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Oliver-García VS, Moore KJ, Denize T, Hoang MP, Neel VA, Demehri S. Cutaneous angiosarcoma of the scalp in a pediatric patient with xeroderma pigmentosum. JAAD Case Rep 2023; 41:37-39. [PMID: 37842153 PMCID: PMC10568230 DOI: 10.1016/j.jdcr.2023.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Affiliation(s)
- Valeria S. Oliver-García
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kevin J. Moore
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Thomas Denize
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mai P. Hoang
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Victor A. Neel
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shadmehr Demehri
- Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Maimouna M, Sofian B, Latifatou G, Joséphine Frédérique Mendouga E, Papa Macoumba G, Mamadou Moustapha D, Dirk VG. Unresectable and chemoresistant conjunctival squamous cell carcinoma on xeroderma pigmentosum treated by salvage radiation therapy: A case report and a review of the literature. Clin Case Rep 2022; 10:e6360. [PMID: 36188050 PMCID: PMC9508803 DOI: 10.1002/ccr3.6360] [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: 07/05/2021] [Revised: 04/11/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
Xeroderma pigmentosum (XP) is a rare genetic disease, which vital prognosis is conditioned by the occurrence of cancers essentially of the skin and ocular surfaces, requiring an early and adapted management. Radiation therapy (RT) is a very effective modality in the therapeutic arsenal alongside surgery, but it remains underused as it is wrongly considered to be deleterious for these patients. In this article, we report the case of a 10-years-old girl with XP treated with external beam RT for a squamous cell carcinoma (SCC) of the right ocular conjunctiva. The clinical tolerance was excellent and we obtained a good tumoral response. Therefore, the place of RT in these patients could/should be reconsidered, especially since these suspicions have still not been confirmed.
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Affiliation(s)
- Mané Maimouna
- Department of Radiation‐OncologyDalal Jamm National University HospitalDakarSenegal
| | - Benkhaled Sofian
- Institut Jules‐Bordet, Department of Radiation OncologyUniversité Libre de BruxellesBrusselsBelgium
| | - Guèye Latifatou
- Department of Radiation‐OncologyDalal Jamm National University HospitalDakarSenegal
| | | | - Gaye Papa Macoumba
- Department of Radiation‐OncologyDalal Jamm National University HospitalDakarSenegal
| | | | - Van Gestel Dirk
- Institut Jules‐Bordet, Department of Radiation OncologyUniversité Libre de BruxellesBrusselsBelgium
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Altinok P, Tekçe E, Ergün S, Mayadagli A. Radiation therapy for squamous cell cancer of the skin in a patient with xeroderma pigmentosum. J Cancer Res Ther 2022; 18:801-803. [DOI: 10.4103/jcrt.jcrt_534_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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de Andrade FAG, Cavalcanti CEDO, Isoldi FC, Ferreira LM. Therapeutics of xeroderma pigmentosum: A PRISMA-compliant systematic review. Indian J Dermatol Venereol Leprol 2021; 87:176-189. [PMID: 33769755 DOI: 10.25259/ijdvl_431_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 02/01/2020] [Indexed: 01/13/2023]
Abstract
Xeroderma pigmentosum is a rare hereditary autosomal recessive genodermatosis. At present, there are many treatment options for xeroderma pigmentosum, covering medical/procedural, surgical and combined modalities. However, the quality of these interventions has not been assessed. Our study aimed to perform a systematic review of the literature regarding the treatment of xeroderma pigmentosum. Multiple medical databases were accessed with the Medical Subject Headings terms; "xeroderma pigmentosum," "therapeutics" and "surgical procedures, operative" from January 2000 to April 2019, including articles published in Portuguese, Spanish and English (PROSPERO-CRD42018114858). Two hundred and ninety-eight studies were found in the databases researched, of which, after applying the inclusion criteria, only 33 studies remained. The 33 complete articles were read by three of the authors, having been found: 16 reported medical/procedural and 17 reported surgical treatments. Only one clinical study presented a good level of evidence (EL: 2): a randomized clinical trial using a T4 endonuclease V (T4N5) liposome lotion which reduced the development of skin lesions in patients with xeroderma pigmentosum. Amongst surgical modalities, all studies presented low evidence level (EL: 4). Three illustrative cases are also presented, to emphasize the multiple number of times that surgical modalities may be required in these patients. The therapeutic modalities, both clinical and surgical, for xeroderma pigmentosum presented a low level of scientific evidence which did not allow meta-analysis. More therapeutic studies, both clinical and surgical, with better scientific evidence are needed.
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A Painful Firm Plaque on the Midback of a 53-Year-Old Woman: Answer. Am J Dermatopathol 2018; 40:621-622. [PMID: 30028761 DOI: 10.1097/dad.0000000000000864] [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]
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Giordano CN, Yew YW, Spivak G, Lim HW. Understanding photodermatoses associated with defective DNA repair: Syndromes with cancer predisposition. J Am Acad Dermatol 2017; 75:855-870. [PMID: 27745641 DOI: 10.1016/j.jaad.2016.03.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 01/11/2023]
Abstract
Hereditary photodermatoses are a spectrum of rare photosensitive disorders that are often caused by genetic deficiency or malfunction of various components of the DNA repair pathway. This results clinically in extreme photosensitivity, with many syndromes exhibiting an increased risk of cutaneous malignancies. This review will focus specifically on the syndromes with malignant potential, including xeroderma pigmentosum, Bloom syndrome, and Rothmund-Thomson syndrome. The typical phenotypic findings of each disorder will be examined and contrasted, including noncutaneous identifiers to aid in diagnosis. The management of these patients will also be discussed. At this time, the mainstay of therapy remains strict photoprotection; however, genetic therapies are under investigation.
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Affiliation(s)
| | - Yik Weng Yew
- Department of Dermatology, National Skin Centre, Singapore
| | - Graciela Spivak
- Department of Biology, Stanford University, Stanford, California
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum. Arch Plast Surg 2016; 43:344-51. [PMID: 27462567 PMCID: PMC4959977 DOI: 10.5999/aps.2016.43.4.344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 06/01/2016] [Accepted: 06/07/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment. METHODS Between 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated. RESULTS The mean age of the patients was 32 years (range, 10-43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1-25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up. CONCLUSIONS Although genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.
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Abstract
Genetic skin diseases, or genodermatoses, often have extracutaneous manifestations. Ocular manifestations in particular can have significant clinical implications, like blindness. Other manifestations, such as the corneal opacities that occur in X-linked ichthyosis, are asymptomatic but characteristic of a particular genodermatosis. Ophthalmologic examination can aid in diagnosis when characteristic findings are seen. The genodermatoses with ocular manifestations will be reviewed, but neurocutaneous, syndromes, genetic pigmentary disorders, and genetic metabolic diseases are not included because they are covered elsewhere in this issue.
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Affiliation(s)
- Melinda Jen
- Section of Pediatric Dermatology, Children's Hospital of Philadelphia; Departments of Pediatrics and Dermatology, Perelman School of Medicine at the University of Pennsylvania, 3550 Market St, Second floor, Philadelphia, PA, 19104.
| | - Sudha Nallasamy
- The Vision Center, Children's Hospital Los Angeles; Department of Ophthalmology, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd, MS #88, Los Angeles, CA, 90027
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Invasive basal cell carcinoma in a xeroderma pigmentosum patient: facing secondary and tertiary aggressive recurrences. J Craniofac Surg 2015; 25:e336-8. [PMID: 24978686 DOI: 10.1097/scs.0000000000000596] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Xeroderma pigmentosum (XP) is characterized by photohypersensitivity of sun-exposed tissues and several thousand-fold increased risk of developing malignant neoplasms of the skin and eyes. Inherited molecular defects in nucleotide excision repair genes cause the autosomal recessive condition XP. A 56-year-old woman with XP presented with an extensive multirecurrence basal cell carcinoma in the left naso-orbital region. At the time of the first visit, the patient had already received several interventions with local reconstructive techniques, a full course of radiotherapy, and bilateral neck dissection. A large tumor resection and free flap reconstruction were performed. Three years 9 months afterward, an aggressive recurrence occurred, and a second resection was needed. A new free flap was transferred, and microvascular anastomoses were done to the pedicle of the previously transferred flap. Nine months later, the patient returned with frontal bone tumoral lesions, and third microsurgical intervention was done. At that time, the reconstruction was practiced by a composite chimeric flap with a rib portion. Its pedicle was anastomosed to the one of the second free flaps. The objective of this article was to report the authors' experience concerning a unique case of XP requiring a complex reconstruction of the anterior skull base. Xeroderma pigmentosum patients need an early diagnosis and removal of cutaneous tumor lesions as some of them behave aggressively, especially those affecting the face. Free flaps are good solutions for reconstruction and should proceed from non-sun-exposed areas of the body. If reconstructed areas are highly radiated and/or skin tumors affect deep anatomical areas, complications are frequent.
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Rambhatla PV, Brescoll J, Hwang F, Juzych M, Lim HW. Photosensitive disorders of the skin with ocular involvement. Clin Dermatol 2015; 33:238-46. [DOI: 10.1016/j.clindermatol.2014.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gogia A, Bansal A, Suri V, Bakhshi S. Childhood orbital soft tissue sarcoma in xeroderma pigmentosum with good tolerance to chemotherapy and radiotherapy. Pediatr Blood Cancer 2013; 60:2093-4. [PMID: 23946134 DOI: 10.1002/pbc.24716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 07/12/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Ajay Gogia
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Furudate S, Fujimura T, Tojo GI, Haga T, Aiba S. Basal cell carcinoma arising from xeroderma pigmentosum: a case report and an immunohistochemical study. Case Rep Dermatol 2013; 5:64-8. [PMID: 23626541 PMCID: PMC3617891 DOI: 10.1159/000350182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a 26-year-old Japanese patient with basal cell carcinoma arising from xeroderma pigmentosum (XP). Immunohistochemical staining revealed dense infiltration of CD163+ M2 macrophages, together with Foxp3+ regulatory T cells. Interestingly, MMP9, which was reported as one of the functional markers for immunosuppressive macrophages, was also detected in the CD163+ M2 macrophage-infiltrated areas. Our case suggests the immunological background of tumor development in a patient with XP.
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