insights into Disease Pathogenesis. J Invest Dermatol 2018; 139:960-964. [PMID: 30414910 DOI: 10.1016/j.jid.2018.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/25/2018] [Accepted: 10/03/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Damian J Ralser
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Hideyuki Takeuchi
- Department of Biochemistry and Cell Biology, Institute of Cell and Developmental Biology, Stony Brook University, Stony Brook, New York, USA; Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, USA; Department of Molecular Biochemistry, Nagoya University School of Medicine, Nagoya, Japan
| | - Günter Fritz
- Institute of Neuropathology, University of Freiburg, Freiburg, Germany
| | - F Buket Basmanav
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Neuro- and Sensory Physiology, University Medical Center, Göttingen, Göttingen, Germany; Campus Laboratory for Advanced Imaging, Microscopy and Spectroscopy, University of Göttingen, Göttingen, Germany
| | - Maike Effern
- Institute of Clinical Chemistry and Clinical Pharmacology, Unit for RNA Biology, University Hospital of Bonn, Bonn, Germany; Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunology, The University of Melbourne, Melbourne, Australia
| | | | | | - Ece N Degirmentepe
- Department of Dermatology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Emek Kocatürk
- Department of Dermatology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Manuraj Singh
- Department of Dermatopathology, St John's Institute of Dermatology, London, United Kingdom
| | - Nina Booken
- Department of Dermatology, University of Hamburg-Eppendorf, Hamburg, Germany
| | - Natalia M K Spierings
- Department of Dermatology, Leeds Teaching Hospitals National Health Service Trust, United Kingdom
| | - Viktor Schnabel
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Andre Heineke
- Department of Dermatology, Helios Klinikum Hildesheim GmbH, Hildesheim, Germany
| | - Jana Knuever
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - Sabrina Wolf
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Maria Wehner
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Michael Tronnier
- Department of Dermatology, Helios Klinikum Hildesheim GmbH, Hildesheim, Germany
| | - Martin Leverkus
- Department of Dermatology, Venereology, and Allergology, Medical Faculty, Mannheim, University of Heidelberg, Mannheim, Germany; Department of Dermatology and Allergology, University Hospital of Aachen, RWTH, Aachen, Aachen, Germany
| | - Iliana Tantcheva-Poór
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - Jörg Wenzel
- Department of Dermatology, University of Bonn, Bonn, Germany
| | - Vinzenz Oji
- Department of Dermatology, University of Münster, Münster, Germany
| | - Cristina Has
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Hölzel
- Institute of Clinical Chemistry and Clinical Pharmacology, Unit for RNA Biology, University Hospital of Bonn, Bonn, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Robert S Haltiwanger
- Department of Biochemistry and Cell Biology, Institute of Cell and Developmental Biology, Stony Brook University, Stony Brook, New York, USA; Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, USA
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Bonn, Germany.
| |
Collapse
|
38
|
Li W, Xu H, He Y, Lin L, Li C. Comorbidities or different entities? Phenotype variability associated with
PSENEN
mutations. Br J Dermatol 2018; 180:221-222. [DOI: 10.1111/bjd.17111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- W. Li
- Department of Dermatology Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing JiangsuChina
| | - H. Xu
- Department of Dermatology Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing JiangsuChina
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Nanjing Jiangsu China
| | - Y. He
- Department of Dermatology Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing JiangsuChina
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Nanjing Jiangsu China
| | - L. Lin
- Department of Dermatology Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing JiangsuChina
| | - C. Li
- Department of Dermatology Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing JiangsuChina
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Nanjing Jiangsu China
| |
Collapse
|
39
|
A novel NCSTN gene mutation in a Chinese family with acne inversa. Mol Genet Genomics 2018; 293:1469-1475. [DOI: 10.1007/s00438-018-1475-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 07/12/2018] [Indexed: 11/26/2022]
|
40
|
Linke M, Orouji A, Géraud C. Vesicular variant of Dowling-Degos disease. Br J Dermatol 2018; 179:795-796. [DOI: 10.1111/bjd.16906] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- M. Linke
- Department of Dermatology, Venereology and Allergy; University Medical Center and Medical Faculty Mannheim; Heidelberg University; Theodor-Kutzer-Ufer 1-3 68167 Mannheim Germany
| | - A. Orouji
- Department of Dermatology, Venereology and Allergy; University Medical Center and Medical Faculty Mannheim; Heidelberg University; Theodor-Kutzer-Ufer 1-3 68167 Mannheim Germany
| | - C. Géraud
- Department of Dermatology, Venereology and Allergy; University Medical Center and Medical Faculty Mannheim; Heidelberg University; Theodor-Kutzer-Ufer 1-3 68167 Mannheim Germany
| |
Collapse
|
41
|
Pavlovsky M, Sarig O, Eskin‐Schwartz M, Hafner A, Sprecher E. Novel
POFUT
1
mutation associated with hidradenitis suppurativa–Dowling–Degos disease firm up a role for Notch signalling in the pathogenesis of this disorder: reply from the authors. Br J Dermatol 2018; 178:986. [PMID: 29274076 DOI: 10.1111/bjd.16274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- M. Pavlovsky
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - O. Sarig
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - M. Eskin‐Schwartz
- Department 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
| | - A. Hafner
- Department of Dermatology Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - E. Sprecher
- Department 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
| |
Collapse
|