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Kinariwalla N, Coromilas AJ, Garzon MC, Levin LE, Magro C, Lauren CT. Acquired epidermodysplasia verruciformis (AEV) in three children after cardiac transplantation: A case series and review of the literature. Pediatr Dermatol 2021; 38:1541-1545. [PMID: 34669978 DOI: 10.1111/pde.14701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Acquired epidermodysplasia verruciformis (AEV) describes epidermodysplasia verruciformis developing in an immunocompromised host. There is limited information in the literature regarding AEV in the pediatric population; of the patients reported, most patients described had HIV, with only two reported cases of children who developed AEV post-transplantation. This case series describes three pediatric patients who developed AEV on immunosuppressant therapy following cardiac transplantation. We review risk factors, treatment options, and prognosis of AEV in the pediatric population.
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Affiliation(s)
- Neha Kinariwalla
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Alexandra J Coromilas
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Maria C Garzon
- Department of Dermatology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Laura E Levin
- Department of Dermatology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Cynthia Magro
- Department of Pathology, Weill Cornell Medical College, New York, NY, USA
| | - Christine T Lauren
- Department of Dermatology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Esenboga S, Cagdas D, Alkanat NE, Güler Tezel G, Ersoy Evans S, Boztug K, Tezcan I. TMC8 mutation in a Turkish family with epidermodysplasia verruciformis including laryngeal papilloma and recurrent skin carcinoma. J Cosmet Dermatol 2021; 21:2263-2267. [PMID: 34416085 DOI: 10.1111/jocd.14393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 08/01/2021] [Accepted: 08/10/2021] [Indexed: 12/01/2022]
Abstract
The vast majority of primary immunodeficiencies (PIDs) occur due to the defects in cells originating from hematopoietic stem cells, while in some PIDs, there are defects in various genes responsible for non-leucocyte immune response such as seen in epidermodysplasia verruciformis (EV). EV caused by the mutations in TMC6, TMC8, and CIB1 genes is called "typical." "Atypical" EV may develop in patients with primary immunodeficiencies originating from hematopoietic stem cells, which include severe T-cell failure, caused by inactivating biallelic mutations of STK4, RHOH, CORO1A, ITK, TPP2, DCLRE1C, LCK, RASGRP1, or DOCK8 genes. Here, we present a family with TMC8 gene mutation leading to disseminated epidermodysplasia verruciformis including laryngeal papilloma and recurrent cutaneous squamous cell carcinomas. Typical EV with impaired local, keratinocyte-intrinsic immune response should be considered when routine immunological examinations are normal in patients presenting with clinical signs of EV. Although it is not possible to prevent EV lesions, early and appropriate surveillance for malignancy is mandatory.
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Affiliation(s)
- Saliha Esenboga
- Pediatric Immunology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Deniz Cagdas
- Pediatric Immunology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nazli Eylem Alkanat
- Department of Pathology Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gaye Güler Tezel
- Department of Pathology Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sibel Ersoy Evans
- Department of Dermatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kaan Boztug
- Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Ilhan Tezcan
- Pediatric Immunology Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Bushara O, Miller D, Giubellino A, Schomaker M, Thyagarajan B, Nelson AC. Diagnosis of epidermodysplasia verruciformis: Two cases highlighting the role of direct HPV L1 gene sequencing. J Cutan Pathol 2019; 46:436-441. [PMID: 30773702 DOI: 10.1111/cup.13444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 01/21/2023]
Abstract
Epidermodysplasia verruciformis (EV) is a rare skin disease characterized by the development of multiple flat warts with the potential for malignant transformation. Patients are susceptible to human papillomavirus (HPV) infection that develops in a background of either a genetic or acquired immunodeficiency predisposing patients to infection with specific HPV types that are ubiquitous but generally non-pathogenic in healthy individuals. There is no standard clinical methodology for determining the causative HPV from patients with suspected EV. Here, we report the diagnostic workup of two EV cases and describe the use of L1 gene Sanger sequencing as a specific method to accurately identify the causative HPV genotype and confirm the diagnosis of EV.
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Affiliation(s)
- Omar Bushara
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Daniel Miller
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Matthew Schomaker
- Molecular Diagnostics Laboratory, MHealth University of Minnesota Medical Center-Fairview, Minneapolis, Minnesota
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Andrew C Nelson
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota.,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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de Jong SJ, Imahorn E, Itin P, Uitto J, Orth G, Jouanguy E, Casanova JL, Burger B. Epidermodysplasia Verruciformis: Inborn Errors of Immunity to Human Beta-Papillomaviruses. Front Microbiol 2018; 9:1222. [PMID: 29946305 PMCID: PMC6005841 DOI: 10.3389/fmicb.2018.01222] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/22/2018] [Indexed: 12/24/2022] Open
Abstract
Epidermodysplasia verruciformis (EV) is an autosomal recessive skin disorder with a phenotype conditional on human beta-papillomavirus (beta-HPV) infection. Such infections are common and asymptomatic in the general population, but in individuals with EV, they lead to the development of plane wart-like and red or brownish papules or pityriasis versicolor-like skin lesions, from childhood onwards. Most patients develop non-melanoma skin cancer (NMSC), mostly on areas of UV-exposed skin, from the twenties or thirties onwards. At least half of the cases of typical EV are caused by biallelic loss-of-function mutations of TMC6/EVER1 or TMC8/EVER2. The cellular and molecular basis of disease in TMC/EVER-deficient patients is unknown, but a defect of keratinocyte-intrinsic immunity to beta-HPV is suspected. Indeed, these patients are not susceptible to other infectious diseases and have apparently normal leukocyte development. In contrast, patients with an atypical form of EV due to inborn errors of T-cell immunity invariably develop clinical symptoms of EV in the context of other infectious diseases. The features of the typical and atypical forms of EV thus suggest that the control of beta-HPV infections requires both EVER1/EVER2-dependent keratinocyte-intrinsic immunity and T cell-dependent adaptive immunity.
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Affiliation(s)
- Sarah J de Jong
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York NY, United States
| | - Elias Imahorn
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Peter Itin
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland.,Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia PA, United States
| | | | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York NY, United States.,INSERM UMR 1163, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Hospital for Sick Children, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York NY, United States.,INSERM UMR 1163, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Hospital for Sick Children, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France.,Pediatric Hematology and Immunology Unit, Necker Hospital for Sick Children, Paris, France.,Howard Hughes Medical Institute, New York NY, United States
| | - Bettina Burger
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
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Ho JD, Kam SA, Al-Haseni A, Markova A, Sahni D, Lam C, Goldberg LJ, Bhawan J. Benign and malignant hybrid adnexal tumors in a patient with epidermodysplasia verruciformis. J Cutan Pathol 2017; 44:969-973. [PMID: 28796338 DOI: 10.1111/cup.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/11/2017] [Accepted: 08/06/2017] [Indexed: 01/19/2023]
Abstract
Epidermodysplasia verruciformis (EV) is a genodermatosis characterized by overgrowth of flat warts, pityriasis versicolor-like lesions and an increased propensity for developing cutaneous squamous cell carcinomas due to abnormal susceptibility to infection with beta-human papilloma viruses. Adnexal tumors are not typically associated with EV. Here we report a spectrum of hybrid adnexal tumors with divergent eccrine and folliculosebaceous differentiation, and cytologic features ranging from benign to frankly atypical, in a patient with inherited EV.
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Affiliation(s)
- Jonathan D Ho
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.,Department of Pathology & Laboratory Medicine, Boston University, Boston, Massachusetts
| | - Sarah A Kam
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Ali Al-Haseni
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Alina Markova
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Debjani Sahni
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Christina Lam
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Lynne J Goldberg
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.,Department of Pathology & Laboratory Medicine, Boston University, Boston, Massachusetts
| | - Jag Bhawan
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.,Department of Pathology & Laboratory Medicine, Boston University, Boston, Massachusetts
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Yoshida R, Kato T, Kawase M, Honda M, Mitsuishi T. Two sisters reveal autosomal recessive inheritance of epidermodysplasia verruciformis: a case report. BMC DERMATOLOGY 2014; 14:12. [PMID: 25048734 PMCID: PMC4110534 DOI: 10.1186/1471-5945-14-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/16/2014] [Indexed: 11/16/2022]
Abstract
Background Epidermodysplasia verruciformis is a rare genodermatosis characterized by a unique susceptibility to cutaneous human papillomaviruses infection. Most patients show autosomal recessive patterns of inheritance. Case presentation We report a case of two sisters with clinically epidermodysplasia verruciformis specific lesions on the face, neck, trunk, and extremities. PCR analysis indicated the presence of human papillomavirus type 5 in the lesions. Electron microscopic examination showed viral-like particles in keratinocyte nuclei and the stratum corneum of the epidermodysplasia verruciformis lesions. In addition, we examined the EVER1 and EVER2 genes using eight different primer pairs without finding any nonsense or frameshift mutations in the gDNA from lymphocytes of the elder sister. Conclusions In this report, the patient’s parents did not have epidermodysplasia verruciformis lesions or a consanguineous marriage. EV did not develop in the elder sister until five years of age, so the parents did not perceive EV as an inherited disease. The probability that EV developed in both sisters was only 6.25%. Thus, it is rare for both sisters to develop epidermodysplasia verruciformis lesions considering that the parents were presumed to be carriers and the disease reveal an autosomal recessive pattern of inheritance.
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Affiliation(s)
| | | | | | | | - Tsuyoshi Mitsuishi
- Department of Dermatology, Tokyo Women's Medical University Yachiyo Medical Center, 477-96, Ohwada-Shinden, Yachiyo 276-8524, Chiba, Japan.
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Droitcourt C, Ramarozatovo L, Favre M, Moerhle M, Vergier B, Amici JM, Taïeb A, Jouary T. Recurrent HPV5 associated squamous cell carcinoma in a plaque of psoriasis. J Eur Acad Dermatol Venereol 2010; 25:120-2. [PMID: 20477916 DOI: 10.1111/j.1468-3083.2010.03713.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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