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Anker P, Kiss N, Kocsis I, Czemmel É, Becker K, Zakariás S, Plázár D, Farkas K, Mayer B, Nagy N, Széll M, Ács N, Szalai Z, Medvecz M. Report of a Novel ALOX12B Mutation in Self-Improving Collodion Ichthyosis with an Overview of the Genetic Background of the Collodion Baby Phenotype. Life (Basel) 2021; 11:life11070624. [PMID: 34199106 PMCID: PMC8304297 DOI: 10.3390/life11070624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022] Open
Abstract
Collodion baby is a congenital, transient phenotype encountered in approximately 70–90% of autosomal recessive congenital ichthyosis and is an important entity of neonatal erythroderma. The clinical outcome after this severe condition is variable. Genetic mutations of components of the epidermal lipoxygenase pathway have been implicated in the majority of self-improving collodion ichthyosis (SICI). In SICI, the shedding of the collodion membrane reveals clear skin or only mild residual manifestation of ichthyosis. Here we report the case of a girl born with a severe form of collodion baby phenotype, whose skin almost completely cleared within the first month of life. At the age of 3 years, only mild symptoms of a keratinization disorder remained. However, the severity of erythema and scaling showed mild fluctuations over time. To objectively evaluate the skin changes of the patient, we assessed the ichthyosis severity index. Upon sequencing of the ALOX12B gene, we identified a previously unreported heterozygous nonsense mutation, c.1607G>A (p.Trp536Ter) with the recurrent, heterozygous mutation c.1562A>G (p.Tyr521Cys). Thereby, our findings expand the genotypic spectrum of SICI. In addition, we summarize the spectrum of further genetic diseases that can present at birth as collodion baby, in particular the SICI.
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Affiliation(s)
- Pálma Anker
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - István Kocsis
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (I.K.); (É.C.); (N.Á.)
| | - Éva Czemmel
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (I.K.); (É.C.); (N.Á.)
| | - Krisztina Becker
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - Sára Zakariás
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - Dóra Plázár
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - Balázs Mayer
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
| | - Nikoletta Nagy
- MTA-SZTE Dermatological Research Group, 6720 Szeged, Hungary; (N.N.); (M.S.)
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary
| | - Márta Széll
- MTA-SZTE Dermatological Research Group, 6720 Szeged, Hungary; (N.N.); (M.S.)
- Department of Medical Genetics, University of Szeged, 6720 Szeged, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (I.K.); (É.C.); (N.Á.)
| | - Zsuzsanna Szalai
- Department of Dermatology, Heim Pál National Children’s Institute, 1089 Budapest, Hungary;
| | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (P.A.); (N.K.); (K.B.); (S.Z.); (D.P.); (K.F.); (B.M.)
- Correspondence:
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Renz P, Imahorn E, Spoerri I, Aushev M, March OP, Wariwoda H, Von Arb S, Volz A, Itin PH, Reichelt J, Burger B. Arginine- but not alanine-rich carboxy-termini trigger nuclear translocation of mutant keratin 10 in ichthyosis with confetti. J Cell Mol Med 2019; 23:8442-8452. [PMID: 31638346 PMCID: PMC6850952 DOI: 10.1111/jcmm.14727] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 11/30/2022] Open
Abstract
Ichthyosis with confetti (IWC) is a genodermatosis associated with dominant-negative variants in keratin 10 (KRT10) or keratin 1 (KRT1). These frameshift variants result in extended aberrant proteins, localized to the nucleus rather than the cytoplasm. This mislocalization is thought to occur as a result of the altered carboxy (C)-terminus, from poly-glycine to either a poly-arginine or -alanine tail. Previous studies on the type of C-terminus and subcellular localization of the respective mutant protein are divergent. In order to fully elucidate the pathomechanism of IWC, a greater understanding is critical. This study aimed to establish the consequences for localization and intermediate filament formation of altered keratin 10 (K10) C-termini. To achieve this, plasmids expressing distinct KRT10 variants were generated. Sequences encoded all possible reading frames of the K10 C-terminus as well as a nonsense variant. A keratinocyte line was transfected with these plasmids. Additionally, gene editing was utilized to introduce frameshift variants in exon 6 and exon 7 at the endogenous KRT10 locus. Cellular localization of aberrant K10 was observed via immunofluorescence using various antibodies. In each setting, immunofluorescence analysis demonstrated aberrant nuclear localization of K10 featuring an arginine-rich C-terminus. However, this was not observed with K10 featuring an alanine-rich C-terminus. Instead, the protein displayed cytoplasmic localization, consistent with wild-type and truncated forms of K10. This study demonstrates that, of the various 3' frameshift variants of KRT10, exclusively arginine-rich C-termini lead to nuclear localization of K10.
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Affiliation(s)
- Patricia Renz
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Elias Imahorn
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Iris Spoerri
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Magomet Aushev
- Wellcome Centre for Mitochondrial ResearchInstitute of Genetic MedicineNewcastle upon TyneUK
| | - Oliver P. March
- Department of DermatologyEB House AustriaUniversity Hospital of the Paracelsus Medical UniversitySalzburgAustria
| | - Hedwig Wariwoda
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Sarah Von Arb
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
| | - Andreas Volz
- DermatologyUniversity Hospital BaselBaselSwitzerland
| | - Peter H. Itin
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
- DermatologyUniversity Hospital BaselBaselSwitzerland
| | - Julia Reichelt
- Department of DermatologyEB House AustriaUniversity Hospital of the Paracelsus Medical UniversitySalzburgAustria
| | - Bettina Burger
- Department of BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland
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Peter Rout D, Nair A, Gupta A, Kumar P. Epidermolytic hyperkeratosis: clinical update. Clin Cosmet Investig Dermatol 2019; 12:333-344. [PMID: 31190940 PMCID: PMC6512611 DOI: 10.2147/ccid.s166849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 04/01/2019] [Indexed: 12/29/2022]
Abstract
Epidermolytic hyperkeratosis (EHK), earlier termed as bullous congenital ichthyosiform erythroderma is a skin disorder characterized as an autosomal dominant and rare disorder which has been observed to affect 1 in over 200,000 infants as a consequence of a significant mutation in the genes responsible for the keratin proteins, mostly keratin 1 and 10. The features present at birth include erythema and blistering. In adults, the hallmarks include hyperkeratosis, erosions, and blisters. The major symptoms including xerosis, pruritus, and painful fissuring lead not only to cosmetic problems but also stress, inferiority complex and other psychological conditions. While clinical inspection followed by confirmatory tests including histopathology and electron microscopic assessment is used for diagnosis, treatment modalities can be further improved for better diagnosis. This article reviews subtypes of ichthyosis, with a focus on EHK, genetics behind the disease, recently reported mutations, the existing diagnostics and treatments for the same and potential of new modalities in diagnosis/treatment.
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Affiliation(s)
- Denice Peter Rout
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
| | - Anushka Nair
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
| | - Anand Gupta
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
| | - Piyush Kumar
- Amity Institute of Biotechnology, Amity University Mumbai, Navi Mumbai, India
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Saito R, Boyce A, Hsu C, Rashidghamat E, Hide M, Wedgeworth E, Flohr C, Mellerio J, McGrath J. Predictive phenotyping of inherited ichthyosis by next‐generation
DNA
sequencing. Br J Dermatol 2016; 176:249-251. [DOI: 10.1111/bjd.14807] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- R. Saito
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
- Department of Dermatology Hiroshima University Hiroshima Japan
| | - A. Boyce
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - C.‐K. Hsu
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
- Department of Dermatology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - E. Rashidghamat
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
| | - M. Hide
- Department of Dermatology Hiroshima University Hiroshima Japan
| | - E.K. Wedgeworth
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - C. Flohr
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - J.E. Mellerio
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
- St John's Institute of Dermatology Guy's and St Thomas’ NHS Foundation Trust London U.K
| | - J.A. McGrath
- St John's Institute of Dermatology King's College London Guy's Hospital London U.K
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Guerra L, Diociaiuti A, El Hachem M, Castiglia D, Zambruno G. Ichthyosis with confetti: clinics, molecular genetics and management. Orphanet J Rare Dis 2015; 10:115. [PMID: 26381864 PMCID: PMC4573700 DOI: 10.1186/s13023-015-0336-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 09/01/2015] [Indexed: 11/10/2022] Open
Abstract
Ichthyosis with confetti (IWC) is an autosomal dominant congenital ichthyosis also known as ichthyosis variegata or congenital reticular ichthyosiform erythroderma. It manifests at birth with generalized ichthyosiform erythroderma or with a collodion baby picture. The erythrodermic and ichthyotic phenotype persists during life and its severity may modify. However, the hallmark of the disease is the appearance, in childhood or later in life, of healthy skin confetti-like spots, which increase in number and size with time. IWC is a very rare genodermatosis, with a prevalence <1/1,000,000 and only 40 cases reported worldwide. The most important associated clinical features include ear deformities, mammillae hypoplasia, palmoplantar keratoderma, hypertrichosis and ectropion. IWC is due to dominant negative mutations in the KRT10 and KRT1 genes, encoding for keratins 10 and keratin 1, respectively. In this context, healthy skin confetti-like spots represent “repaired” skin due to independent events of reversion of keratin gene mutations via mitotic recombination. In most cases, IWC clinical suspicion is delayed until the detection of white skin spots. Clinical features, which may represent hint to the diagnosis of IWC even before appearance of confetti-like spots, include ear and mammillae hypoplasia, the progressive development of hypertrichosis and, in some patients, of adherent verrucous plaques of hyperkeratosis. Altogether the histopathological finding of keratinocyte vacuolization and the nuclear staining for keratin 10 and keratin 1 by immunofluorescence are pathognomonic. Nevertheless, mutational analysis of KRT10 or KRT1 genes is at present the gold standard to confirm the diagnosis. IWC has to be differentiated mainly from congenital ichthyosiform erythroderma. Differential diagnosis also includes syndromic ichthyoses, in particular Netherton syndrome, and the keratinopathic ichthyoses. Most of reported IWC cases are sporadic, but familial cases with autosomal dominant mode of inheritance have been also described. Therefore, knowledge of the mutation is the only way to properly counsel the couples. No specific and satisfactory therapy is currently available for IWC. Like for other congenital ichthyoses, topical treatments (mainly emollients and keratolytics) are symptomatic and offer only temporary relief. Among systemic treatments, retinoids, in particular acitretin, improve disease symptoms in most patients. Although at present there is no curative therapy for ichthyoses, treatments have improved considerably over the years and the best therapy for each patient is always the result of both physician and patient efforts.
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Affiliation(s)
- Liliana Guerra
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy.
| | - Andrea Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy.
| | - May El Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy.
| | - Daniele Castiglia
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy.
| | - Giovanna Zambruno
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy.
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