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Tran TNA, Vu TTP, Pham NN, Bui CB, Nguyen HT. Pachyonychia congenita: A father and son with a novel variant in the KRT16 gene. Pediatr Dermatol 2024. [PMID: 38978313 DOI: 10.1111/pde.15701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 06/25/2024] [Indexed: 07/10/2024]
Abstract
This study underscores the significance of identifying the clinical manifestations of pachyonychia congenita (PC) and emphasizes the patterns of genetic inheritance. A 12-month-old boy presented with a "white hairy tongue" and, following a comprehensive evaluation, was diagnosed with PC. His father exhibited similar symptoms. Genetic testing revealed a KRT16 pathogenic variant (c.616 T > G) in both the patient and his father, marking it as a novel variant in the PC literature. This case contributes to a broader understanding of PC's genetic diversity and its clinical presentations.
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Affiliation(s)
- Tu Nguyen Anh Tran
- Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Thao Thi Phuong Vu
- Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Nguyen Nhat Pham
- Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
| | - Chi-Bao Bui
- School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
| | - Hao Trong Nguyen
- Ho Chi Minh City Hospital of Dermato-Venereology, Ho Chi Minh City, Vietnam
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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Lipner SR, Falotico JM, Matushansky JT, Evans H, Schwartz J, Hansen CD. Walking a day in a pachyonychia congenita patient's shoes: Impact on plantar pain and activity levels measured with wristband activity trackers. Indian J Dermatol Venereol Leprol 2023; 89:850-853. [PMID: 37317732 DOI: 10.25259/ijdvl_939_2022] [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: 10/18/2022] [Accepted: 01/04/2023] [Indexed: 06/16/2023]
Abstract
Background Plantar keratoderma is a common finding in pachyonychia congenita, significantly impairing ambulation and quality of life. Due to the variation of pain reporting in pachyonychia congenita clinical studies, it is difficult to evaluate the efficacy of treatment outcomes for painful plantar keratodermas. Objectives To objectively analyse associations between plantar pain and activity levels in pachyonychia congenita patients using a wristband tracker. Methods Pachyonychia congenita patients and matched normal controls wore wristband activity trackers and completed a daily digital survey to record their highest and total pain scores (0-10 scale) each day for 28 consecutive days during four different seasons. Results Twenty four participants (12 pachyonychia congenita patients and 12 matched normal controls) completed the study. Pachyonychia congenita patients walked 1801.30 fewer steps/day (95% CI, -3666.4, 64.1) than normal controls (P = 0.072) and had greater average total [5.26; SD, 2.10] and highest (6.92; SD, 2.35) daily pain than normal controls [0.11 (SD, 0.47), 0.30 (SD, 0.22), respectively] (P < 0.001, both). On average, for each one unit increase in daily highest pain level, pachyonychia congenita activity decreased 71.54 steps/day (SE, 38.90, P = 0.066). Limitation The study had a small number of participants, limiting statistical power. Only pachyonychia congenita patients, ages 18 years or older, with keratin 6a, keratin 16, and keratin 17 mutations were included, limiting generalizability. Conclusion Pachyonychia congenita patients were less active with significantly higher pain than normal controls. There was an inverse correlation between pain and activity. Our findings suggest that wristband tracker technology may be used to evaluate treatment efficacy in future trials on severe plantar pain; therapeutic interventions that decrease plantar pain should correlate with significant increases in activity using wristband trackers.
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Affiliation(s)
- Shari R Lipner
- Department of Dermatology, Weill Cornell Medical College, New York, United States of America
| | - Julianne M Falotico
- Department of Dermatology, Renaissance School of Medicine, Stony Brook University, Stony Brook, United States of America
| | | | - Holly Evans
- Department of Dermatology, Pachyonychia Congenita Project, Salt Lake City, Utah, United States of America
| | - Janice Schwartz
- Department of Dermatology, Pachyonychia Congenita Project, Murray, Utah, United States of America
| | - C David Hansen
- Department of Dermatology, University of Utah School of Medicine, Murray, Utah, United States of America
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Mohamad J, Samuelov L, Assaf S, Malki L, Malovitski K, Meijers O, Adir N, Granot E, Pavlovsky M, Sarig O, Sprecher E. Autosomal recessive congenital ichthyosis caused by a pathogenic missense variant in CLDN1. Am J Med Genet A 2022; 188:2879-2887. [PMID: 35920354 DOI: 10.1002/ajmg.a.62924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 01/31/2023]
Abstract
Autosomal recessive congenital ichthyosis (ARCI) refers to a large and genetically heterogenous group of non-syndromic disorders of cornification featuring diffuse scaling. Ichthyosis, leukocyte vacuoles, alopecia, and sclerosing cholangitis (ILVASC) syndrome is a rare autosomal recessive syndromic form of ichthyosis. The disease usually results from premature termination codon-causing pathogenic variants in CLDN1 encoding CLAUDIN-1 (CLDN1). We used whole exome sequencing (WES), Sanger sequencing, 3D protein modeling, Western blotting, and immunofluorescence confocal microscopy to delineate the genetic basis of ichthyosis in two siblings with ichthyosis but no other ectodermal abnormalities. One of the two siblings underwent liver transplantation in early childhood due to biliary atresia. Both patients were found to carry a homozygous missense pathogenic variant, c.242G>A (p.Arg81His), in CLDN1. The variant resulted in decreased CLDN1 expression in patient skin. 3D protein modeling predicted that p.Arg81His induces deleterious conformational changes. Accordingly, HaCaT cells transfected with a construct expressing the mutant CLDN1 cDNA featured decreased levels and mislocation of CLDN1 as compared with cells expressing the wildtype cDNA. In conclusion, we describe the first pathogenic missense variant in CLDN1 shown to result in ARCI.
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Affiliation(s)
- Janan Mohamad
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Samuelov
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sari Assaf
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liron Malki
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Kiril Malovitski
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Odile Meijers
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Noam Adir
- Schulich Faculty of Chemistry, Technion, Haifa, Israel
| | | | - Mor Pavlovsky
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Sarig
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Pavlovsky M, Peled A, Sarig O, Astman N, Malki L, Meijers O, Assaf S, Schwartz J, Malovitski K, Hansen D, Sprecher E, Samuelov L. Coexistence of pachyonychia congenita and hidradenitis suppurativa: more than a coincidence. Br J Dermatol 2022; 187:392-400. [PMID: 35606927 PMCID: PMC9796395 DOI: 10.1111/bjd.21674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 04/30/2022] [Accepted: 05/21/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The coexistence of pachyonychia congenita (PC) and hidradenitis suppurativa (HS) has been described in case reports. However, the pathomechanism underlying this association and its true prevalence are unknown. OBJECTIVES To determine the genetic defect underlying the coexistence of PC and HS in a large kindred, to delineate a pathophysiological signalling defect jointly leading to both phenotypes, and to estimate the prevalence of HS in PC. METHODS We used direct sequencing and a NOTCH luciferase reporter assay to characterize the pathophysiological basis of the familial coexistence of HS and PC. A questionnaire was distributed to patients with PC registered with the International Pachyonychia Congenita Research Registry (IPCRR) to assess the prevalence of HS among patients with PC. RESULTS Direct sequencing of DNA samples obtained from family members displaying both PC and HS demonstrated a missense variant (c.275A>G) in KRT17, encoding keratin 17. Abnormal NOTCH signalling has been suggested to contribute to HS pathogenesis. Accordingly, the KRT17 c.275A>G variant resulted in a significant decrease in NOTCH activity. To ascertain the clinical importance of the association of HS with PC, we distributed a questionnaire to all patients with PC registered with the IPCRR. Seventy-two of 278 responders reported HS-associated clinical features (25·9%). Disease-causing mutations in KRT17 were most prevalent among patients with a dual phenotype of PC and HS (43%). CONCLUSIONS The coexistence of HS and KRT17-associated PC is more common than previously thought. Impaired NOTCH signalling as a result of KRT17 mutations may predispose patients with PC to HS. What is already known about this topic? The coexistence of pachyonychia congenita (PC) and hidradenitis suppurativa (HS) has been described in case reports. However, the pathomechanism underlying this association and its true prevalence are unknown. What does this study add? A dual phenotype consisting of PC and HS was found to be associated with a pathogenic variant in KRT17. This variant was found to affect NOTCH signalling, which has been previously implicated in HS pathogenesis. HS was found to be associated with PC in a large cohort of patients with PC, especially in patients carrying KRT17 variants, suggesting that KRT17 variants causing PC may also predispose to HS. What is the translational message? These findings suggest that patients with PC have a higher prevalence of HS than previously thought, and hence physicians should have a higher level of suspicion of HS diagnosis in patients with PC.
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Affiliation(s)
- Mor Pavlovsky
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Alon Peled
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Ofer Sarig
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Nadav Astman
- Department of DermatologySheba Medical CenterTel‐HashomerRamat GanIsrael,Israel Defense Forces Medical CorpsRamat GanIsrael
| | - Liron Malki
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Odile Meijers
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Sari Assaf
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | | | - Kiril Malovitski
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - David Hansen
- Pachyonychia Congenita ProjectHolladayUTUSA,Department of DermatologyUniversity of UtahSalt Lake CityUTUSA
| | - Eli Sprecher
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
| | - Liat Samuelov
- Division of DermatologyTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael,Sackler Faculty of MedicineTel‐Aviv UniversityTel AvivIsrael
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