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Liu J, Guo K, Zhang R, Wang R, Ma D, Zhang X. Compound heterozygous ABCA12 variants identified in a Chinese patient with congenital ichthyosiform erythroderma: Advancing genotype-phenotype correlations and literature review. Mol Genet Genomic Med 2024; 12:e2431. [PMID: 38702946 PMCID: PMC11069050 DOI: 10.1002/mgg3.2431] [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: 06/14/2023] [Revised: 02/25/2024] [Accepted: 03/20/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Ichthyosis is a common keratotic skin disease with high clinical, etiological and genetic heterogeneity. There are four types of non-syndromic hereditary ichthyoses, among which autosomal recessive congenital ichthyosis (ARCI) is a heterogeneous group of recessive Mendelian disorders. ARCI present with different phenotypes and ABCA12 pathogenic variants have been shown to cause complex ARCI phenotypes, including harlequin ichthyosis (HI), lamellar ichthyosis (LI) and congenital ichthyosiform erythroderma (CIE). METHODS A sporadic male patient, clinically diagnosed with CIE, was enrolled in this study. Exome sequencing was combined with Sanger sequencing to confirm the diagnosis and identify the pathogenic variants. In silico predictions were made using multiple software programs, and the identified variants were interpreted using the ACMG guidelines. A review of all literature reported ABCA12 variants was performed to explore genotype-phenotype correlations. RESULTS Compound heterozygous ABCA12 variants [c.5381+1G>A and c.5485G>C (p.Asp1829His)] (NM_173076) were identified. The two variants were not detected in the public database. c.5381+1G>A is predicted to affect ABCA12 mRNA splicing and Asp1829 is highly conserved among various species. In silico analysis suggested that these two variants were responsible for the phenotype of the patient. Genotype-phenotype correlation analysis showed that biallelic truncation variants and/or exon/amino acid deletions in ABCA12 are the most common causes of HI. Biallelic missense variants are most common in LI and CIE. CONCLUSIONS The compound heterozygous ABCA12 variants caused the CIE phenotype observed in the patient. The spectrum of ABCA12 pathogenic variants were broaden. Genotype-phenotype correlation analysis provided detailed evidence which can be used in future prenatal diagnosis and can inform the need for genetic counselling for patients with ABCA12-related ARCIs.
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Affiliation(s)
- Jia‐Wei Liu
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesBeijingChina
| | - Kexin Guo
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
- Department of Prenatal DiagnosisWomen's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare HospitalNanjingChina
| | - Rui Zhang
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
| | - Rongrong Wang
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
| | - Dong‐Lai Ma
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic DiseasesBeijingChina
| | - Xue Zhang
- McKusick‐Zhang Center for Genetic Medicine, State Key Laboratory for Complex Severe and Rare DiseasesInstitute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeBeijingChina
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Spingler T, Wiechers C, Hoopmann M, Kagan KO. Prenatal diagnosis of a fetal harlequin ichthyosis. Arch Gynecol Obstet 2024; 309:1651-1653. [PMID: 37491629 PMCID: PMC10894122 DOI: 10.1007/s00404-023-07164-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Tobias Spingler
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany
| | - Cornelia Wiechers
- Department of Neonatology, University of Tuebingen, Tübingen, Germany
| | - Markus Hoopmann
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany
| | - Karl Oliver Kagan
- Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tübingen, Germany.
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Hanania HL, Hopkins CR, Herd TJ. Skin Hardening and Eczema in a 9-month-old Girl. Pediatr Rev 2024; 45:239-243. [PMID: 38556512 DOI: 10.1542/pir.2022-005701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
| | | | - Tiffany J Herd
- Department of Dermatology, Texas Children's Hospital, Houston, TX
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4
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Bahashwan E, Alfaifi J, Mohamed Moursi SE, Soliman YE. Retinoid Therapy in a Case of Harlequin Ichthyosis with a Short Literature Review. Case Rep Dermatol Med 2024; 2024:8729318. [PMID: 38250222 PMCID: PMC10798836 DOI: 10.1155/2024/8729318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Harlequin ichthyosis (HI) is a genetically inherited epidermal disorder due to the mutation of the ABCA12 gene, which is responsible for lipid transportation, and presents with large keratinised scales characterised by deep erythematous fissures, with ectropion and eclabium. A moderate number of cases and a high mortality rate have been recorded. In this case report, a pregnant lady gave birth to a 33-week-old premature foetus with characteristic symptoms of HI. After admitting him to the NICU, a multidisciplinary treatment approach was conducted with paediatric dermatologists, ophthalmologists, urologists, and dieticians. The prognosis is positive, with desquamation of the hyperkeratotic plate revealing an erythematous and shiny skin. A short literature review on HI characteristics, diagnostic aids, and management has also been added.
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Affiliation(s)
- Emad Bahashwan
- Division of Dermatology, Department of Internal Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia
| | - Jaber Alfaifi
- Department of Child Health, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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5
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Merz E, Pashaj S. Prenatal diagnosis of ichthyosis congenita gravis (Harlequin ichthyosis [HI]) using 3D sonography. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:576-579. [PMID: 38048780 DOI: 10.1055/a-2180-6906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Affiliation(s)
- E Merz
- Centre for Ultrasound and Prenatal Medicine, Frankfurt/Main - Germany
| | - S Pashaj
- Centre for Ultrasound and Prenatal Medicine, Frankfurt/Main - Germany
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6
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Lainingwala AC, Gajula S, Fatima U, Afroze S, Posani S, Moondra M, Mangukiya NP, Parmar MP, Venugopal V. A Unique Case of Harlequin Ichthyosis in the Tertiary Health Care System in a Rural Area. Cureus 2023; 15:e43342. [PMID: 37700957 PMCID: PMC10495033 DOI: 10.7759/cureus.43342] [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: 07/25/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Harlequin ichthyosis (HI) is a severe and rare genetic anomaly that affects skin development and leads to the formation of thick, diamond-shaped plates of keratinized skin. The adenosine triphosphate binding cassette A 12 (ABCA12) gene, which is essential for the transportation of lipids required for the skin's barrier function, has mutations that result in this condition. The affected individuals exhibit distinct clinical features, including thickened skin, deep cracks, and fissures, which can result in significant physical and functional impairments. HI is usually apparent at birth, with affected infants presenting with tight and rigid skin that restricts movement and normal growth. The condition is associated with various complications, including difficulty breathing, feeding difficulties, and increased susceptibility to infections. Due to the impaired skin barrier, affected individuals are also prone to dehydration and temperature dysregulation. In this case report, we present a unique case of ichthyosis in a nine-month-old child. Despite advances in medical care, HI remains a challenging condition with a high mortality rate, particularly in the neonatal period. However, with early detection, appropriate interventions, and an improved understanding of the underlying molecular mechanisms, there is hope for enhanced management and improved quality of life for individuals living with HI.
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Affiliation(s)
- Aashka C Lainingwala
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Sahini Gajula
- Internal Medicine, Gandhi Medical College and Hospital, Secunderabad, IND
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Umaima Fatima
- Internal Medicine, Shadan Institute of Medical Sciences, Teaching Hospital and Research Centre, Hyderabad, IND
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Sabah Afroze
- Internal Medicine, Shadan Institute of Medical Sciences, Teaching Hospital and Research Centre, Hyderabad, IND
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Sarojini Posani
- Internal Medicine, Sri Devaraj Urs Medical College, Kolar, IND
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Mudit Moondra
- Internal Medicine, Rabindranath Tagore Medical College, Udaipur, IND
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Nisarg P Mangukiya
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Mihirkumar P Parmar
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
| | - Vishal Venugopal
- Internal Medicine, Bhaarath Medical College & Hospital, Chennai, IND
- Internal Medicine, Gujarat Medical Education & Research Society Medical College, Vadnagar, Mehsana, IND
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Hotz A, Kopp J, Bourrat E, Oji V, Süßmuth K, Komlosi K, Bouadjar B, Tantcheva-Poór I, Hellström Pigg M, Betz RC, Giehl K, Schedel F, Weibel L, Schulz S, Stölzl DV, Tadini G, Demiral E, Berggard K, Zimmer AD, Alter S, Fischer J. Mutational Spectrum of the ABCA12 Gene and Genotype–Phenotype Correlation in a Cohort of 64 Patients with Autosomal Recessive Congenital Ichthyosis. Genes (Basel) 2023; 14:genes14030717. [PMID: 36980989 PMCID: PMC10048568 DOI: 10.3390/genes14030717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Autosomal recessive congenital ichthyosis (ARCI) is a non-syndromic congenital disorder of cornification characterized by abnormal scaling of the skin. The three major phenotypes are lamellar ichthyosis, congenital ichthyosiform erythroderma, and harlequin ichthyosis. ARCI is caused by biallelic mutations in ABCA12, ALOX12B, ALOXE3, CERS3, CYP4F22, NIPAL4, PNPLA1, SDR9C7, SULT2B1, and TGM1. The most severe form of ARCI, harlequin ichthyosis, is caused by mutations in ABCA12. Mutations in this gene can also lead to congenital ichthyosiform erythroderma or lamellar ichthyosis. We present a large cohort of 64 patients affected with ARCI carrying biallelic mutations in ABCA12. Our study comprises 34 novel mutations in ABCA12, expanding the mutational spectrum of ABCA12-associated ARCI up to 217 mutations. Within these we found the possible mutational hotspots c.4541G>A, p.(Arg1514His) and c.4139A>G, p.(Asn1380Ser). A correlation of the phenotype with the effect of the genetic mutation on protein function is demonstrated. Loss-of-function mutations on both alleles generally result in harlequin ichthyosis, whereas biallelic missense mutations mainly lead to CIE or LI.
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Affiliation(s)
- Alrun Hotz
- Institute of Human Genetics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Center for Cornification Disorders, Freiburg Center for Rare Diseases, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- European Reference Networks (ERN Skin), 75015 Paris, France
| | - Julia Kopp
- Institute of Human Genetics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Emmanuelle Bourrat
- Department of Dermatology, Reference Center for Rare Skin Diseases MAGEC, Saint Louis Hospital AP-HP, 75015 Paris, France
| | - Vinzenz Oji
- European Reference Networks (ERN Skin), 75015 Paris, France
- Department of Dermatology and Venereology, Muenster University Medical Center, 48149 Muenster, Germany
| | - Kira Süßmuth
- Department of Dermatology and Venereology, Muenster University Medical Center, 48149 Muenster, Germany
| | - Katalin Komlosi
- Institute of Human Genetics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Center for Cornification Disorders, Freiburg Center for Rare Diseases, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- European Reference Networks (ERN Skin), 75015 Paris, France
| | - Bakar Bouadjar
- Department of Dermatology, CHU of Bab-El-Oued Algiers, Algiers 16008, Algeria
| | - Iliana Tantcheva-Poór
- Department of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany
| | | | - Regina C. Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty & University Hospital Bonn, 53127 Bonn, Germany
| | - Kathrin Giehl
- European Reference Networks (ERN Skin), 75015 Paris, France
- Department of Dermatology, Venerology und Allergology, University Hospital of Munich, 80337 Munich, Germany
| | - Fiona Schedel
- Department of Dermatology and Venereology, Muenster University Medical Center, 48149 Muenster, Germany
| | - Lisa Weibel
- Pediatric Skin Center, Dermatology Department, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Solveig Schulz
- Synlab Medical Practice for Human Genetics Jena, 07747 Jena, Germany
| | - Dora V. Stölzl
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Gianluca Tadini
- European Reference Networks (ERN Skin), 75015 Paris, France
- Pediatric Dermatology Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Emine Demiral
- Department of Medical Genetics, Inonu University School of Medicine, 44280 Malatya, Turkey
| | - Karin Berggard
- Department of Dermatology and Venereology, Skåne University Hospital, 221 85 Lund, Sweden
| | - Andreas D. Zimmer
- Institute of Human Genetics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Svenja Alter
- Institute of Human Genetics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Center for Cornification Disorders, Freiburg Center for Rare Diseases, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- European Reference Networks (ERN Skin), 75015 Paris, France
| | - Judith Fischer
- Institute of Human Genetics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
- Center for Cornification Disorders, Freiburg Center for Rare Diseases, Medical Center, University of Freiburg, 79106 Freiburg, Germany
- European Reference Networks (ERN Skin), 75015 Paris, France
- Correspondence: ; Tel.: +49-(0)761-270-70510; Fax: +49-(0)761-270-70410
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Tran VK, Diep QM, Zilong Q, Phuong LT, Tran HA, Van Tung N, Lien NTK, Xuan NT, Ha LT, Van Ta T, Tran TH, Hoang NH. Case Report: Novel rare mutation c.6353C > G in the ABCA12 gene causing harlequin ichthyosis identified by whole exome sequencing. Front Pediatr 2023; 11:1128716. [PMID: 36873642 PMCID: PMC9977293 DOI: 10.3389/fped.2023.1128716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Harlequin ichthyosis (HI) is a severe rare genetic disease that mainly affects the skin. Neonates with this disease are born with thick skin and large diamond-shaped plates covering most of their bodies. Affected neonates lose the ability to control dehydration and regulate temperature and are more susceptible to infections. They also face respiratory failure and feeding problems. These clinical symptoms are factors associated with high mortality rates of neonates with HI. Until now, there are still no effective treatments for HI patients and most patients die in the newborn period. Mutation in the ABCA12 gene, which encodes an adenosine triphosphate-binding cassette (ABC) transporter, has been demonstrated as the major cause of HI. CASE PRESENTATION In this study, we report the case who is one infant that was born prematurely at 32 gestational weeks with the whole body covered with thick plate-like scales of skin. The infant was severely infected with mild edema, multiple cracked skins full of the body, yellow discharge, and necrosis of fingers and toes. The infant was suspected to be affected by HI. Whole exome sequencing (WES) was performed as a tool for detecting the novel mutation in one prematurely born Vietnam infant with HI phenotype. And after that, the mutation was confirmed by the Sanger sequencing method in the patient and the members of his family. In this case, one novel mutation c.6353C > G (p.S2118X, Hom) in the ABCA12 gene, was detected in the patient. The mutation has not been reported in any HI patients previously. This mutation was also found in a heterozygous state in the members of the patient's family, including his parents, an older brother, and an older sister who are no symptoms. CONCLUSIONS In this study, we identified a novel mutation in a Vietnamese patient with HI by whole exome sequencing. The results for the patient and the members of his family will be helpful in understanding the etiology of the disease, diagnosing carriers, assisting in genetic counseling, and emphasizing the need for DNA-based prenatal screening for families with a history of the disease.
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Affiliation(s)
- Van Khanh Tran
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Quang Minh Diep
- Assisted Reproductive Technology Center, Quang Ninh Hospital for Obstetric and Pediatric, Quang ninh, Vietnam
| | - Qiu Zilong
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | - Le Thi Phuong
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Hai Anh Tran
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Van Tung
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.,Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Nguyen Thi Kim Lien
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Nguyen Thi Xuan
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Le Thi Ha
- Neonatal Care Center, Vietnam National Hospital of Pediatrics, Hanoi, Vietnam
| | - Thanh Van Ta
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Thinh Huy Tran
- Department of Molecular Pathology Faculty of Medical Technology and Center for Gene and Protein Research, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Huy Hoang
- Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.,Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
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Nikbina M, Sayahi M. Harlequin ichthyosis newborn: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221139610. [PMCID: PMC9742929 DOI: 10.1177/2050313x221139610] [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: 08/16/2022] [Accepted: 10/31/2022] [Indexed: 12/13/2022] Open
Abstract
Harlequin ichthyosis is a rare and severe genetic skin disorder that occurs
within the developing foetus. Harlequin ichthyosis is the most severe and
devastating form of autosomal recessive congenital ichthyoses. It is caused by
mutations in the lipid transporter adenosine triphosphate binding cassette A 12.
Here, we reported a case of harlequin ichthyosis with no family history. No
abnormalities were detected in prenatal sonography. A 24-year-old pregnant woman
with premature rupture of membrane and labour pain was referred to a hospital in
Shoushtar city, Iran. The mother delivered a male baby with harlequin
ichthyosis. The infant baby died on the 5th day. Harlequin ichthyosis is
associated with adenosine triphosphate binding cassette A 12 gene mutation;
therefore, genetic screening and counselling for susceptible parents should be
taken into account. Prenatal diagnosis of harlequin ichthyosis principally via
sonographic techniques is important in managing the disorder.
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Affiliation(s)
- Maryam Nikbina
- Maryam Nikbina, Department of Midwifery,
Shoushtar Faculty of Medical Sciences, Shahid Sherafat Blvd, Shoushtar,
84534-64516, Iran.
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Serra G, Memo L, Cavicchioli P, Cutrone M, Giuffrè M, La Torre ML, Schierz IAM, Corsello G. Novel mutations of the ABCA12, KRT1 and ST14 genes in three unrelated newborns showing congenital ichthyosis. Ital J Pediatr 2022; 48:145. [PMID: 35964051 PMCID: PMC9375412 DOI: 10.1186/s13052-022-01336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Congenital ichthyosis (CI) is a heterogeneous group of genetic disorders characterized by generalized dry skin, scaling and hyperkeratosis, often associated to erythroderma. They are rare diseases, with overall incidence of 6.7 in 100,000. Clinical manifestations are due to mutations in genes mostly involved in skin barrier formation. Based on clinical presentation, CI is distinguished in non-syndromic and syndromic forms. To date, mutations of more than 50 genes have been associated to different types of CI. Cases presentation We report on three Italian unrelated newborns showing clinical signs compatible with different forms of CI of variable severity, namely Harlequin ichtyosis (HI), epidermolytic ichtyosis (EI) and autosomal recessive ichtyosis with hypotrichosis (ARIH). Target next generation sequencing (NGS) analysis identified three novel mutations of the ABCA12, KRT1 and ST14 genes, respectively associated to such congenital ichtyoses, not reported in literature. Genomic investigation allowed to provide the more appropriate management to each patient, based on an individualized approach. Conclusions Our report highlights the wide genetic heterogeneity and phenotypic variability of CI. It expands the current knowledge on such diseases, widening their genomic database, and providing a better clinical characterization. Furthermore, it underlines the clinical relevance of NGS, which is essential to address the management of patients. Indeed, it may guide towards the most adequate approach, preventing clinical obstinacy for subjects with more severe forms and unfavorable outcomes (together with the support, in such situations, of bioethicists included within the multidisciplinary care team), as well as reassuring families in those with milder course and favorable evolution.
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Affiliation(s)
- Gregorio Serra
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy.
| | - Luigi Memo
- Clinical Genetics Outpatient Service, Serenissima Unit of Health and Social Services 3, Venice, Italy
| | - Paola Cavicchioli
- Pediatrics and Neonatal Intensive Care Unit, Angel Hospital, Mestre, Venice, Italy
| | - Mario Cutrone
- Pediatric Dermatology Outpatient Service, Angel Hospital, Mestre, Venice, Italy
| | - Mario Giuffrè
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Maria Laura La Torre
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Ingrid Anne Mandy Schierz
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G. D'Alessandro", University of Palermo, Palermo, Italy
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11
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Tsivilika M, Kavvadas D, Karachrysafi S, Sioga A, Papamitsou T. Management of Harlequin Ichthyosis: A Brief Review of the Recent Literature. CHILDREN (BASEL, SWITZERLAND) 2022; 9:893. [PMID: 35740830 PMCID: PMC9221756 DOI: 10.3390/children9060893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/05/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
Harlequin ichthyosis (HI) is a life-threatening genetic disorder that largely affects the skin of infants. HI is the most severe form of the autosomal recessive disorder known as ichthyosis. It is caused by mutations in the A12 cassette (lipid-transporter adenosine triphosphate-binding cassette A12). Neonates affected by this disease are born with specific morphological characteristics, the most prominent of which is the appearance of platelet keratotic scales separated by erythematous fissures. The facial features include eclabium, ectropion, a distinct flattened nose, and dysplastic ears. A common finding among those with HI is impaired skin barrier function. The purpose of the present narrative review is to assess the most recent literature regarding the management of HI. Emphasis is given to surgical management and consultation, to the indications for timing and surgical intervention, to the risks that are presented with surgery, and to the details of the surgical procedure itself. Management of HI requires a multidisciplinary team of experts, and specific guidelines are needed in order for the risks to be minimized and viability to be increased.
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12
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Harlequin Ichthyosis (HI) Associated with Atrial Septal Defect (ASD) and Choanal Atresia. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2021. [DOI: 10.2478/sjdv-2020-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Harlequin ichthyosis (HI) is a severe form of congenital ichthyosis with autosomal recessive inheritance. Incidence of harlequin ichthyosis is 1 in 3,00,000 live births. We report a case of HI associated with bilateral choanal atresia and atrial septal defects, which is a rare association in this skin disorder. A-month-old preterm male baby born out of consanguineous marriage presented with features of armour-like scales and erythema all over body, ectropion, eclabium and fissures over flexures. The patient was born with a colloidion membrane at birth. The baby was operated for bilateral choanal atresia soon after birth because he developed cyanosis upon breast feeding which improved on crying. Upon flexible nasal endoscopy, diagnosis of membranous type of choanal atresia was confirmed by ENT (ear, nose, throat) surgeon. Heart auscultation revealed a murmur in our patient. Electrocardiogram and 2D Echocardiography was reported as atrial septal defect (4.5 mm OsASD). The patient was started on acitretin (1 mg/kg/day) and emollients after complete evaluation and is currently on regular follow up. Harlequin ichthyosis is linked to mutation of ABCA12 gene. It is often associated with eclabium, ectropion, hypoplastic nose, ears and fingers. Congenital heart diseases are rarely reported with HI in literature. This makes it mandatory to screen HI patients for internal defects.
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13
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Liu J, Zhang X, Wang W, Lan X, Dong M, Yan K, Lei Y, Chen P, Yang M, Shan Q, Jin C. Case Report: Prenatal Diagnosis of a Fetus With Harlequin Ichthyosis Identifies Novel Compound Heterozygous Variants: A Case Report. Front Genet 2021; 11:608196. [PMID: 33510771 PMCID: PMC7835937 DOI: 10.3389/fgene.2020.608196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 12/14/2020] [Indexed: 11/27/2022] Open
Abstract
Background Harlequin ichthyosis (HI) is the most severe form of the keratinizing disorders, and it is characterized by whole-body hard stratum corneum. ABCA12 has been identified as the major disease-causing gene of HI. Methods A case of HI was prenatally diagnosed by ultrasonography and genetic tests. The fetus had been found with dentofacial deformity and profound thickening of the palm and plantar soft tissues. Chromosomal microarray analysis (CMA) and whole exome sequencing (WES) were then performed on the amniotic fluid to identify germline pathogenic variants for the fetus. Candidate variants were verified by Sanger sequencing. Results Compound heterozygous frameshift variants (p.Q719QfsX21; p.F2286LfsX6) of ABCA12 were identified for the fetus, suggesting the former variants were maternally inherited and the latter paternally inherited. The fetus was terminated. Conclusion A prenatal molecular diagnosis is an important approach for the prevention of HI. In the study, we provided a successful case of genetic counseling for a family with an HI baby.
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Affiliation(s)
- Jiao Liu
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
| | - Xingyu Zhang
- Shanghai Children's Medical Center, Institute of Pediatric Translational Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weilan Wang
- Department of Dermatology, Shaoxing Central Hospital, Shaoxing, China
| | - Xiaofang Lan
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
| | - Minyue Dong
- Department of Reproductive Genetics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kai Yan
- Department of Reproductive Genetics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yongliang Lei
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
| | - Penglong Chen
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
| | - Mufeng Yang
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
| | - Qunda Shan
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
| | - Chunlei Jin
- Center of Medical Prenatal Diagnosis, Lishui Maternity and Child Health Care Hospital, Lishui, China
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Zhou XJ, Lin YJ, Chen XW, Zheng JH, Zhou YJ. Prenatal diagnosis of harlequin ichthyosis by ultrasonography: a case report. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:183. [PMID: 33569485 PMCID: PMC7867921 DOI: 10.21037/atm-20-8223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Autosomal recessive congenital ichthyosis is a genetically and phenotypically heterogeneous group of skin disorders, including harlequin ichthyosis (HI), lamellar ichthyosis, and bullous congenital ichthyosiform erythroderma. HI is the most phenotypically severe autosomal recessive congenital ichthyosis associated with the mutation of the adenosine triphosphate—binding cassette subfamily A member 12 (ABCA12) gene. The clinical manifestations include generalized hyperkeratotic plaques and deep fissures, ectropion, eclabium, and contractures. However, the severe HI may easily be misdiagnosed as epidermolysis bullosa or syndromic ichthyosis. Meanwhile, no consensus exists about the best used in clinical trials or clinical practice when more elaborate scoring systems have been proposed to evaluate skin xerosis, palmoplantar keratoderma, and disease extension an accurate prenatal diagnosis is necessary. Until the ABCA12 gene was identified as the pathogenic gene, prenatal diagnosis of HI had been performed by the invasive techniques of fetal skin biopsy. Now, advances in ultrasound technology and fetal DNA-based analysis have replaced it. The mortality rate is markedly high and prompt; prenatal diagnosis of neonate HI is critical for appropriate perinatal and postnatal management. It is also essential to prepare parents for future pregnancies and reduce the family’s physical and mental distress and financial burden. This report presents a rare case of harlequin ichthyosis diagnosed by the ultrasound and discusses the significance of prenatal ultrasound diagnosis and molecular diagnosis in the prenatal diagnosis of HI.
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Affiliation(s)
- Xiao-Jing Zhou
- Seven Section of Department of Gynaecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yu-Jie Lin
- Department of Ultrasound, the Julu County Hospital, Xingtai, China
| | - Xi-Wei Chen
- Seven Section of Department of Gynaecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia-Hua Zheng
- Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ying-Jie Zhou
- Seven Section of Department of Gynaecology, the Second Hospital of Hebei Medical University, Shijiazhuang, China
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15
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Prenatal Diagnosis of Harlequin Ichthyosis: A Case Report. MATERNAL-FETAL MEDICINE 2020. [DOI: 10.1097/fm9.0000000000000064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Lee K. A novel pig model capturing clinical symptoms of harlequin ichthyosis. J Mol Cell Biol 2020; 11:1027-1028. [PMID: 31065689 PMCID: PMC6934147 DOI: 10.1093/jmcb/mjz034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/02/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- Kiho Lee
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA 24061, USA
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17
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Prenatal diagnosis of harlequin ichthyosis: a case report. Obstet Gynecol Sci 2020; 63:94-97. [PMID: 31970133 PMCID: PMC6962590 DOI: 10.5468/ogs.2020.63.1.94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 07/04/2019] [Accepted: 07/15/2019] [Indexed: 11/08/2022] Open
Abstract
Harlequin ichthyosis (HI) is a rare and severe form of ichthyosis and is characterized by thickened, hard, armor-like plates of skin that cover the entire body. This disease is caused by mutations in the adenosine triphosphate-binding cassette transporter protein A12 gene, and the pattern of inheritance is autosomal recessive. Prenatal sonographic diagnosis of HI has not been frequently reported. Here, we report a case of HI detected at 28 weeks of gestation and discuss with the sonographic findings and a brief review of literature. The diagnosis was reached mainly based on 2-dimensional and 3-dimensional ultrasound findings. Three-dimensional ultrasound applications help recognize facial morphology, and thus, greatly contributes to prenatal diagnoses.
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Kale KA, Ghonge NP, Kaul A. Prenatal diagnosis of congenital harlequin ichthyosis with fetal MRI. Indian J Radiol Imaging 2019; 29:448-451. [PMID: 31949351 PMCID: PMC6958889 DOI: 10.4103/ijri.ijri_105_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/17/2019] [Accepted: 10/23/2019] [Indexed: 01/16/2023] Open
Abstract
Most of the fetal deformities are caused due to genetic abnormalities. Although magnetic resonance imaging (MRI) may be used to accurately diagnose these deformities, it has been reported that gene analysis is a more accurate diagnostic method. Harlequin ichthyosis (HI) or Ichthyosis fetalis (IF) is a rare and extremely severe hereditary skin disorder with autosomal recessive inheritance. The ultrasound features have been described well and the diagnosis can be made with a fair degree of confidence. However, the final diagnosis needs to be established by prenatal invasive tests. In the present study, we describe the diagnosis of HI in the third trimester on fetal MRI referred to our department with suspicion of anterior encephalocele which was later confirmed through postnatal genetic evaluation.
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Affiliation(s)
- Kiran A Kale
- Department of Radiology, Indraprasth Apollo Hospital, Sarita Vihar, New Delhi, India
| | - Nitin P Ghonge
- Department of Radiology, Indraprasth Apollo Hospital, Sarita Vihar, New Delhi, India
| | - Anita Kaul
- Department of Fetal Medicine, Indraprasth Apollo Hospital, Sarita Vihar, New Delhi, India
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Moraes ELLD, Freire MHDS, Rocha F, Secco IL, Costa T, Afonso RQ. Nursing care for a newborn with Lamellar Ichthyosis: a case study in a neonatal unit. Rev Esc Enferm USP 2019; 53:e03519. [PMID: 31800813 DOI: 10.1590/s1980-220x2018031603519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/17/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To present the nursing care of a newborn with Lamellar Ichthyosis admitted to the neonatal intensive care unit of a public children's hospital in a municipality in the state of Paraná, Brazil. METHOD A qualitative intralocal study implementing the Case Study methodology, in which a real case was explored in a delimited system with data collection from multiple sources of information during 66 days of hospitalization in 2016. RESULTS The nursing care present in the protocol was based on: maintaining skin integrity through hydration and continuous lubrication with emollients, temperature control, nutrition and prevention of secondary infections. CONCLUSION Through the case study, it is affirmed that implementation of the Nursing Process, especially the care plan, was essential for the multidisciplinary success of the treatment. There was improvement in the skin and mucous membranes, as well as prevention of infections, culminating in favorable survival conditions and the autonomy of parents for home care.
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Affiliation(s)
| | | | - Franciele Rocha
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem Mestrado Profissional, Curitiba, PR, Brasil
| | | | - Taine Costa
- Hospital Infantil Waldemar Monastier, Campo Largo, PR, Brasil
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20
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Palmer MA, Blakeborough L, Harries M, Haslam IS. Cholesterol homeostasis: Links to hair follicle biology and hair disorders. Exp Dermatol 2019; 29:299-311. [PMID: 31260136 DOI: 10.1111/exd.13993] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/24/2019] [Accepted: 06/19/2019] [Indexed: 01/10/2023]
Abstract
Lipids and lipid metabolism are critical factors in hair follicle (HF) biology, and cholesterol has long been suspected of influencing hair growth. Altered cholesterol homeostasis is involved in the pathogenesis of primary cicatricial alopecia, mutations in a cholesterol transporter are associated with congenital hypertrichosis, and dyslipidaemia has been linked to androgenic alopecia. The underlying molecular mechanisms by which cholesterol influences pathways involved in proliferation and differentiation within HF cell populations remain largely unknown. As such, expanding our knowledge of the role for cholesterol in regulating these processes is likely to provide new leads in the development of treatments for disorders of hair growth and cycling. This review describes the current state of knowledge with respect to cholesterol homeostasis in the HF along with known and putative links to hair pathologies.
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Affiliation(s)
- Megan A Palmer
- School of Applied Sciences, Department of Biological and Geographical Sciences, University of Huddersfield, Huddersfield, UK
| | - Liam Blakeborough
- School of Applied Sciences, Department of Biological and Geographical Sciences, University of Huddersfield, Huddersfield, UK
| | - Matthew Harries
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Iain S Haslam
- School of Applied Sciences, Department of Biological and Geographical Sciences, University of Huddersfield, Huddersfield, UK
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21
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Devnani J, Kumari U, Zil-E-Rubab. Harlequin fetus born from Consanguinity: A deleterious case report. Pak J Med Sci 2019; 35:1472-1474. [PMID: 31489029 PMCID: PMC6717440 DOI: 10.12669/pjms.35.5.916] [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] [Indexed: 11/15/2022] Open
Abstract
Harlequin Ichthyosis (HI) is a dreadful skin disorder with steady rise of cases with prolonged survival. Harlequin fetus follows an autosomal recessive pattern with the incidence of 1in 300,000 live births. In the succeeding case report, a male child was born with keratinized and kaleidoscopic diamond pattern of skin suggestive of HI. He was born at 36th week of gestation from consanguineous marriage. The newborn remained under extensive intensive care in a tertiary care unit where he breathed his last on 11th day after birth. Prenatal diagnosis and genetic counseling is of vital importance due to the association of ABCA12 mutation with HI.
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Affiliation(s)
- Joti Devnani
- Joti Devnani, Ziauddin Medical College, Ziauddin University, Karachi, Pakistan
| | - Ujalla Kumari
- Ujalla Kumari, Ziauddin Medical College, Ziauddin University, Karachi, Pakistan
| | - Zil-E-Rubab
- Zil-e-Rubab, MBBS, M-Phil, PhD, Ziauddin Medical College, Ziauddin University, Karachi, Pakistan
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22
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Mazereeuw-Hautier J, Hernández-Martín A, O'Toole EA, Bygum A, Amaro C, Aldwin M, Audouze A, Bodemer C, Bourrat E, Diociaiuti A, Dolenc-Voljč M, Dreyfus I, El Hachem M, Fischer J, Ganemo A, Gouveia C, Gruber R, Hadj-Rabia S, Hohl D, Jonca N, Ezzedine K, Maier D, Malhotra R, Rodriguez M, Ott H, Paige DG, Pietrzak A, Poot F, Schmuth M, Sitek JC, Steijlen P, Wehr G, Moreen M, Vahlquist A, Traupe H, Oji V. Management of congenital ichthyoses: European guidelines of care, part two. Br J Dermatol 2018; 180:484-495. [PMID: 29897631 DOI: 10.1111/bjd.16882] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 01/03/2023]
Abstract
These guidelines for the management of congenital ichthyoses have been developed by a multidisciplinary group of European experts following a systematic review of the current literature, an expert conference held in Toulouse in 2016, and a consensus on the discussions. These guidelines summarize evidence and expert-based recommendations and intend to help clinicians with the management of these rare and often complex diseases. These guidelines comprise two sections. This is part two, covering the management of complications and the particularities of some forms of congenital ichthyosis.
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Affiliation(s)
- J Mazereeuw-Hautier
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Toulouse, France
| | | | - E A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts, and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - A Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - C Amaro
- Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - M Aldwin
- Ichthyosis Support Group, PO Box 1242, Yateley, GU47 7FL, U.K
| | - A Audouze
- Association Ichtyose France, Bellerive sur Allier, France
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Saint-Louis, Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - E Bourrat
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Saint-Louis, Paris, France
| | - A Diociaiuti
- Dermatology Division, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - M Dolenc-Voljč
- Department of Dermatovenereology, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - I Dreyfus
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Toulouse, France
| | - M El Hachem
- Dermatology Division, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - J Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Ganemo
- Department of Dermatology, Institute of Clinical Research in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - C Gouveia
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R Gruber
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Saint-Louis, Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - D Hohl
- Department of Dermatology, Hôpital de Beaumont, Lausanne, Switzerland
| | - N Jonca
- Epithelial Differentiation and Rheumatoid Autoimmunity Unit (UDEAR), UMR 1056 Inserm - Toulouse 3 University, Purpan Hospital, Toulouse, France
| | - K Ezzedine
- Depatment of Dermatology, Hôpital Henri Mondor, EA EpiDerm, UPEC-Université Paris-Est Créteil, 94010, Créteil, France
| | - D Maier
- Dermatology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex, U.K
| | - M Rodriguez
- Department of Ear, Nose and Throat, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - H Ott
- Division of Pediatric Dermatology and Allergology, Auf Der Bult Children's Hospital, Hanover, Germany
| | - D G Paige
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, U.K
| | - A Pietrzak
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - F Poot
- ULB-Erasme Hospital, Department of Dermatology, Brussels, Belgium
| | - M Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - J C Sitek
- Department of Dermatology and Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - P Steijlen
- Department of Dermatology, Maastricht University Medical Centre, GROW Research School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - G Wehr
- Selbsthilfe Ichthyose, Kürten, Germany
| | - M Moreen
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology KU Leuven, Leuven, Belgium
| | - A Vahlquist
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Von-Esmarch-Straße 58, D-48149, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Von-Esmarch-Straße 58, D-48149, Münster, Germany.,Hautarztpraxis am Buddenturm, Rudolf-von-Langen-Straße 55, D-48147, Münster, Germany
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23
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Liang Q, Xiong F, Liang X, Zheng D, Su S, Wen Y, Wang X. Two successive cases of fetal harlequin ichthyosis: A case report. Exp Ther Med 2018; 17:449-452. [PMID: 30651820 DOI: 10.3892/etm.2018.6917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 12/23/2016] [Indexed: 11/05/2022] Open
Abstract
Harlequin ichthyosis (HI) is a genetic skin disorder characterized by thickening and splitting of the skin. In fetuses presenting with the disorder, the mortality rate is markedly high. A number of fetal HI cases have been documented. The present study reports a case of a pregnant woman who underwent two successive pregnancies at the ages of 35 and 36, respectively, with both fetuses presenting with HI. The first fetus was delivered alive though succumbed shortly after birth, while the second fetus was stillborn and birthed by induced labor. The fetuses exhibited typical features of fetal HI, including thick, platelike scaling and fissuring, which act as a nidus for infection. The present study is the first to report two cases of fetal HI from successive pregnancies in the same woman. Improved understanding of the genetic basis of HI indicates that genetic screening for candidate gene mutations related to HI, particularly mutations in the adenosine triphosphate binding-cassette transporter ABCA12, may prove beneficial in prenatal diagnosis. Establishing methods for early diagnosis of fetal HI may reduce the physical and mental distress to parents and relatives.
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Affiliation(s)
- Qianhong Liang
- Ultrasound Department, He Xian Memorial Hospital, Panyu, Guangzhou, Guangdong 511400, P.R. China
| | - Fu Xiong
- Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Xuankun Liang
- Ultrasound Department, He Xian Memorial Hospital, Panyu, Guangzhou, Guangdong 511400, P.R. China
| | - Dongming Zheng
- Ultrasound Department, He Xian Memorial Hospital, Panyu, Guangzhou, Guangdong 511400, P.R. China
| | - Shuguang Su
- Ultrasound Department, He Xian Memorial Hospital, Panyu, Guangzhou, Guangdong 511400, P.R. China
| | - Yunjie Wen
- Guangzhou Huayin Medical Laboratory Center, Co., Ltd., Guangzhou, Guangdong 510663, P.R. China
| | - Xiaodan Wang
- Guangzhou Huayin Medical Laboratory Center, Co., Ltd., Guangzhou, Guangdong 510663, P.R. China
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24
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Prenatal diagnose of a fetus with Harlequin ichthyosis in a Chinese family. Taiwan J Obstet Gynecol 2018; 57:452-455. [PMID: 29880184 DOI: 10.1016/j.tjog.2018.04.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Harlequin ichthyosis (HI) was the most severe form of ichthyoses, which leaded to neonatal death in 50% of cases. It was the result of mutations in ABCA12 gene. With the development of ultrasound skills and genetic analysis, HI could be prenatal diagnosed. CASE REPORT Here, we reported a case of HI, which was prenatal diagnosed by ultrasound examination and genetic analysis. The fetus was found that severe ectropion, eclabium, flattened nose, and rudimentary ears by ultrasound at 20 weeks gestation. A molecular genetic analysis was performed and revealed two mutations in the ABCA12 gene. One of two mutations were not reported in the past. The fetus was terminated. CONCLUSION HI was associated with the poor prognosis of HI neonates. Prenatal ultrasound and genetic analysis were important for prenatal diagnosis of HI and were helpful to give sufficient prenatal counsels for the family with HI baby.
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25
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Lau M, Anemüller W, Tröger B, Fischer J, Busche A. Kongenitale ichthyosiforme Erythrodermie. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-016-0140-9] [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]
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26
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Washio K, Sumi M, Nakata K, Fukunaga A, Yamana K, Koda T, Morioka I, Nishigori C, Yamanishi K. Case of harlequin ichthyosis with a favorable outcome: Early treatment and novel, differentially expressed, alternatively spliced transcripts of the ATP-binding cassette subfamily A member 12 gene. J Dermatol 2017; 44:950-953. [DOI: 10.1111/1346-8138.13823] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/01/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Ken Washio
- Division of Dermatology; Nishi-Kobe Medical Center; Kobe Japan
- Division of Dermatology; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Mayuko Sumi
- Division of Dermatology; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Kaori Nakata
- Division of Dermatology; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Atsushi Fukunaga
- Division of Dermatology; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Keiji Yamana
- Division of Pediatrics; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Tsubasa Koda
- Division of Pediatrics; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Ichiro Morioka
- Division of Pediatrics; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
| | - Chikako Nishigori
- Division of Dermatology; Department of Internal Related; Kobe University Graduate School of Medicine; Kobe Japan
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Glick JB, Craiglow BG, Choate KA, Kato H, Fleming RE, Siegfried E, Glick SA. Improved Management of Harlequin Ichthyosis With Advances in Neonatal Intensive Care. Pediatrics 2017; 139:peds.2016-1003. [PMID: 27999114 DOI: 10.1542/peds.2016-1003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2016] [Indexed: 11/24/2022] Open
Abstract
Harlequin ichthyosis (HI) is the most severe phenotype of the autosomal recessive congenital ichthyoses. HI is caused by mutations in the lipid transporter adenosine triphosphate binding cassette A 12 (ABCA12). Neonates are born with a distinct clinical appearance, encased in a dense, platelike keratotic scale separated by deep erythematous fissures. Facial features are distorted by severe ectropion, eclabium, flattened nose, and rudimentary ears. Skin barrier function is markedly impaired, which can lead to hypernatremic dehydration, impaired thermoregulation, increased metabolic demands, and increased risk of respiratory dysfunction and infection. Historically, infants with HI did not survive beyond the neonatal period; however, recent advances in neonatal intensive care and coordinated multidisciplinary management have greatly improved survival. In this review, the authors combine the growing HI literature with their collective experiences to provide a comprehensive review of the management of neonates with HI.
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Affiliation(s)
- Jaimie B Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York
| | | | - Keith A Choate
- Departments of Dermatology.,Genetics, and.,Pathology, Yale University School of Medicine, New Haven, Connecticut; and
| | | | | | - Elaine Siegfried
- Departments of Pediatrics and.,Dermatology, Saint Louis University School of Medicine, St Louis, Missouri
| | - Sharon A Glick
- Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York;
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Abstract
Limb constriction or encasement in patients with harlequin ichthyosis can cause tissue injury resulting in necrosis and auto-amputation. Surgical release of constrictive plaques has been previously demonstrated, but the perioperative and intraoperative considerations surrounding this infrequent intervention have not been discussed in detail. This report documents a case of harlequin ichthyosis requiring surgical treatment, focusing on the importance of early surgical consultation, risks of surgery, indications for and timing of surgical intervention, and the details of the operation.
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Affiliation(s)
- Mitchell A Pet
- Plastic and Reconstructive Surgery, Seattle Children's Hospital, Seattle, Washington.
| | - Deepti Gupta
- Dermatology, Seattle Children's Hospital, Seattle, Washington
| | - Raymond W Tse
- Plastic and Reconstructive Surgery, Seattle Children's Hospital, Seattle, Washington
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Xie H, Xie Y, Peng R, Li L, Zhu Y, Guo J. Harlequin ichthyosis: a novel compound mutation of ABCA12 with prenatal diagnosis. Clin Exp Dermatol 2016; 41:636-9. [PMID: 27381714 DOI: 10.1111/ced.12861] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/26/2022]
Abstract
Harlequin ichthyosis (HI) is the most severe form of recessive congenital ichthyosis, and is frequently lethal. We describe a family with prenatal diagnosis of HI in two siblings. We applied genomic capture and massively parallel sequencing to detect all mutations in 20 genes, including ABCA12, with inherited mutations that predispose to congenital ichthyosis. Sequence analysis of the ABCA12 gene identified two mutations, c.5232 G>A (p.Trp1744*) in exon 34 and c.6443 C>A (p.Pro2148Gln) in exon 44, each in a heterozygous state. Sanger sequencing confirmed that each parent was a heterozygous carrier for one of the variants. The spectrum of mutations identified in this study and previous studies reveals a novel compound mutation of ABCA12.
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Affiliation(s)
- H Xie
- Department of Ultrasonic Medicine, Fetal Medical Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Y Xie
- Department of Prenatal Diagnosis, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - R Peng
- Department of Ultrasonic Medicine, Fetal Medical Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - L Li
- Department of Ultrasonic Medicine, Fetal Medical Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Y Zhu
- Department of Ultrasonic Medicine, Fetal Medical Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - J Guo
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
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Kün-Darbois JD, Molin A, Jeanne-Pasquier C, Paré A, Bénateau H, Veyssière A. Facial features in Harlequin ichthyosis: Clinical findings about 4 cases. ACTA ACUST UNITED AC 2015; 117:51-3. [PMID: 26740202 DOI: 10.1016/j.revsto.2015.11.007] [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: 08/28/2015] [Revised: 10/12/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
We report 4 cases of Harlequin ichthyosis, which is a rare and severe congenital ichthyosis involving the face. Facial appearance consists in severe ectropion, conjonctival edema, eclabium, flattened ears, broadened nose and large, thick, plate-like skin scales. Recent advances in neonatal care have been made, such as retinoid therapy, and have led to an increased survival rate. Early surgical correction of ectropion may be required because of ocular complications.
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Affiliation(s)
- J-D Kün-Darbois
- Service de chirurgie maxillo-faciale, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex, France.
| | - A Molin
- Service d'anatomopathologie, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex, France
| | - C Jeanne-Pasquier
- Service d'anatomopathologie, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex, France
| | - A Paré
- Service de chirurgie maxillo-faciale, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex, France
| | - H Bénateau
- Service de chirurgie maxillo-faciale, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex, France
| | - A Veyssière
- Service de chirurgie maxillo-faciale, hôpital Côte de Nacre, CHU de Caen, 14033 Caen cedex, France
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Rathore S, David LS, Beck MM, Bindra MS, Arunachal G. Harlequin Ichthyosis: Prenatal Diagnosis of a Rare Yet Severe Genetic Dermatosis. J Clin Diagn Res 2015; 9:QD04-6. [PMID: 26675324 DOI: 10.7860/jcdr/2015/15250.6705] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/31/2015] [Indexed: 11/24/2022]
Abstract
Harlequin Ichthyosis (HI) is an extremely rare genetic skin disorder. It is the most severe type of ichthyosis. It is characterized by thickened, dry, rough and armor like plates of skin with deep cracks in between. Alternative names for HI include- keratosis diffusafetalis, ichthyosis congenital, icthyosis fetalis, harlequin fetus and icthyosis congenital gravior. It is an autosomal recessive disorder with the majority of affected individuals being homozygous for mutation in the ABCA 12 gene. This condition presents with a wide range of severity and symptoms. Affected neonates usually do not survive beyond first few days of life. We are presenting prenatal diagnosis of a case of this rare condition.
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Affiliation(s)
- Swati Rathore
- Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Liji Sarah David
- Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Manisha Madhai Beck
- Associate Professor, Department of Obstetrics and Gynaecology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Mandeep Singh Bindra
- Assistant Professor, Department of General Pathology, Christian Medical College , Vellore, Tamil Nadu, India
| | - Gautham Arunachal
- Assistant Professor, Department of Medical Genetics, Christian Medical College , Vellore, Tamil Nadu, India
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De Leonibus C, Lembo C, Santantonio A, Fioretti T, Rojo S, Salvatore F, De Vivo M, Esposito G, Giliberti P. Photoletter to the editor: Lamellar ichthyosis and arthrogryposis in a premature neonate. J Dermatol Case Rep 2015; 9:49-51. [PMID: 26236414 DOI: 10.3315/jdcr.2015.1202] [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: 02/04/2015] [Accepted: 03/09/2015] [Indexed: 11/11/2022]
Abstract
Lamellar ichthyosis is a rare congenital disorder characterized by collodion membrane at birth and facial anomalies (eclabium and ectropion). The major underlying genetic defect is in TGM1, with mutations of this gene found in 50% of patients. An early diagnosis is fundamental in view of establishing a specific treatment due to the severity of the disease. We report a case of severe lamellar ichthyosis and arthrogryposis, without the typical facial presentation, negative for TGM1 mutations. The clinical improvement was achieved only after treatment with oral retinoids, highlighting the importance of early diagnosis and prompt administration of a specific therapy.
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Affiliation(s)
| | - Claudio Lembo
- Dermatology Department, University Federico II, Naples, Italy
| | | | - Tiziana Fioretti
- Department of Molecular Medicine and Medical Biotechnologies, University Federico II, Naples, Italy
| | - Silvana Rojo
- Neonatal Intensive Care Unit, V. Monaldi Hospital, Naples, Italy
| | | | | | - Gabriella Esposito
- Department of Molecular Medicine and Medical Biotechnologies, University Federico II, Naples, Italy; ; CEINGE-Biotecnologie Avanzate s.c. a r.l., Naples, Italy
| | - Paolo Giliberti
- Neonatal Intensive Care Unit, V. Monaldi Hospital, Naples, Italy
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Interdisziplinäre Versorgung von Neugeborenen mit Epidermolysis bullosa und schweren kongenitalen Ichthyosen. Hautarzt 2015; 66:236-44. [DOI: 10.1007/s00105-015-3610-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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