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Park JS, Saeidian AH, Youssefian L, Kondratuk KE, Pride HB, Vahidnezhad H, Uitto J. Inherited ichthyosis as a paradigm of rare skin disorders: Genomic medicine, pathogenesis, and management. J Am Acad Dermatol 2023; 89:1215-1226. [PMID: 35963288 DOI: 10.1016/j.jaad.2022.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/26/2022]
Abstract
Great advances have been made in the field of heritable skin disorders using next-generation sequencing (NGS) technologies (ie, whole-genome sequencing, whole-exome sequencing, whole-transcriptome sequencing, and disease-targeted multigene panels). When NGS first became available, the cost and lack of access to these technologies were limiting factors; however, with decreasing sequencing costs and the expanding knowledge base of genetic skin diseases, fundamental awareness of NGS has become prudent. The heritable ichthyoses comprise a genotypically and phenotypically heterogeneous group of monogenic keratinization disorders characterized by persistent scaling, with at least 55 distinct genes currently implicated in causing nonsyndromic and syndromic forms of the disease. By providing a simplified overview of available NGS techniques and applying them in the context of ichthyosis, one of the most common genodermatoses, we hope to encourage dermatologists to offer, when appropriate, genetic testing earlier in patients with unsolved presentations. With the aid of NGS, dermatologists can provide diagnostic certainty in cases of suspected genodermatoses and offer potentially life-changing genome-guided and targeted therapies as they become available.
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Affiliation(s)
- Jason S Park
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amir Hossein Saeidian
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Leila Youssefian
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Howard B Pride
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
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González-Quintana A, Garrido-Moraga R, Palencia-Pérez SI, Hernández-Martín Á, Sánchez-Munárriz J, Lezana-Rosales JM, Quesada-Espinosa JF, Martín MA, Arteche-López A. Integration of Phenotype Term Prioritization and Gene Expression Analysis Reveals a Novel Variant in the PERP Gene Associated with Autosomal Recessive Erythrokeratoderma. Genes (Basel) 2023; 14:1494. [PMID: 37510397 PMCID: PMC10379359 DOI: 10.3390/genes14071494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Hereditary palmoplantar keratodermas (PPKs) are a clinically and genetically heterogeneous group of disorders characterized by excessive epidermal thickening of palms and soles. Several genes have been associated with PPK including PERP, a gene encoding a crucial component of desmosomes that has been associated with dominant and recessive keratoderma. We report a patient with recessive erythrokeratoderma (EK) in which whole exome sequencing (WES) prioritized by human phenotype ontology (HPO) terms revealed the presence of the novel variant c.153C > A in the N-terminal region the PERP gene. This variant is predicted to have a nonsense effect, p.(Cys51Ter), resulting in a premature stop codon. We demonstrated a marked reduction in gene expression in cultured skin fibroblasts obtained from the patient. Despite the PERP gene is expressed at low levels in fibroblasts, our finding supports a loss-of-function (LoF) mechanism for the identified variant, as previously suggested in recessive EK. Our study underscores the importance of integrating HPO analysis when using WES for molecular genetic diagnosis in a clinical setting, as it facilitates continuous updates regarding gene-clinical feature associations.
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Affiliation(s)
- Adrián González-Quintana
- Servicio Bioquímica Clínica/Análisis Clínicos, Hospital 12 de Octubre, 28041 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
- Grupo de Enfermedades Mitocondriales y Neurometabólicas, Instituto de Investigación Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
| | - Rocío Garrido-Moraga
- Grupo de Enfermedades Mitocondriales y Neurometabólicas, Instituto de Investigación Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
| | - Sara I Palencia-Pérez
- Departamento de Dermatología, Hospital Universitario 12 de Octubre y Universidad Complutense de Madrid, 28041 Madrid, Spain
| | - Ángela Hernández-Martín
- Departamento de Dermatología, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain
| | - Jon Sánchez-Munárriz
- Servicio Bioquímica Clínica/Análisis Clínicos, Hospital 12 de Octubre, 28041 Madrid, Spain
| | - José M Lezana-Rosales
- Servicio de Genética, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- UDisGen (Unidad de Dismorfología y Genética), Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Juan F Quesada-Espinosa
- Servicio de Genética, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- UDisGen (Unidad de Dismorfología y Genética), Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Miguel A Martín
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
- Grupo de Enfermedades Mitocondriales y Neurometabólicas, Instituto de Investigación Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
- Servicio de Genética, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- UDisGen (Unidad de Dismorfología y Genética), Hospital 12 de Octubre, 28041 Madrid, Spain
| | - Ana Arteche-López
- Servicio de Genética, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- UDisGen (Unidad de Dismorfología y Genética), Hospital 12 de Octubre, 28041 Madrid, Spain
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Youssefian L, Naji M, Park JS, Rajabi F, Abdollahimajd F, Mahmoudi H, Kamyab-Hesari K, Ghalamkarpour F, Zabihi M, Teimoorian M, Youssefian L, Zeinali S, Vahidnezhad H, Uitto J. Ichthyosis follicularis syndromes in patients with germline mutations in GJB2. Clin Exp Dermatol 2022; 47:1561-1566. [PMID: 35396755 DOI: 10.1111/ced.15217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/29/2022]
Abstract
Ichthyosis follicularis (IF) manifests as generalized spiny follicular projections found in syndromic diseases secondary to SREBF1 and MBTPS2 mutations. We sought the genetic cause of IF in two distinct families from a cohort of 180 ichthyosis patients. In Family 1, the proband presented with IF, bilateral sensorineural hearing loss (SNHL) and punctate palmoplantar keratoderma, and compound heterozygous GJB2 mutations were discovered in DNA from peripheral blood lymphocytes: GJB2:c.526A>G and c.35delG. In Family 2, the proband presented with a previously unreported IF phenotype in the context of KID syndrome, and whole-exome sequencing found a de novo heterozygous GJB2:c.148G>A mutation. Histopathology was consistent with porokeratotic eccrine ostial and dermal duct nevus (PEODDN) and IF in Probands 1 and 2, respectively. Our findings add to the clinical and histopathological spectrum of IF and emphasize the association of PEODDN-like entities with GJB2 variants.
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Affiliation(s)
- Leila Youssefian
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mahtab Naji
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jason S Park
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Fatemeh Rajabi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Mahmoudi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Kamyab-Hesari
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Ghalamkarpour
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Zabihi
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mehrdad Teimoorian
- Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Laya Youssefian
- ENT and Head & Neck Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sirous Zeinali
- Kawsar Human Genetics Research Center, Tehran, Iran.,Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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