1
|
Liu C, Han C, Liang J, Yang C, Wang Y, Chen P, Chen H, Lu H, Cai Y, Wang Q, Zhang X, Zeng K, Li C. Variants in the Gene Encoding Filaggrin Cause Autosomal-Dominant Symmetrical Acral Keratoderma. J Invest Dermatol 2023; 143:1313-1317.e8. [PMID: 36716921 DOI: 10.1016/j.jid.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/29/2023]
Affiliation(s)
- Chenmei Liu
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chunlei Han
- Department of Dermatology, the Sixth People's Hospital of Dongguan, Dongguan, China
| | - Jingyao Liang
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Chao Yang
- Department of Dermatology, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Youyi Wang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pingjiao Chen
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongyu Chen
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongyan Lu
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Cai
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Wang
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xibao Zhang
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Kang Zeng
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Changxing Li
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| |
Collapse
|
2
|
Xiao Q, Zhou R, Li Y, Zhao L, Xiong L, Tang J, Li L. Symmetrical Acrokeratoderma: A Case Report and Literature Review. Clin Cosmet Investig Dermatol 2022; 15:247-252. [PMID: 35210802 PMCID: PMC8860353 DOI: 10.2147/ccid.s350695] [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: 12/07/2021] [Accepted: 01/29/2022] [Indexed: 02/05/2023]
Abstract
The current study explores a case of symmetrical acrokeratoderma, and related literature is reviewed. A 27-year-old male presented with brownish-black plaques distributed symmetrically on the dorsum of the hands and feet for 3 years, and white maceration of the lesions was observed after immersion in water. The patient was diagnosed with symmetrical acrokeratoderma, and Hirudoid ointment was topically administered twice a day for a month. The symptoms were partially alleviated, and the patient is currently under follow-up observation.
Collapse
Affiliation(s)
- Qing Xiao
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Runke Zhou
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Yu Li
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Lingyun Zhao
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Lidan Xiong
- Cosmetics Safety and Efficacy Evaluation Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, Sichuan, People's Republic of China
| | - Jie Tang
- Cosmetics Safety and Efficacy Evaluation Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, Sichuan, People's Republic of China
| | - Li Li
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Cosmetics Safety and Efficacy Evaluation Center, West China Hospital of Sichuan University, Chengdu, People's Republic of China.,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, Sichuan, People's Republic of China
| |
Collapse
|
3
|
Nomura T, Takeda M, Teng Peh J, Orita A, Inamura E, Miyauchi T, Suzuki S, Moriuchi R, Shimizu H. Symmetrical acral keratoderma: A waxing and waning scaly pigmented skin lesions on the acral extremities. J Dermatol 2020; 48:e151-e152. [PMID: 33340370 DOI: 10.1111/1346-8138.15732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Toshifumi Nomura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masae Takeda
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Jin Teng Peh
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Orita
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Emi Inamura
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinari Miyauchi
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shotaro Suzuki
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | | | - Hiroshi Shimizu
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
4
|
Chen W, Song Z, Yang CC, Hao F. Symmetrical acral keratoderma revisited: proposal for a new term, 'pigmented carpotarsal hyperkeratosis'. J Eur Acad Dermatol Venereol 2018; 33:277-280. [PMID: 30284750 DOI: 10.1111/jdv.15266] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/27/2018] [Indexed: 01/27/2023]
Abstract
First reported from Taiwan mistakenly as acral acanthosis nigricans in 1991, pigmented carpotarsal hyperkeratosis or hyperkeratosis nigricans carpi et tarsi displays a peculiar distribution of velvety brown-grey hyperpigmented plaques symmetrically on the flexural side of the wrists and ankles and on the dorsal sides of the hands and feet. A marked epidermal hyperkeratosis with typically mild acanthosis and papillomatosis is observed in histology. Whitish maceration upon perspiration or water exposure, with exacerbation in summer but remission in winter, is common. The association with obesity, endocrine disorders, atopic dermatitis, ichthyosis or malignancy is unknown. Familial occurrence and hereditary patterns are ill-defined. There is preliminary evidence indicating a pathogenic role of missense mutation in the transcription factor 4 gene. Treatment is empirical, with good outcome with topical retinoids and keratolytic agents. Recurrence is common, and long-term prognosis is unclear. To be distinguished are acral acanthosis nigricans, palmoplantar keratoderma of the Nagashima type, palmoplantar keratoderma of the Bothnian type and aquagenic palmoplantar keratoderma. Most reported cases are from Southern China and are predominantly observed in men between the ages of 20 and 40 years. The currently used term 'symmetrical acral keratoderma' is non-specific and misleading and may lead to global unawareness, underreporting or misdiagnosis of this phenomenon. Further genetic and molecular studies are required to clarify its pathogenesis and relation to palmoplantar keratoderma.
Collapse
Affiliation(s)
- W Chen
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany
| | - Z Song
- Department of Dermatology and Venereology, Third Military Medical University, Chongqing, China
| | - C-C Yang
- Department of Dermatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan
| | - F Hao
- Department of Dermatology and Venereology, Third Military Medical University, Chongqing, China
| |
Collapse
|
5
|
Yang PP, Peng J, Wu YY, Liu Z, Sheng P, Zhou Y, Li SJ, Fan YM. Immunohistochemical evaluation of epidermal proliferation, differentiation and melanocytic density in symmetrical acrokeratoderma. Clin Exp Dermatol 2017; 42:509-515. [PMID: 28543665 DOI: 10.1111/ced.13118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Symmetrical acrokeratoderma (SAK) is characterized by brown to black hyperkeratotic patches on acral regions. Although epidermal hyperkeratosis and acanthosis are consistent pathological changes, the nature of epidermal hyperplasia is unknown. AIM To evaluate epidermal proliferation and differentiation and melanocytic density in skin lesions of SAK. METHODS Expression of keratin 10 (K10), K14, K16, involucrin, filaggrin, Ki-67, and Melan-A was detected by immunohistochemistry in eight patients with SAK, seven patients with ichthyosis vulgaris (IV) and six healthy controls (HCs). RESULTS Expression of K14, K16, involucrin and filaggrin was upregulated in patients with SAK compared with patients with IV and the HCs (P < 0.01-0.05), but K10 expression was similar for the three groups (P > 0.05). Numbers of Ki-67+ and Melan-A+ cells were higher in patients with SAK than in patients with IV and the HCs (P < 0.05). CONCLUSIONS These results demonstrate that excessive keratinocyte proliferation and abnormal differentiation contribute to epidermal hyperplasia, while melanocytic proliferation is responsible for the pigmented lesions in SAK.
Collapse
Affiliation(s)
- P-P Yang
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - J Peng
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Y-Y Wu
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Z Liu
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - P Sheng
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Y Zhou
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - S-J Li
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Y-M Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| |
Collapse
|
6
|
Vinay K, Sawatkar GU, Saikia UN, Dogra S. Symmetrical acrokeratoderma: a case series in Indian patients. Orphanet J Rare Dis 2016; 11:156. [PMID: 27876091 PMCID: PMC5120419 DOI: 10.1186/s13023-016-0541-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 11/24/2022] Open
Abstract
Abstract Symmetrical acrokeratoderma is a recently described dermatosis in young adult males of Chinese descent. In this report, we describe a series of five cases of symmetrical acrokeratoderma from India. All 5 patients had asymptomatic, brownish-black plaques distributed symmetrically over dorsum of hand and feet with variable involvement of wrist, flexural surface of forearm, elbow, ankles, shin and knee joint. Palms and soles were characteristically spared. Typically whitish maceration of the lesions was seen after immersing in water. The disease showed exacerbation in hot and humid climate with spontaneous resolution in winter. Histopathological examination showed basket weave hyperkeratosis, irregular acanthosis and mild peri-vascular lymphomononuclear infiltrate. Loosening of the stratum corneum was seen in post-immersion biopsy specimens. Acitretin appeared to provide symptomatic improvement in the short term without any long-term effect on the natural disease course. The genetic and environmental factors involved in disease causation needs to be elucidated in future. Trial registration The study was not registered in a trial registry since it was a retrospective analysis of the clinical records and not an interventional/observational study.
Collapse
Affiliation(s)
- Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Gitesh U Sawatkar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - Uma N Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
| |
Collapse
|
7
|
New described dermatological disorders. BIOMED RESEARCH INTERNATIONAL 2014; 2014:616973. [PMID: 25243162 PMCID: PMC4163364 DOI: 10.1155/2014/616973] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 07/02/2014] [Accepted: 08/07/2014] [Indexed: 11/18/2022]
Abstract
Many advances in dermatology have been made in recent years. In the present review article, newly described disorders from the last six years are presented in detail. We divided these reports into different sections, including syndromes, autoinflammatory diseases, tumors, and unclassified disease. Syndromes included are “circumferential skin creases Kunze type” and “unusual type of pachyonychia congenita or a new syndrome”; autoinflammatory diseases include “chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome,” “pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH) syndrome,” and “pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH) syndrome”; tumors include “acquired reactive digital fibroma,” “onychocytic matricoma and onychocytic carcinoma,” “infundibulocystic nail bed squamous cell carcinoma,” and “acral histiocytic nodules”; unclassified disorders include “saurian papulosis,” “symmetrical acrokeratoderma,” “confetti-like macular atrophy,” and “skin spicules,” “erythema papulosa semicircularis recidivans.”
Collapse
|
8
|
Li CX, Wen J, Zeng K, Tian X, Li XM, Zhang XB. Ultrastructural study of symmetrical acral keratoderma. Ultrastruct Pathol 2014; 38:420-4. [PMID: 24956169 DOI: 10.3109/01913123.2014.930080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Symmetrical acral keratoderma is characterized by symmetrical brown hyperkeratotic patches on the acral extremities. However, no studies about its electron microscopic examination have been documented. OBJECTIVE Our study was performed to further characterize the histopathology of symmetrical acral keratoderma. METHODS A biopsy was taken from brown hyperkeratotic patches on the wrists. Investigative studies included light and electron microscopy. RESULTS Light microscopy showed epidermal basket-weave hyperkeratosis and acanthosis. Ultrastructurally, the epidermis was thickened by acanthosis and compact stratum corneum. The horny cell layers were remarkably thicker in clinical affected skin than in adjacent clinically unaffected and healthy skin. The keratin filaments were remarkably clumped or aggregated and irregularly distributed in the horny, spinous, granular and basal cell layers. The tonofilaments formed tight clumps or aggregated at the perinuclear cytoplasm. CONCLUSION The main ultrastructural features of symmetrical acral keratoderma were epidermal hyperkeratosis and abnormalities of the keratin filaments and tonofilaments.
Collapse
Affiliation(s)
- Chang-Xing Li
- Department of Dermatology, Nanfang Hospital, South Medical University , Guangzhou, Guangdong Province , People's Republic of China
| | | | | | | | | | | |
Collapse
|
9
|
Li CX, Han CL, Zeng K, Zhang XB, Ma ZL. Clinical, demographic and histopathological features of symmetrical acral keratoderma. Br J Dermatol 2014; 170:948-51. [PMID: 24341804 DOI: 10.1111/bjd.12754] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C.-X. Li
- Department of Dermatology; Nanfang Hospital; South Medical University; Guangzhou China
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| | - C.-L. Han
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| | - K. Zeng
- Department of Dermatology; Nanfang Hospital; South Medical University; Guangzhou China
| | - X.-B. Zhang
- Department of Dermatology; Guangzhou Institute of Dermatology; Guangzhou China
| | - Z.-L. Ma
- Department of Dermatology; Dongguan Institute of Dermatology; Dongguan China
| |
Collapse
|
10
|
Symmetrical acrokeratoderma: A peculiar entity in China? Clinicopathologic and immunopathologic study of 34 new cases. J Am Acad Dermatol 2014; 70:533-8. [PMID: 24388424 DOI: 10.1016/j.jaad.2013.10.061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/21/2013] [Accepted: 10/29/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Symmetrical acrokeratoderma seems to be a new disorder in China, and 138 cases have been reported in the Chinese literature. OBJECTIVE We sought to summarize the clinicopathologic features and immunophenotyping of inflammatory cells in 34 new cases. METHODS Clinical data of 34 patients were prospectively collected over 4 years. Histopathology and immunostaining of infiltrated cells were performed in 27 and 9 patients, respectively. RESULTS Brown to black hyperkeratotic patches were symmetrically distributed over the acral regions in 33 cases and on the scalp in 1 case, with a whitish change after water contact or sweating. The condition was aggravated in summer and alleviated in winter in 33 patients. History of ichthyosis vulgaris was seen in 23 cases. The typical histopathology included epidermal hyperkeratosis, acanthosis, and papillary dermal perivascular infiltrate of lymphohistiocytes. Number of CD3(+), CD4(+), and CD8(+) cells increased in lesional and perilesional skin compared with normal-appearing skin. The skin lesions developed slowly but were confined to the acral predilection sites after the mean follow-up of 25.4 ± 13.8 months. LIMITATIONS The follow-up time was short. CONCLUSION This disorder may represent a peculiar dermatosis that is frequently associated with ichthyosis vulgaris. No specific therapy is available for the disorder.
Collapse
|