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Zaouak A, Chamli A, Mansour NB, Jouini W, Fenniche S, Hammami H. Nail Involvement in Autosomal Recessive Congenital Ichthyosis. Clin Dermatol 2022; 40:388-394. [PMID: 35181410 DOI: 10.1016/j.clindermatol.2022.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Autosomal recessive congenital ichthyosis (ARCI) is a clinically and genetically heterogeneous category of non-syndromic ichthyosis (2). Nail changes in ARCI are generally frequent but have been rarely reported and studied in the literature. This stimulated us to conduct a study to describe nail changes in ARCI using a combined literature review and prospective examination from March 2019 to August 2019 (6 months) in the Dermatology Department of Habib Thameur Hospital, Tunis, Tunisia. A total of twenty-five patients with ARCI had a clinical and dermatoscopic review. Mean age was 19.8 years old [range 1-43], with a female predominance- 17 women (68%) and 8 men (32%). Seventy-two percent had nail unit changes involving more than one nail, none with single nail disease, involvement of fingernails (64%) and toenails (68%) cases including periungual hyperkeratosis (64%), xanthonychia (40%), pachyonychia (40%), macrolunula (36%), digital clubbing (32%) and onychomycosis (24%). Rarer findings included pseudoainhum, transverse leukonychia, longitudinal melanonychia, and subungual hemorrhages each in one patient (4%). There was a statistically significant increased frequency of nail changes in adults over children (p = 0.001). Nail abnormalities statistically associated with ARCI were macrolunula, periungual hyperkeratosis, xanthonychia, and pachyonychia. A comprehensive review of the literature was performed, creating the first comprehensive review addressing nail disease in ARCI.
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Key Words
- Clubbing, enlarged nails that are hypercurved transversally and longitudinally, resembling a watch glass
- Eclabium, eversion of the lips
- Ectropion, eversion of the eyelids
- Glossary (1): Ainhum, constricting bands surrounding the fifth toe
- Leukonychia, white discoloration of the nail
- Macrolunula, enlargement of the lunula, the white moon-shaped area at the base of the nail
- Melanonychia, the black-brown band that crosses the nail plate longitudinally, from underneath the cuticle to the free edge
- Onychogryphosis, nail plate thickening, yellow and laterally deviated, and impossible to trim
- Onychomycosis, thickening and heaping up of the nail due to fungal infection
- Pachyonychia, nail thickening with loss of the normal nail transparency
- Pitting, the nail plate surface having multiple punctuate depressions
- Pseudoainhum, constricting bands surrounding the digits or extremities
- Subungual hemorrhages, one or more red-brown striae in the distal part of the nail
- Xanthonychia, yellow discoloration of the nail plate
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Affiliation(s)
- Anissa Zaouak
- Department of Dermatology, Research Unit "Genodermatosis and Cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia.
| | - Amal Chamli
- Department of Dermatology, Research Unit "Genodermatosis and Cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Nadia Ben Mansour
- Cardiovascular Epidemiology and Prevention Research Laboratory, Tunis, Tunisia
| | - Wafa Jouini
- Department of Dermatology, Research Unit "Genodermatosis and Cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Samy Fenniche
- Department of Dermatology, Research Unit "Genodermatosis and Cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Houda Hammami
- Department of Dermatology, Research Unit "Genodermatosis and Cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
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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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9
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Ran Zhu T, Bass J, Schmidt S. Surgical management of digital ischemia caused by constriction band formation in a patient with ichthyosis vulgaris. J Surg Case Rep 2018; 2017:rjx183. [PMID: 29423165 PMCID: PMC5798143 DOI: 10.1093/jscr/rjx183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 08/20/2017] [Accepted: 08/28/2017] [Indexed: 11/28/2022] Open
Abstract
Ichthyosis is a broad and loosely defined group of hereditary and acquired disorders characterized by filaggrin dysfunction and impaired epidermal homeostasis that results in dry, scaly and thickened skin. Individuals with truncation mutations in the profilaggrin gene coding for filaggrin are strongly predisposed to severe forms of ichthyosis. The phenotypical expression of ichthyosis caused by the same genotypical mutation can vary considerably in severity and in regards to how much constricting scar tissue develops. Here, we report a case of digital ichthyosis threatening the neurovascular integrity to the small finger to discuss the importance of early diagnosis and role of Z-plasty flaps in the surgical treatment of constriction band formation.
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Affiliation(s)
- Tian Ran Zhu
- Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Jonathan Bass
- Department of Plastic and Reconstructive Surgery, Brown University, 2 Dudley Street, Providence, RI 02905, USA
| | - Scott Schmidt
- Department of Plastic and Reconstructive Surgery, Brown University, Providence, 235 Plain Street, Suite 203, RI 02905, USA
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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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