Dermatological features of inherited cancer syndromes in adults

Hereditary leiomyomatosis and renal cell cancer linked with FH mutations

The diagnosis of hereditary leiomyomatosis and renal cell cancer was revolutionized over 20 years ago by the establishment of links between fumarate hydratase mutations and the syndrome of cutaneous and uterine leiomyomata, with a risk of potentially fatal renal cell carcinoma. Dermatologists can help with the initial clinical diagnosis and a skin biopsy, as well as long-term clinical screening for leiomyosarcoma.

Successful treatment of mucosal neuromas by radiofrequency ablation in a patient with multiple endocrine neoplasia type 2B

This is the first report of mucosal neuromas being treated successfully with radiofrequency ablation in a patient with multiple endocrine neoplasia type 2B.

A clinicopathological study of the oral lesions of Cowden disease

BACKGROUND

Cowden disease is a multisystemic cancer predisposition disorder, inherited in an autosomal dominant pattern. Cutaneous and visceral lesions are either malignant tumours or are believed to represent hamartomatous growths. Mucocutaneous lesions are present on almost 100% of affected individuals. Nonetheless, some authors consider that the mucocutaneous manifestations of Cowden disease are, in reality, viral warts at distinct steps of evolution. There are only a few studies regarding the oral manifestations of Cowden disease.

OBJECTIVES

To study the oral manifestations of Cowden disease in nine patients clinically and histopathologically.

METHODS

The oral mucosal aspects of nine patients with clinical diagnosis of Cowden disease were photographed, and biopsies were taken from typical lesions.

RESULTS

All biopsied lesions depicted histopathological aspects suggestive of viral warts at distinct steps of development: incipient, well established and in regression.

CONCLUSION

Our findings seem to reinforce the poorly understood hypothesis that the mucocutaneous manifestations of Cowden disease are in reality viral warts. Additional studies are needed to explain why a syndrome caused by the mutation of a tumour suppression gene may cause propensity to warts.

Facial involvement in genodermatoses

Facial involvement represents a characteristic feature of a wide range of genodermatoses. Specific facial findings often help point to the correct diagnosis, which improves counseling and management. In particular, this can facilitate the identification and treatment of associated extracutaneous disease. The highly visible nature of facial lesions in genodermatoses and facial birthmarks can result in stigmatization and frequently leads to particular concern in patients and their family members. It is therefore critical for dermatologists to be aware of the broad spectrum of facial manifestations in genetic skin disease, especially when these findings have important implications with regard to monitoring and treatment. In this contribution, facial involvement in genodermatoses is divided into five morphologic categories based on the most prominent feature: Papules, scaling, photosensitivity/findings associated with aging (eg, telangiectasias, atrophy, lentigines), blisters/erosions, and birthmarks. Hopefully, this will provide a practical and clinically useful approach to a large and diverse assortment of genetic skin conditions.