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Papanikolaou M, Nattkemper L, Benzian-Olsson N, Liu L, Guy A, Lu H, Kadiyirire T, Hou PC, Aala W, Serrano S, Pramanik R, Walters N, Dimitrakopoulou K, Lwin S, Kalfas E, Satoc J, Laddach R, Cozzetto D, Thomas B, Kesidou E, Rashidghamat E, Orchard G, O'Toole EA, Hsu CK, Saqi M, Steinhoff M, Onoufriadis A, Yosipovitch G, Gould H, Mellerio JE, McGrath JA. Th2 response drives itch in dystrophic epidermolysis bullosa pruriginosa: A case-control study. J Am Acad Dermatol 2024; 91:130-133. [PMID: 38484894 DOI: 10.1016/j.jaad.2024.01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/05/2024] [Accepted: 01/27/2024] [Indexed: 04/29/2024]
Affiliation(s)
- Marieta Papanikolaou
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK.
| | - Leigh Nattkemper
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Natashia Benzian-Olsson
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Lu Liu
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Synnovis, Guy's Hospital, London, UK
| | - Alyson Guy
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Synnovis, Guy's Hospital, London, UK
| | - Han Lu
- King's Genomics Center, Franklin-Wilkins Building, Waterloo Campus, King's College London, London, UK
| | - Tendai Kadiyirire
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Ping-Chen Hou
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wilson Aala
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sonia Serrano
- NIHR Biomedical Research Center, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Rashida Pramanik
- NIHR Biomedical Research Center, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Nina Walters
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Konstantina Dimitrakopoulou
- NIHR Biomedical Research Center, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Su Lwin
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Emily Kalfas
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Jose Satoc
- Dermatopathology Laboratory, Synnovis, St Thomas' Hospital, London, UK
| | - Roman Laddach
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Domenico Cozzetto
- NIHR Biomedical Research Center, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Bjorn Thomas
- Center for Cell Biology and Cutaneous Research, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Evangelia Kesidou
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Ellie Rashidghamat
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Guy Orchard
- Dermatopathology Laboratory, Synnovis, St Thomas' Hospital, London, UK
| | - Edel A O'Toole
- Center for Cell Biology and Cutaneous Research, Blizard Institute, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; International Research Center of Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Mansoor Saqi
- NIHR Biomedical Research Center, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Martin Steinhoff
- Department of Dermatology and Translational Research Institute, Hamad Medical Corporation, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Alexandros Onoufriadis
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK; Laboratory of Medical Biology and Genetics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Gil Yosipovitch
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Hannah Gould
- Randall Center for Cell and Molecular Biophysics and School of Basic and Medical Biosciences, King's College London, London, UK
| | - Jemima E Mellerio
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
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Popp C, Miller W, Eide C, Tolar J, McGrath JA, Ebens CL. Beyond the Surface: A Narrative Review Examining the Systemic Impacts of Recessive Dystrophic Epidermolysis Bullosa. J Invest Dermatol 2024:S0022-202X(24)00198-2. [PMID: 38613531 DOI: 10.1016/j.jid.2024.03.008] [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: 09/15/2023] [Revised: 02/09/2024] [Accepted: 03/02/2024] [Indexed: 04/15/2024]
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic disease resulting from inadequate type VII collagen (C7). Although recurrent skin blisters and wounds are the most apparent disease features, the impact of C7 loss is not confined to the skin and mucous membranes. RDEB is a systemic disease marred by chronic inflammation, fibrotic changes, pain, itch, and anemia, significantly impacting QOL and survival. In this narrative review, we summarize these systemic features of RDEB and promising research avenues to address them.
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Affiliation(s)
- Courtney Popp
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - William Miller
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cindy Eide
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jakub Tolar
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA; MHealth Fairview Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - John A McGrath
- St. John's Institute of Dermatology, Guy's Hospital, School of Basic & Medical Biosciences, King's College London, London, United Kingdom
| | - Christen L Ebens
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA; MHealth Fairview Masonic Children's Hospital, Minneapolis, Minnesota, USA.
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3
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Roque Quintana B, Piqué Durán E, Pérez Cejudo JA. [Translated article] Successful Control of Recalcitrant Pruritus in Epidermolysis Bullosa Pruriginosa With Dupilumab. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T184-T186. [PMID: 38048956 DOI: 10.1016/j.ad.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/29/2022] [Indexed: 12/06/2023] Open
Affiliation(s)
- B Roque Quintana
- Servicio de Dermatología, Hospital Dr. José Molina Orosa, Lanzarote, Las Palmas, Spain.
| | - E Piqué Durán
- Servicio de Dermatología, Hospital Dr. José Molina Orosa, Lanzarote, Las Palmas, Spain
| | - J A Pérez Cejudo
- Servicio de Dermatología, Hospital Dr. José Molina Orosa, Lanzarote, Las Palmas, Spain
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Roque Quintana B, Piqué Durán E, Pérez Cejudo JA. Successful Control of Recalcitrant Pruritus in Epidermolysis Bullosa Pruriginosa With Dupilumab. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:184-186. [PMID: 36871818 DOI: 10.1016/j.ad.2022.05.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/29/2022] [Indexed: 03/06/2023] Open
Affiliation(s)
- B Roque Quintana
- Servicio de Dermatología, Hospital Dr. José Molina Orosa, Arrecife, Las Palmas, España.
| | - E Piqué Durán
- Servicio de Dermatología, Hospital Dr. José Molina Orosa, Arrecife, Las Palmas, España
| | - J A Pérez Cejudo
- Servicio de Dermatología, Hospital Dr. José Molina Orosa, Arrecife, Las Palmas, España
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Yang DY, Jing WW, Liu X, Li L, Lu T, Li XL. Pruritus Anesis in Dystrophic Epidermolysis Bullosa Pruriginosa with Dupilumab. Adv Skin Wound Care 2024; 37:1-4. [PMID: 38241457 DOI: 10.1097/asw.0000000000000096] [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: 01/21/2024]
Abstract
ABSTRACT Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr) is a rare subtype of dystrophic epidermolysis bullosa, and traditional treatments have limited efficacy. Dupilumab has demonstrated remarkable efficacy in relieving pruritus. In this case study, after traditional treatment failed, providers recommended the patient begin dupilumab to treat his pruritus. The patient was administrated a loading dose of 600 mg of dupilumab and a dose of 300 mg every 2 weeks. The Dermatology Life Quality Index and Pruritic Numeric Rating Scale were used to assess the patient's situation. After several months, the patient's DEB-Pr was considered in remission. Dupilumab may be a better choice than immunosuppressants for the treatment of pruritus in patients with DEB-Pr.
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Affiliation(s)
- Dan-Yang Yang
- At the Xi'an Jiaotong University and Second Affiliated Hospital, Shaanxi, China, Dan-Yang Yang, MM, Wen-Wen Jing, BM, and Xin Liu, BM, are Medical Students; Li Li, MM, and Tao Lu, MM, are Doctors; and Xiao-Li Li, PhD, is Associate Professor
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Yang Y, Gao Y, Zhang M, Qian H, Zhao K, Wang W, Ma Y, Zhang D, Li X, Hu F, Sun X. Genetic diagnosis of a rare COL7A1 variant causing dystrophic epidermolysis bullosa pruriginosa through whole‑exome sequencing. Exp Ther Med 2023; 26:502. [PMID: 37822584 PMCID: PMC10562958 DOI: 10.3892/etm.2023.12201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/25/2023] [Indexed: 10/13/2023] Open
Abstract
Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr) is a rare subtype of inherited DEB. In the present study, whole-exome sequencing was conducted on 12 individuals from the same affected family and a rare heterozygous variation was identified in the collagen type VII, α1 (COL7A1) gene, namely c.6859G>A (p.Gly2287Arg). Subsequently, this heterozygous variant was confirmed using Sanger sequencing of individual plasma cell-free DNA (cfDNA) and it was demonstrated for the first time, to the best of our knowledge, that COL7A1 exons can be amplified from plasma cfDNA. Within the large pedigree examined, 14 out of 18 individuals carried the variant, 3 carried the wild type, and one exceptional case, III-9, showed no disease symptoms despite carrying the disease variant. A general association between genotype and phenotype was established. Of note, the mutation landscape indicated that this G2287R variant is primarily reported in Asian countries. In silico structure prediction suggested that the residue resulting from the mutation may affect collagen protein stability. In conclusion, the present study provides evidence for the involvement of the COL7A1 G2287R gene variant in the development of DEB-Pr and highlights the potential utility of cfDNA in genetic disease diagnosis.
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Affiliation(s)
- Yanhui Yang
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
| | - Yangmin Gao
- Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province, The Affiliated Dermatology Hospital of Nanchang University, Nanchang, Jiangxi 330200, P.R. China
| | - Mengna Zhang
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
| | - Hua Qian
- Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province, The Affiliated Dermatology Hospital of Nanchang University, Nanchang, Jiangxi 330200, P.R. China
- Department of Laboratory Medicine, Chronic Disease Research Center, Medical College, Dalian University, Dalian, Liaoning 116622, P.R. China
| | - Ke Zhao
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
| | - Weijuan Wang
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
| | - Yanxiu Ma
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
| | - Dan Zhang
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
| | - Xiaoguang Li
- Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province, The Affiliated Dermatology Hospital of Nanchang University, Nanchang, Jiangxi 330200, P.R. China
- Department of Laboratory Medicine, Chronic Disease Research Center, Medical College, Dalian University, Dalian, Liaoning 116622, P.R. China
| | - Fengming Hu
- Jiangxi Provincial Clinical Research Center for Skin Diseases, Dermatology Hospital of Jiangxi Province, The Affiliated Dermatology Hospital of Nanchang University, Nanchang, Jiangxi 330200, P.R. China
| | - Xiaoming Sun
- Key Laboratory of Aging and Cancer Biology, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang 311121, P.R. China
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Mellerio JE, Pillay EI, Ledwaba-Chapman L, Bisquera A, Robertson SJ, Papanikolaou M, McGrath JA, Wang Y, Martinez AE, Jeffs E. Itch in recessive dystrophic epidermolysis bullosa: findings of PEBLES, a prospective register study. Orphanet J Rare Dis 2023; 18:235. [PMID: 37559055 PMCID: PMC10410928 DOI: 10.1186/s13023-023-02817-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/08/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Itch is common and distressing in epidermolysis bullosa (EB) but has not previously been studied in depth in different recessive dystrophic EB (RDEB) subtypes. OBJECTIVES As part of a prospective register study of the natural history of RDEB we explored features of itch, medications used, and correlation with disease severity and quality of life. METHODS Fifty individuals with RDEB aged 8 years and above completed the Leuven Itch Scale (LIS) (total 243 reviews over a 7-year period). Data included itch frequency, severity, duration, distress, circumstances, consequences, itch surface area and medications for itch. The iscorEB disease severity score and the validated EB quality of life tool, QOLEB, were compared to LIS domains and analysed by RDEB subtype. RESULTS Itch was frequent, present in the preceding month in 93% of reviews. Itch severity and distress were significantly greater in severe (RDEB-S) and pruriginosa (RDEB-Pru) subtypes compared to intermediate RDEB (RDEB-I). Itch medications were reported in just over half of reviews including emollients, topical corticosteroids and antihistamines; the proportion of participants not using medication despite frequent pruritus suggests limited efficacy. In inversa RDEB (RDEB-Inv) and RDEB-I, LIS domains correlated with iscorEB and QOLEB. In contrast to previous studies, correlations were lacking in RDEB-S suggesting that global disease burden relatively reduces the contribution of itch. CONCLUSIONS This comprehensive study of RDEB-associated itch highlights differences between RDEB subtypes, suggests an unmet need for effective treatments and could serve as control data for future clinical trials incorporating itch as an endpoint.
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Affiliation(s)
- Jemima E Mellerio
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
- Genetic Skin Disease Group, King's College London, London, UK.
| | - Elizabeth I Pillay
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
| | | | | | - Susan J Robertson
- Departments of Dermatology, The Royal Children's Hospital, The Royal Melbourne Hospital and Monash Health, Melbourne, Australia
| | | | - John A McGrath
- Genetic Skin Disease Group, King's College London, London, UK
| | - Yanzhong Wang
- Department of Population Health Sciences, King's College London, London, UK
| | - Anna E Martinez
- Department of Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Eunice Jeffs
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK
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Trivedi M, Gupta LK, Mittal A, Khare AK. Familial Epidermolysis Bullosa Pruriginosa. Indian Dermatol Online J 2023; 14:410-412. [PMID: 37266102 PMCID: PMC10231695 DOI: 10.4103/idoj.idoj_288_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 06/03/2023] Open
Affiliation(s)
- Madhvi Trivedi
- Department of Dermatology Venereology and Leprosy, RNT Medical College, Udaipur, Rajasthan, India
| | - Lalit Kumar Gupta
- Department of Dermatology Venereology and Leprosy, RNT Medical College, Udaipur, Rajasthan, India
| | - Asit Mittal
- Department of Dermatology Venereology and Leprosy, RNT Medical College, Udaipur, Rajasthan, India
| | - Ashok Kumar Khare
- Department of Dermatology Venereology and Leprosy, RNT Medical College, Udaipur, Rajasthan, India
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Epidermolysis Bullosa—A Different Genetic Approach in Correlation with Genetic Heterogeneity. Diagnostics (Basel) 2022; 12:diagnostics12061325. [PMID: 35741135 PMCID: PMC9222206 DOI: 10.3390/diagnostics12061325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
Epidermolysis bullosa is a heterogeneous group of rare genetic disorders characterized by mucocutaneous fragility and blister formation after minor friction or trauma. There are four major epidermolysis bullosa types based on the ultrastructural level of tissue cleavage: simplex, junctional, dystrophic, and Kindler epidermolysis bullosa. They are caused by mutations in genes that encode the proteins that are part of the hemidesmosomes and focal adhesion complex. Some of these disorders can be associated with extracutaneous manifestations, which are sometimes fatal. They are inherited in an autosomal recessive or autosomal dominant manner. This review is focused on the phenomena of heterogeneity (locus, allelic, mutational, and clinical) in epidermolysis bullosa, and on the correlation genotype–phenotype.
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Effendy S, Zhou T, Eichman H, Petr M, Bazant MZ. Blistering failure of elastic coatings with applications to corrosion resistance. SOFT MATTER 2021; 17:9480-9498. [PMID: 34617080 DOI: 10.1039/d1sm00986a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A variety of polymeric surfaces, such as anti-corrosion coatings and polymer-modified asphalts, are prone to blistering when exposed to moisture and air. As water and oxygen diffuse through the material, dissolved species are produced, which generate osmotic pressure that deforms and debonds the coating. These mechanisms are experimentally well-supported; however, comprehensive macroscopic models capable of predicting the formation osmotic blisters, without extensive data-fitting, is scant. Here, we develop a general mathematical theory of blistering and apply it to the failure of anti-corrosion coatings on carbon steel. The model is able to predict the irreversible, nonlinear blister growth dynamics, which eventually reaches a stable state, ruptures, or undergoes runaway delamination, depending on the mechanical and adhesion properties of the coating. For runaway delamination, the theory predicts a critical delamination length, beyond which unstable corrosion-driven growth occurs. The model is able to fit multiple sets of blister growth data with no fitting parameters. Corrosion experiments are also performed to observe undercoat rusting on carbon steel, which yielded trends comparable with model predictions. The theory is used to define three dimensionless numbers which can be used for engineering design of elastic coatings capable of resisting visible deformation, rupture, and delamination.
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Affiliation(s)
- Surya Effendy
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02138, USA.
| | - Tingtao Zhou
- Division of Engineering and Applied Sciences, California Institute of Technology, 1200 E. California Blvd., Pasadena, CA91125, USA
| | - Henry Eichman
- Dow Coating Materials, 400 Arcola Road, Collegeville, PA19426, USA
| | - Michael Petr
- Dow Wire and Cable, 400 Arcola Road, Collegeville, PA19426, USA
| | - Martin Z Bazant
- Department of Chemical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02138, USA.
- Department of Mathematics, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02138, USA
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11
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Darbord D, Hickman G, Pironon N, Barbieux C, Bonnet-des-Claustres M, Titeux M, Miskinyte S, Cordoliani F, Vignon-Pennamen MD, Amode R, Hovnanian A, Bourrat E. Dystrophic epidermolysis bullosa pruriginosa: a new case series of a rare phenotype unveils skewed Th2 immunity. J Eur Acad Dermatol Venereol 2021; 36:133-143. [PMID: 34543471 DOI: 10.1111/jdv.17671] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr) is a rare subtype of hereditary epidermolysis bullosa, with a poorly understood pathogenesis and no satisfactory treatment. OBJECTIVES To assess the clinical and biological features, genetic basis and therapeutic management, to better characterize this rare genodermatosis. METHODS We have conducted a retrospective study, reviewing the clinical presentation, genetic diagnosis, immunohistopathological findings and biological characteristics and management of patients with dystrophic epidermolysis bullosa pruriginosa. This study was conducted in the Department of Dermatology at Saint-Louis Hospital and the Department of Genetics at Necker Hospital (Paris, France). All patients with a diagnosis of DEB-Pr seen between 2010 and 2020 were included. RESULTS Seven patients were included, the average age of 50.1 years [range 36-76]. Pruriginous-lichenified papules, plaques or nodules appeared at 27.6 years on average [range 7-66] on pretibial areas and forearms, associated with milia and toenails dystrophy. All patients received multiple treatments, but none could sustainably reduce pruritus. Immunohistopathological analysis of lesion skin revealed subepidermal blister with fibrosis, milia and mast cell infiltration. Serum TNFα, IL1β and IL6 levels were elevated in 2/6 patients. Total serum IgE levels were increased in 7/7 patients, with no history of atopy. Immunophenotyping of circulating T-cells revealed an increased Th2 subset in 4/4 patients, with reduced Th1 and Th17 subpopulations. Genetic analysis of COL7A1 identified 7 distinct causative mutations, six of which were new. Intra-familial clinical variability was documented in 5/7 patients and was associated with the co-inheritance of a recessive COL7A1 mutation or an FLG2 mutation in 2 families. CONCLUSION Our study confirms the stereotyped presentation of DEB-Pr with large intra-familial variability in disease expression. Mast cell infiltration, elevated IgE and increased Th2 subset without atopy strongly support a role of Th2-mediated immunity in DEB-Pr, and further argue for new targeted therapeutic options such as dupilumab.
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Affiliation(s)
- D Darbord
- Department of Dermatology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - G Hickman
- Department of Dermatology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,Centre de référence maladies rares MAGEC Nord Site Saint Louis, Hôpital Saint Louis, Paris, France
| | - N Pironon
- INSERM UMR 1163, Laboratory of genetic skin diseases, Institut Imagine, Paris Université, Paris, France
| | - C Barbieux
- INSERM UMR 1163, Laboratory of genetic skin diseases, Institut Imagine, Paris Université, Paris, France
| | - M Bonnet-des-Claustres
- INSERM UMR 1163, Laboratory of genetic skin diseases, Institut Imagine, Paris Université, Paris, France
| | - M Titeux
- INSERM UMR 1163, Laboratory of genetic skin diseases, Institut Imagine, Paris Université, Paris, France
| | - S Miskinyte
- INSERM UMR 1163, Laboratory of genetic skin diseases, Institut Imagine, Paris Université, Paris, France
| | - F Cordoliani
- Department of Dermatology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | | | - R Amode
- Department of Dermatology, Hôpital Bichat, AP-HP, Paris, France
| | - A Hovnanian
- INSERM UMR 1163, Laboratory of genetic skin diseases, Institut Imagine, Paris Université, Paris, France.,Department of Genetics, Hôpital Necker-enfants malades, AP-HP, Paris, France
| | - E Bourrat
- Department of Dermatology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France.,Centre de référence maladies rares MAGEC Nord Site Saint Louis, Hôpital Saint Louis, Paris, France
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12
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Wang Z, Lin Y, Duan XW, Hang HY, Zhang X, Li LL. Misdiagnosed dystrophic epidermolysis bullosa pruriginosa: A case report. World J Clin Cases 2021; 9:3090-3094. [PMID: 33969095 PMCID: PMC8080732 DOI: 10.12998/wjcc.v9.i13.3090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/28/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dystrophic epidermolysis bullosa pruriginosa (DEB-Pr) is a rare subtype of DEB, characterized by recurrent pruritus of the extremities, pruritus papules, nodules, and mossy-like plaques. To date, fewer than 100 cases have been reported. We report a misdiagnosed 30-year-old man with sporadic late-onset DEB-Pr who responded well to tacrolimus treatment, thereby serving as a guide to correct diagnosis and treatment.
CASE SUMMARY A 30-year-old man presented with recurrent itching plaques of 1-year duration in the left tibia that aggravated and involved both legs and the back. Examination revealed multiple symmetrical, purple, and hyperpigmented papules and nodules with surface exfoliation involving the tibia and dorsum of the neck with negative Nissl's sign, no abnormalities in the skin, mucosa, hair, or fingernail, and no local lymph node enlargement. Blisters were never reported prior to presentation. Serum immunoglobulin E level was 636 IU/mL. Clinical manifestations suggested DEB-Pr. Histological examination showed subepidermal fissure, scar tissue, and milia. Direct immunofluorescence showed no obvious abnormalities. However, we were unable to perform electron microscopy or genetic research following his choice. We treated him with topical tacrolimus. After 2 wk, the itching alleviated, and the skin lesions began to subside. No adverse reactions were observed during treatment.
CONCLUSION Topical tacrolimus is a safe treatment option for patients with DEB-Pr and can achieve continuous relief of severe itching.
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Affiliation(s)
- Zi Wang
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100000, China
| | - Yi Lin
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100000, China
| | - Xing-Wu Duan
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100000, China
| | - Hai-Yan Hang
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100000, China
| | - Xia Zhang
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100000, China
| | - Ling-Ling Li
- Department of Dermatology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100000, China
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13
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Khan FF, Khan N, Rehman S, Ejaz A, Ali U, Erfan M, Ahmed ZM, Naeem M. Identification and Computational Analysis of Novel Pathogenic Variants in Pakistani Families with Diverse Epidermolysis Bullosa Phenotypes. Biomolecules 2021; 11:620. [PMID: 33921969 PMCID: PMC8143555 DOI: 10.3390/biom11050620] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 12/17/2022] Open
Abstract
Epidermolysis bullosa (EB) includes a group of rare gesnodermatoses that result in blistering and erosions of the skin and mucous membranes. Genetically, pathogenic variants in around 20 genes are known to alter the structural and functional integrity of intraepidermal adhesion and dermo-epidermal anchorage, leading to four different types of EB. Here we report the underlying genetic causes of EB phenotypes segregating in seven large consanguineous families, recruited from different regions of Pakistan. Whole exome sequencing, followed by segregation analysis of candidate variants through Sanger sequencing, identified eight pathogenic variants, including three novel (ITGB4: c.1285G>T, and c.3373G>A; PLEC: c.1828A>G) and five previously reported variants (COL7A1: c.6209G>A, and c.1573C>T; FERMT1: c.676insC; LAMA3: c.151insG; LAMB3: c.1705C>T). All identified variants were either absent or had very low frequencies in the control databases. Our in-silico analyses and 3-dimensional (3D) molecular modeling support the deleterious impact of these variants on the encoded proteins. Intriguingly, we report the first case of a recessively inherited form of rare EBS-Ogna associated with a homozygous variant in the PLEC gene. Our study highlights the clinical and genetic diversity of EB in the Pakistani population and expands the mutation spectrum of EB; it could also be useful for prenatal diagnosis and genetic counseling of the affected families.
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Affiliation(s)
- Fehmida F. Khan
- Medical Genetics Research Laboratory, Department of Biotechnology, Quaid-i-Azam University, Islamabad 45320, Pakistan; (F.F.K.); (N.K.)
| | - Naima Khan
- Medical Genetics Research Laboratory, Department of Biotechnology, Quaid-i-Azam University, Islamabad 45320, Pakistan; (F.F.K.); (N.K.)
| | - Sakina Rehman
- Laboratory of Neurogenetics and Translational Research, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Amir Ejaz
- Army Medical College, Rawalpindi 46000, Pakistan;
| | - Uzma Ali
- Department of Dermatology, Capital Hospital, Islamabad 44000, Pakistan;
| | - Muhammad Erfan
- Department of Dermatology, Federal Government Polyclinic Hospital, Islamabad 44000, Pakistan;
| | - Zubair M. Ahmed
- Laboratory of Neurogenetics and Translational Research, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
| | - Muhammad Naeem
- Medical Genetics Research Laboratory, Department of Biotechnology, Quaid-i-Azam University, Islamabad 45320, Pakistan; (F.F.K.); (N.K.)
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14
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Papanikolaou M, Onoufriadis A, Mellerio JE, Nattkemper LA, Yosipovitch G, Steinhoff M, McGrath JA. Prevalence, pathophysiology and management of itch in epidermolysis bullosa. Br J Dermatol 2020; 184:816-825. [PMID: 32810291 DOI: 10.1111/bjd.19496] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2020] [Indexed: 12/18/2022]
Abstract
Epidermolysis bullosa (EB) is a highly diverse group of inherited skin disorders, resulting from mutations in genes encoding proteins of the dermoepidermal junction. Itch (pruritus) is one of the most common symptoms across all EB subtypes. It occurs in blistered or wounded sites, or manifests as a generalized phenomenon, thereby affecting both intact skin and healing wounds. The mechanism of pruritus in EB is unclear. It is likely that skin inflammation secondary to barrier disruption, wound healing cascades and dysregulated activation of epidermal sensory nerve endings are all involved in its pathophysiology on the molecular and cellular level. Understanding these mechanisms in depth is crucial in developing optimized treatments for people with EB and improving quality of life. This review summarizes current evidence on the prevalence, mechanisms and management of itch in EB.
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Affiliation(s)
- M Papanikolaou
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - A Onoufriadis
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - J E Mellerio
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - L A Nattkemper
- Dr Phillip Frost Department of Dermatology & Cutaneous Surgery and Miami Itch Centre, University of Miami Miller School of Medicine, Miami, FL, USA
| | - G Yosipovitch
- Dr Phillip Frost Department of Dermatology & Cutaneous Surgery and Miami Itch Centre, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Steinhoff
- Department of Dermatology, Hamad Medical Corporation, Weill Cornell Medicine-Qatar, Doha, Qatar.,Translational Research Institute, Hamad Medical Corporation, Weill Cornell Medicine-Qatar, Doha, Qatar.,Weill Cornell Medicine, New York, NY, USA
| | - J A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
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15
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Mariath LM, Santin JT, Schuler-Faccini L, Kiszewski AE. Inherited epidermolysis bullosa: update on the clinical and genetic aspects. An Bras Dermatol 2020; 95:551-569. [PMID: 32732072 PMCID: PMC7563003 DOI: 10.1016/j.abd.2020.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/17/2020] [Indexed: 12/14/2022] Open
Abstract
Inherited epidermolysis bullosa is a group of genetic diseases characterized by skin fragility and blistering on the skin and mucous membranes in response to minimal trauma. Epidermolysis bullosa is clinically and genetically very heterogeneous, being classified into four main types according to the layer of skin in which blistering occurs: epidermolysis bullosa simplex (intraepidermal), junctional epidermolysis bullosa (within the lamina lucida of the basement membrane), dystrophic epidermolysis bullosa (below the basement membrane), and Kindler epidermolysis bullosa (mixed skin cleavage pattern). Furthermore, epidermolysis bullosa is stratified into several subtypes, which consider the clinical characteristics, the distribution of the blisters, and the severity of cutaneous and extracutaneous signs. Pathogenic variants in at least 16 genes that encode proteins essential for the integrity and adhesion of skin layers have already been associated with different subtypes of epidermolysis bullosa. The marked heterogeneity of the disease, which includes phenotypes with a broad spectrum of severity and many causal genes, hinders its classification and diagnosis. For this reason, dermatologists and geneticists regularly review and update the classification criteria. This review aimed to update the state of the art on inherited epidermolysis bullosa, with a special focus on the associated clinical and genetic aspects, presenting data from the most recent reclassification consensus, published in 2020.
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Affiliation(s)
- Luiza Monteavaro Mariath
- Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Tosetto Santin
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Dermatology Service, Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Ana Elisa Kiszewski
- Dermatology Service, Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Department of Clinical Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Pediatric Dermatology Unit, Santa Casa de Misericórdia de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
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16
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Ferreira S, Azevedo A, Velho GC, Sanches M, Selores M. Epidermolysis Bullosa Pruriginosa successfully treated with concomitant topical and systemic agents. Australas J Dermatol 2020; 61:355-357. [PMID: 32524588 DOI: 10.1111/ajd.13342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/01/2022]
Abstract
Epidermolysis bullosa pruriginosa, a genetic mechanobullous disease, manifests at birth or late in life and is characterised by intense pruritus, resulting in lichenified or nodular prurigo-like lesions and scarring most prominent on the shins. Treatment is unsatisfactory. We report a patient treated with success using a combination of topical and systemic agents.
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Affiliation(s)
- Sandra Ferreira
- Dermatology Department, Centro Hospital e Universitário do Porto, Porto, Portugal
| | - Alexandra Azevedo
- Dermatology Department, Centro Hospital e Universitário do Porto, Porto, Portugal
| | - Glória C Velho
- Dermatology Department, Centro Hospital e Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédica Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Madalena Sanches
- Dermatology Department, Centro Hospital e Universitário do Porto, Porto, Portugal
| | - Manuela Selores
- Dermatology Department, Centro Hospital e Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédica Abel Salazar, Universidade do Porto, Porto, Portugal
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17
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Ertop P, Vural S, Gökpınar Ili E, Durmaz CD, Heper AO, McGrath JA, Ilgın RH, Boyvat A. Promising effect of intravenous immunoglobulin therapy for epidermolysis bullosa pruriginosa. Int J Dermatol 2020; 59:851-855. [PMID: 32506551 DOI: 10.1111/ijd.14951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/10/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidermolysis bullosa pruriginosa (EBP) is rare a clinical variant of dystrophic epidermolysis bullosa characterized by trauma-induced bullae formation, milia and nail dystrophy accompanied by severe pruritus. Treatment pruritus of EBP focuses on immunosuppressive treatment with limited efficacy. Treatment strategies are not well-established. AIM To provide the genetic characterization of a multi-generational EBP family and discuss the efficacy of intravenous immunoglobulin treatment in EBP. MATERIALS & METHODS The clinical characteristics of patients diagnosed with EBP in three consecutive generations were determined. The mutation is analyzed in the index patient's genomic DNA by Sanger sequencing, and this mutation was confirmed in other affected members of the family. Index case with severe phenotype was treated with intravenous immunoglobulin (IVIG). RESULTS A heterozygous single nucleotide transition, c.6127G>A, in exon 73 of COL7A1 was identified in all affected members. Physical examination of patients revealed lichenoid papules on extensor surfaces of extremities, excoriations, milia formation and nail dystrophy. Majority of patients had elevated serum IgE levels (%86 (6/7)) without a medical history for atopy. Female patients had generalized involvement and severe phenotype. The skin lesions of the index case were refractory to high dose systemic steroids and cyclosporine treatment. Lesions improved significantly with intravenous immunoglobulin therapy. CONCLUSION In severe cases, unresponsive to other therapies, IVIG may be a preferable therapeutic approach to modulate the inflammatory response in patients with EBP.
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Affiliation(s)
- Pelin Ertop
- Department of Dermatology, Ankara University, Ankara, Turkey
| | - Secil Vural
- Department of Dermatology, Koç University, İstanbul, Turkey
| | | | - Ceren D Durmaz
- Department of Medical Genetics, Ankara University, Ankara, Turkey
| | - Aylin O Heper
- Department of Pathology, Ankara University, Ankara, Turkey
| | - John A McGrath
- King's College London, Guy's Hospital, St John's Institute of Dermatology, London, UK
| | - Ruhi H Ilgın
- Department of Medical Genetics, Ankara University, Ankara, Turkey
| | - Ayse Boyvat
- Department of Dermatology, Ankara University, Ankara, Turkey
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18
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O'Connor C, Heffron C, McGrath J, O'Shea S, Bourke J. Epidermolysis bullosa (EB) pruriginosa associated with recessive homozygous mutations in COL7A1: case report of a rare EB genotype-phenotype. J Eur Acad Dermatol Venereol 2020; 34:e501-e504. [PMID: 32250485 DOI: 10.1111/jdv.16418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - C Heffron
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - J McGrath
- National Diagnostic Epidermolysis Bullosa Laboratory, Guy's Hospital, London, UK
| | - S O'Shea
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - J Bourke
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
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19
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Rani S, Gupta A, Bhardwaj M. Epidermolysis bullosa pruriginosa: A rare entity which responded well to thalidomide. Dermatol Ther 2019; 32:e13035. [PMID: 31355515 DOI: 10.1111/dth.13035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/13/2019] [Accepted: 07/24/2019] [Indexed: 12/26/2022]
Abstract
Epidermolysis bullosa pruriginosa is an unusual clinical variant of dystrophic epidermolysis bullosa characterized by sublamina densa blistering and intense pruritus leading to hypertrophic lichenoid nodules, plaques, milia, and variable presence of albopapuloid lesions. Most cases are sporadic but a few cases have autosomal dominant or recessive inheritance. Treatment has been quite disappointing and failed to produce satisfactory or sustained results. We report a case of 39-years-old male with epidermolysis bullosa pruriginosa and its response to thalidomide.
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Affiliation(s)
- Seema Rani
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Aastha Gupta
- Department of Dermatology, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Department of Pathology, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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20
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Ko CJ, Atzmony L, Lim Y, McNiff JM, Craiglow BG, Antaya RJ, Choate KA. Review of genodermatoses with characteristic histopathology and potential diagnostic delay. J Cutan Pathol 2019; 46:756-765. [DOI: 10.1111/cup.13520] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/16/2019] [Accepted: 05/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Christine J. Ko
- Department of DermatologyYale University Medical School New Haven Connecticut
| | - Lihi Atzmony
- Department of DermatologyYale University Medical School New Haven Connecticut
| | - Young Lim
- Department of DermatologyYale University Medical School New Haven Connecticut
| | - Jennifer M. McNiff
- Department of DermatologyYale University Medical School New Haven Connecticut
| | | | - Richard J. Antaya
- Department of DermatologyYale University Medical School New Haven Connecticut
| | - Keith A. Choate
- Department of DermatologyYale University Medical School New Haven Connecticut
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21
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Hale GI, Cohen MC, Quarrell OW, McGrath JA, Messenger AG. Coinheritance of 2 New Potentially Damaging Heterozygous COL7A1 Variants in a Family With Autosomal Dominant Epidermolysis Bullosa Pruriginosa. Pediatr Dev Pathol 2018; 21:580-584. [PMID: 29504492 DOI: 10.1177/1093526618761497] [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] [Indexed: 11/15/2022]
Abstract
Epidermolysis bullosa pruriginosa (EBP) is a rare subtype of EB which is characterized by intense pruritus with blistering and nodular or lichenoid lesions most prominent on the lower extremities. It is caused by variants in COL7A1 which encodes for type VII collagen. There is wide phenotypic and genotypic variability between affected individuals. We report 2 potentially pathogenic variants in COL7A1 occurring on the same allele in a family with EBP and autosomal dominant inheritance. Late-onset EBP and incomplete penetrance may lead to delayed presentation in affected family members with the same variants. The broad phenotypic variability seen in EBP suggests that further genotypic and environmental factors may influence presentation. Genetic and histopathological diagnosis is essential, given the considerable overlap with clinically similar presentations such as hypertrophic lichen planus.
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Affiliation(s)
- Gordon I Hale
- 1 Department of Dermatology, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, UK
| | - Marta C Cohen
- 2 Department of Histopathology, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, UK
| | - Oliver W Quarrell
- 3 Department of Genetics, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, UK
| | - John A McGrath
- 4 St. John's Institute of Dermatology, Kings College London, London, UK
| | - Andrew G Messenger
- 1 Department of Dermatology, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, UK
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22
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Morimoto N, Shimizu A, Hattori M, Kuriyama Y, Nakano H, Ohnishi K. Dystrophic epidermolysis bullosa pruriginosa presenting with flagellate scarring lesions. Clin Exp Dermatol 2018; 44:e5-e6. [PMID: 30288768 DOI: 10.1111/ced.13803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- N Morimoto
- Department of Dermatology, Japan Red Cross Maebashi Hospital, Maebashi, Japan
| | - A Shimizu
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - M Hattori
- Department of Dermatology, Japan Red Cross Maebashi Hospital, Maebashi, Japan.,Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Y Kuriyama
- Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - H Nakano
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - K Ohnishi
- Department of Dermatology, Japan Red Cross Maebashi Hospital, Maebashi, Japan
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23
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Mu YZ, Du ZC, Zhang ZZ, Yang H, Chen X, Wang YB, Liu LL. The clinical phenotype and a novel COL7A1
mutation in a Chinese family with dystrophic epidermolysis bullosa pruriginosa. J Eur Acad Dermatol Venereol 2018; 32:e372-e373. [PMID: 29512192 DOI: 10.1111/jdv.14917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Y.-Z. Mu
- Department of Dermatology; The Affiliated Hospital of North Sichuan Medical College; Nanchong Sichuan Province China
| | - Z.-C. Du
- Department of Dermatology; The Affiliated Hospital of North Sichuan Medical College; Nanchong Sichuan Province China
| | - Z.-Z. Zhang
- Department of Dermatology; The Affiliated Hospital of North Sichuan Medical College; Nanchong Sichuan Province China
| | - H. Yang
- Department of Dermatology; The Affiliated Hospital of North Sichuan Medical College; Nanchong Sichuan Province China
| | - X. Chen
- Department of Dermatology; The Affiliated Hospital of North Sichuan Medical College; Nanchong Sichuan Province China
| | - Y.-B. Wang
- Department of Dermatology; The Affiliated Hospital of North Sichuan Medical College; Nanchong Sichuan Province China
| | - L.-L. Liu
- Department of Dermatology; Suining Central Hospital; Suining Sichuan Province China
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24
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Knöpfel N, Noguera-Morel L, Hernández-Martin A, García-Martin A, García M, Mencía Á, Pedrero RM, de Lucas R, Escámez MJ, Torrelo A. Identical COL71A1 heterozygous mutations resulting in different dystrophic epidermolysis bullosa phenotypes. Pediatr Dermatol 2018; 35:e94-e98. [PMID: 29272047 DOI: 10.1111/pde.13367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Dystrophic epidermolysis bullosa is a rare blistering condition caused by mutations in the COL7A1 gene. Different clinical variants have been described, with dominant and recessive inheritance, but no consistent findings have been elucidated to establish a genotype-phenotype correlation. We present three unrelated patients with two identical pathogenic compound heterozygous mutations in the COL7A1 gene that developed different clinical forms of dystrophic epidermolysis bullosa-epidermolysis bullosa pruriginosa and mild recessive non-Hallopeau-Siemens-raising the possibility of other genetic or environmental modifying factors responsible for the phenotype of the disease.
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Affiliation(s)
- Nicole Knöpfel
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Lucero Noguera-Morel
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - Adela García-Martin
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), CIEMAT-Centro de Investigación Biomédica en Red de Enfermedades Raras (U714-CIBERER), Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz (IISFJD), Madrid, Spain
| | - Marta García
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), CIEMAT-Centro de Investigación Biomédica en Red de Enfermedades Raras (U714-CIBERER), Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz (IISFJD), Madrid, Spain
| | - Ángeles Mencía
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), CIEMAT-Centro de Investigación Biomédica en Red de Enfermedades Raras (U714-CIBERER), Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz (IISFJD), Madrid, Spain
| | | | - Raúl de Lucas
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - Maria José Escámez
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), CIEMAT-Centro de Investigación Biomédica en Red de Enfermedades Raras (U714-CIBERER), Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz (IISFJD), Madrid, Spain
| | - Antonio Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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25
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26
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Nijhawan M, Agarwal S, Nijhawan S, Jhangra R, Goel P, Sehgal VN. Epidermolysis bullosa pruriginosa a clinico-pathological study in an index case, highlighting its affliction in 11 of 27 member of the family. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2017. [DOI: 10.1016/j.jdds.2017.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Takahashi T, Mizutani Y, Ito M, Nakano H, Sawamura D, Seishima M. Dystrophic epidermolysis bullosa pruriginosa successfully treated with immunosuppressants. J Dermatol 2016; 43:1391-1392. [PMID: 27075048 DOI: 10.1111/1346-8138.13406] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Tomoko Takahashi
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoko Mizutani
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Mitsuru Ito
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hajime Nakano
- Department of Dermatology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Daisuke Sawamura
- Department of Dermatology, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Mariko Seishima
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan.
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Heurung A, Liu J, Hook K. Multiple Pruritic and Reticulated Keloid-Like Plaques Since Childhood. Pediatr Dermatol 2015; 32:549-50. [PMID: 26184401 DOI: 10.1111/pde.12553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ashley Heurung
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Jing Liu
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Kristin Hook
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
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Abstract
Dystrophic epidermolysis bullosa is a rare inherited blistering disorder caused by mutations in the COL7A1 gene encoding type VII collagen. The deficiency and/or dysfunction of type VII collagen leads to subepidermal blistering immediately below the lamina densa, resulting in mucocutaneous fragility and disease complications such as intractable ulcers, extensive scarring, malnutrition, and malignancy. The disease is usually diagnosed by immunofluorescence mapping and/or transmission electron microscopy and subsequently subclassified into one of 14 subtypes. This review provides practical knowledge on the disease, including new therapeutic strategies.
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Affiliation(s)
- Satoru Shinkuma
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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30
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Kim WB, Alavi A, Walsh S, Kim S, Pope E. Epidermolysis bullosa pruriginosa: a systematic review exploring genotype-phenotype correlation. Am J Clin Dermatol 2015; 16:81-7. [PMID: 25690953 DOI: 10.1007/s40257-015-0119-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Epidermolysis bullosa pruriginosa (EBP) is a clinical variant of dystrophic epidermolysis bullosa (DEB), characterized by intense pruritus and hypertrophic, lichenified, prurigo-like papules, plaques, and nodules secondary to scratching. These clinical findings have been attributed to various mutations in the COL7A1 gene. Previous reports have yielded inconsistent findings regarding a possible genotype-phenotype relationship in EBP. OBJECTIVE Our aim was to conduct a systematic review aimed at assessing the genotype-phenotype correlation in EBP. METHODS A systematic review was conducted using PubMed, Medline, EMBASE, and Cochrane databases for all reports of mutation-verified EBP, published from 1946 to September 2014. Statistical comparison of clinical findings between mutation types was performed using logistic regression analysis. RESULTS The review included a total of 28 articles with 74 individuals, which consisted of level 4 non-controlled case series (grade C) and level 5 case reports (grade D). Previous reported mutation types included glycine substitution (GS, 52.7%), in-frame skipping (IFS, 33.8%), non-glycine substitution (NGS, 8.1%), and premature termination codon (PTC, 5.4%). The most common clinical findings were extremities involvement, linear configuration, and nail dystrophy. In comparison with GS mutation carriers, IFS carriers had a higher likelihood of (1) being male (OR 2.99; p = 0.043; 95% CI 1.27-11.4) and (2) presenting with blisters (OR 4.10; p = 0.013; 95% CI 1.34-12.5). CONCLUSIONS To our knowledge, this study is the first systematic review examining the relationship between mutation type and clinical presentation in EBP. The findings in this review (1) identify common clinical characteristics of EBP that may help in the assessment of patients with possible EBP; and (2) indicate that certain mutation carriers may have a higher likelihood of exhibiting particular phenotypes. In the case of potential diagnostic challenge, assessment for presence of common clinical findings as well as molecular testing may facilitate correct identification and prognostication.
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31
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Shi BJ, Zhu XJ, Liu Y, Hao J, Yan GF, Wang SP, Wang XY, Diao QC. Transient bullous dermolysis of the newborn: a novelde novomutation in theCOL7A1gene. Int J Dermatol 2015; 54:438-42. [PMID: 25800346 DOI: 10.1111/ijd.12704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Bing-Jun Shi
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Xiao-Juan Zhu
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Yi Liu
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Jin Hao
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Guo-Fu Yan
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Su-Ping Wang
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Xiu-Yong Wang
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
| | - Qing-Chun Diao
- Department of Dermatology; Chongqing Hospital of Traditional Chinese Medicine (First People's Hospital of Chongqing City); Chongqing China
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32
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Toyonaga E, Nishie W, Komine M, Murata S, Shinkuma S, Natsuga K, Nakamura H, Ohtsuki M, Shimizu H. Skipped exon in COL7A1 determines the clinical phenotypes of dystrophic epidermolysis bullosa. Br J Dermatol 2015; 172:1141-4. [PMID: 25196227 DOI: 10.1111/bjd.13386] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- E Toyonaga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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33
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Abstract
Epidermolysis bullosa (EB) pruriginosa is a rare clinical subtype of dystrophic epidermolysis bullosa (DEB) that is characterized by intense pruritus resulting in hypertrophic, lichenified, prurigo-like plaques and nodules secondary to scratching. The variability in the age of onset, rarity of intact bullae, histologic ambiguities, and close resemblance to other conditions such as acquired inflammatory dermatoses may make diagnosis difficult for this unusual condition, for which fewer than 100 cases have been documented. In this report, we describe 3 cases of EB pruriginosa and review the current literature.
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Affiliation(s)
- Whan B. Kim
- McMaster University, Hamilton, Ontario, Canada
| | - Afsaneh Alavi
- University of Toronto, Toronto, Ontario, Canada
- Women’s College Hospital, Toronto, Ontario, Canada
| | - Elena Pope
- University of Toronto, Toronto, Ontario, Canada
- University of Toronto Hospital for Sick Children, Toronto, Ontario, Canada
| | - Scott Walsh
- University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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34
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Ni C, Zhang J, Zhang H, Cheng RH, Liang JY, Li CX, Li M, Yao ZR. A novel mutation in the COL7A1 gene results in a unique phenotype of epidermolysis bullosa pruriginosa. J Eur Acad Dermatol Venereol 2015; 30:535-6. [PMID: 25556825 DOI: 10.1111/jdv.12933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Ni
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - J Zhang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - H Zhang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - R-H Cheng
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - J-Y Liang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - C-X Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - M Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Z-R Yao
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
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35
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Pai VV, Sori T, Naveen KN, Athanikar SB, Rai V, Shastry DU. Epidermolysis bullosa pruriginosa: A report of two cases. Indian Dermatol Online J 2014; 5:44-7. [PMID: 24616855 PMCID: PMC3937487 DOI: 10.4103/2229-5178.126030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Epidermolysis bullosa (EB) pruriginosa is a very rare pattern of dystrophic EB caused by type VII collagen gene mutation, with distinctive clinico-pathological features. It is characterized by nodular prurigo-like lichenified lesions, nail dystrophy, and variable presence of albopapuloid lesions. We report two such cases.
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Affiliation(s)
| | - Tukaram Sori
- Consultant Dermatologist, Gadag, Karnataka, India
| | | | | | - Vijetha Rai
- Dermatology, SDM College of Medical Sciences and Hospital, Sattur, Dharwad, India
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36
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Fortuna G, Di Lorenzo M, Cepeda-Valdes R, Garcia-Garcia C, Salas-Alanis JC. The largest family of the Americas with dominant dystrophic epidermolysis bullosa pruriginosa: A 18-year longitudinal genotype–phenotype study. J Dermatol Sci 2013; 71:217-21. [DOI: 10.1016/j.jdermsci.2013.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 04/04/2013] [Accepted: 04/19/2013] [Indexed: 12/26/2022]
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37
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Mahto A, McGrath JA, Deroide F, Rustin MHA. Late-onset pretibial recessive dystrophic epidermolysis bullosa. Clin Exp Dermatol 2013; 38:630-2. [PMID: 23786535 DOI: 10.1111/ced.12072] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2012] [Indexed: 12/30/2022]
Abstract
Pretibial epidermolysis bullosa (EB) is a rare form of localized dystrophic EB, characterized by recurrent blistering and scarring plaques occurring predominantly in the pretibial area. In most cases, nail dystrophy, especially of the toenails, is also present. Often there are no clinical abnormalities at birth, and the disorder may only appear after several years. We report a patient who developed symptoms in his fifth decade. Genetic testing identified compound heterozygosity for two pathogenic mutations in the COL7A1 gene. This case highlights a rare variant of mechanobullous disease, and stresses the importance of molecular screening in establishing a correct diagnosis. Precisely why the disorder specifically localizes to the shins or why it may only become apparent in later life is not known.
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Affiliation(s)
- A Mahto
- Department of Dermatology, Royal Free Hospital, London, UK.
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38
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Kim J, Loh CH, Murrell DF. Epidermolysis bullosa pruriginosa triggered by scabies infestation. J Dermatol 2013; 40:562-3. [PMID: 23663219 DOI: 10.1111/1346-8138.12167] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 03/11/2013] [Indexed: 11/30/2022]
Abstract
Epidermolysis bullosa pruriginosa (EB-Pr) is an unusual variant of dystrophic EB. Potential genetic disease modifiers and metabolic factors have been investigated, but thus far no specific insight into this phenotype has emerged. We report an in-depth description of three patients diagnosed as having EB-Pr in whom this particular phenotype developed after scabies infestation and dramatically improved after full treatment. This short communication suggests that scabies infestation could be one of the important triggering factors for the development of the EB-Pr phenotype.
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Affiliation(s)
- Jaehwan Kim
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
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39
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Ranugha PSS, Mohanan S, Chandrashekar L, Basu D, Thappa DM, Rajesh NG. Epidermolysis bullosa pruriginosa showing good response to low-dose thalidomide - a report of two cases. Dermatol Ther 2013; 27:60-3. [DOI: 10.1111/dth.12047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- P. S. S. Ranugha
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - S. Mohanan
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - L. Chandrashekar
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - D. Basu
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - D. M. Thappa
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
| | - N. G. Rajesh
- Jawaharlal Institute of Postgraduate Medical Education and Research; Pondicherry India
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40
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Tang ZL, Lin ZM, Wang HJ, Chen Q, Xu XM, Ge HF, Yang Y. Four novel and two recurrent glycine substitution mutations in the COL7A1 gene in Chinese patients with epidermolysis bullosa pruriginosa. Clin Exp Dermatol 2013; 38:197-9. [PMID: 23397949 DOI: 10.1111/ced.12061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2012] [Indexed: 12/14/2022]
Affiliation(s)
- Z L Tang
- Department of Dermatology, Affiliated Hospital of Qingdao University Medical College, Qingdao, China
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41
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Brick K, Hand JL, Frankel AS, Siegel DH, Thomas KB, El-Azhary R, Krol A. Epidermolysis bullosa pruriginosa: further clarification of the phenotype. Pediatr Dermatol 2012; 29:732-7. [PMID: 23106673 DOI: 10.1111/j.1525-1470.2012.01786.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A defect in type VII collagen causes dystrophic epidermolysis bullosa (DEB). The pruriginosa variant (DEB-Pr) is unique because its initial presentation may be delayed until adolescence or adulthood, and its predominant feature is scarring and pruritus without the characteristic skin fragility of DEB. We describe three families with multiple affected members in which DEB-Pr shows an autosomal-dominant inheritance pattern. All affected individuals were examined, and three previously unreported COL7A1 mutations were identified.
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Affiliation(s)
- Katherine Brick
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA
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42
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Yang CS, Lu Y, Farhi A, Nelson-Williams C, Kashgarian M, Glusac EJ, Lifton RP, Antaya RJ, Choate KA. An incompletely penetrant novel mutation in COL7A1 causes epidermolysis bullosa pruriginosa and dominant dystrophic epidermolysis bullosa phenotypes in an extended kindred. Pediatr Dermatol 2012; 29:725-31. [PMID: 22515571 PMCID: PMC3709244 DOI: 10.1111/j.1525-1470.2012.01757.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epidermolysis bullosa pruriginosa (EBP) is a rare subtype of dystrophic epidermolysis bullosa (DEB) characterized by intense pruritus, nodular or lichenoid lesions, and violaceous linear scarring, most prominently on the extensor extremities. Remarkably, identical mutations in COL7A1, which encodes an anchoring fibril protein present at the dermal-epidermal junction, can cause both DEB and EBP with either autosomal dominant or recessive inheritance. We present one family with both dystrophic and pruriginosa phenotypes of epidermolysis bullosa. The proband is a 19-year-old Caucasian woman who initially presented in childhood with lichenoid papules affecting her extensor limbs and intense pruritus consistent with EBP. Her maternal grandmother saw a dermatologist for similar skin lesions that developed without any known triggers at age 47 and mostly resolved spontaneously after approximately 10 years. The proband's younger brother developed a small crop of pruritic papules on his elbows, dorsal hands, knees, and ankles at age 13. Her second cousin once removed, however, reported a mild blistering disease without pruritus consistent with DEB. Genetic sequencing of the kindred revealed a single dominant novel intron 47 splice site donor G>A mutation, c.4668 + 1 G>A, which we predict leads to exon skipping. Incomplete penetrance is confirmed in her clinically unaffected mother, who carries the same dominant mutation. The wide diversity of clinical phenotypes with one underlying genotype demonstrates that COL7A1 mutations are incompletely penetrant and strongly suggests that other genetic and environmental factors influence clinical presentation.
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Affiliation(s)
- Catherine S Yang
- Department of Dermatology, Howard Hughes Medical Institute, School of Medicine, Yale University, New Haven, Connecticut 06510, USA
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43
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Abstract
For at least half a century, noninvasive techniques have been available to quantify skin barrier function, and these have shown that a number of human skin conditions and disorders are associated with defects in skin permeability. In the past decade, several genes responsible for skin barrier defects observed in both monogenetic and complex polygenic disorders have been elucidated and functionally characterized. This has led to an explosion of work in the past 6 years that has identified pathways connecting epidermal barrier disruption and antigen uptake, as well as the quality and/or magnitude of the antigen-specific adaptive immune response. This review will introduce the notion that diseases arise from the dynamic crosstalk that occurs between skin barrier and the immune system using atopic dermatitis or eczema as the disease prototype. Nevertheless, the concepts put forth are highly relevant to a number of antigen-driven disorders for which skin barrier is at least transiently compromised, such as psoriasis, allergic contact dermatitis, and blistering disorders.
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44
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TAKIYOSHI N, NAKANO H, SAWAMURA D. Epidermolysis bullosa pruriginosa with marked phenotypic heterogeneity caused by a recurrent glycine substitution: Incomplete penetrance or a latent case? J Dermatol 2011; 39:718-9. [DOI: 10.1111/j.1346-8138.2011.01392.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Covaciu C, Grosso F, Pisaneschi E, Zambruno G, Gregersen P, Sommerlund M, Hertz J, Castiglia D. A founder synonymous COL7A1 mutation in three Danish families with dominant dystrophic epidermolysis bullosa pruriginosa identifies exonic regulatory sequences required for exon 87 splicing. Br J Dermatol 2011; 165:678-82. [DOI: 10.1111/j.1365-2133.2011.10414.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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46
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Pruneddu S, Castiglia D, Floriddia G, Cottoni F, Zambruno G. COL7A1 Recessive Mutations in Two Siblings with Distinct Subtypes of Dystrophic Epidermolysis Bullosa: Pruriginosa versus Nails Only. Dermatology 2011; 222:10-4. [DOI: 10.1159/000322619] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 10/28/2010] [Indexed: 02/02/2023] Open
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47
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HAYASHI M, KAWAGUCHI M, HOZUMI Y, NAKANO H, SAWAMURA D, SUZUKI T. Dystrophic epidermolysis bullosa pruriginosa of elderly onset. J Dermatol 2010; 38:173-8. [DOI: 10.1111/j.1346-8138.2010.00953.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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48
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Aoki M, Niimi Y, Ishiko A, Kawana S. Pretibial dystrophic epidermolysis bullosa with localized cutaneous amyloidosis: coincidental or secondary amyloidosis? J Dermatol 2010; 37:259-63. [PMID: 20507391 DOI: 10.1111/j.1346-8138.2009.00794.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Here, we describe the case of a patient with pretibial dystrophic epidermolysis bullosa (PDEB) with amyloid deposition. The patient was a 40-year-old Japanese woman who presented a blistering eruption in the pretibial area with flat violaceous-brown lichenoid papules. The histology of the blister revealed a subepidermal bulla with antibodies bound to basement membrane antigens on the blister roof by immunoflourescent mapping. Electron microscopy revealed a blister cleavage plane below the lamina densa. The histology of the lichenoid papules showed amyloid deposition in the papillary dermis. Because it was confined to just beneath the bulla base of the blister specimen, the amyloid deposition may have been derived from degenerated keratinocytes induced by damage to the epidermal-dermal junction due to blister formation in PDEB in this case. PDEB, in general, is often misdiagnosed as lichen amyloidosis; however, some PDEB cases could actually be associated with amyloid deposition.
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Affiliation(s)
- Mikako Aoki
- Department of Dermatology, Nippon Medical School Musashikosugi Hospital, Kawasaki City, Kanagawa, Japan.
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49
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Abstract
Inherited epidermolysis bullosa (EB) encompasses a number of disorders characterized by recurrent blister formation as the result of structural fragility within the skin and selected other tissues. All types and subtypes of EB are rare; the overall incidence and prevalence of the disease within the United States is approximately 19 per one million live births and 8 per one million population, respectively. Clinical manifestations range widely, from localized blistering of the hands and feet to generalized blistering of the skin and oral cavity, and injury to many internal organs. Each EB subtype is known to arise from mutations within the genes encoding for several different proteins, each of which is intimately involved in the maintenance of keratinocyte structural stability or adhesion of the keratinocyte to the underlying dermis. EB is best diagnosed and subclassified by the collective findings obtained via detailed personal and family history, in concert with the results of immunofluorescence antigenic mapping, transmission electron microscopy, and in some cases, by DNA analysis. Optimal patient management requires a multidisciplinary approach, and revolves around the protection of susceptible tissues against trauma, use of sophisticated wound care dressings, aggressive nutritional support, and early medical or surgical interventions to correct whenever possible the extracutaneous complications. Prognosis varies considerably and is based on both EB subtype and the overall health of the patient.
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Affiliation(s)
- Jo-David Fine
- Department of Medicine (Dermatology, Vanderbilt University School of Medicine, Head, National Epidermolysis Bullosa Registry Nashville, TN, USA.
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50
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Abstract
Dystrophic epidermolysis bullosa (DEB) is relatively well understood. Potential therapies are in development. This article describes the pathogenesis and clinical features of DEB. It also describes therapeutic options and the future of molecular therapies.
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