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Nedelcu R, Dobre A, Turcu G, Andrei R, Balasescu E, Pantelimon F, David-Niculescu M, Dobritoiu A, Radu R, Zaharia GR, Hulea I, Brinzea A, Manea L, Gherghiceanu M, Ion D. Grover's Disease Association with Cutaneous Keratinocyte Cancers: More than a Coincidence? Int J Mol Sci 2024; 25:9713. [PMID: 39273660 PMCID: PMC11395229 DOI: 10.3390/ijms25179713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 08/29/2024] [Accepted: 09/06/2024] [Indexed: 09/15/2024] Open
Abstract
Better mechanistic understanding of desmosome disruption and acantholysis in Grover's disease (GD) may improve management of this disease. Recent molecular studies highlighted promising pathways to be explored by directly comparing GD and selected features of associated skin diseases. The association between GD and cutaneous keratinocyte carcinomas, the most prevalent non-melanoma skin cancers (NMSC), is not completely characterized. To review the medical literature regarding GD-associated cutaneous keratinocyte cancers, focusing on molecular features, pathophysiological mechanisms, and disease associations, to help guide future research and patient management. GD has been associated with a variety of skin conditions, but its association with skin cancers has been rarely reported. Between 1983 and 2024, only nine scientific papers presented data supporting this association. Interestingly, we found that GD may mimic multiple NMSCs, as few authors reported GD cases misdiagnosed as multiple cutaneous squamous cell carcinomas for more than 4 years or the presence of superficial basal cell carcinoma-like areas associated with focal acantholysis. In conclusion: (a) GD may be an imitator of multiple NMSCs, and (b) the relationship between GD and NMSCs may reveal promising pathways for the mechanistic understanding of desmosome disruption and acantholysis in GD and may even lead to its reclassification as a distinctive syndrome.
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Affiliation(s)
- Roxana Nedelcu
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Derma360 Clinic, 011273 Bucharest, Romania
| | - Alexandra Dobre
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Oncologic Dermatology Department, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Gabriela Turcu
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Derma360 Clinic, 011273 Bucharest, Romania
- Dermatology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
| | - Razvan Andrei
- Dermatology Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Synevo, 014192 Bucharest, Romania
| | - Elena Balasescu
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Mihaela David-Niculescu
- Derma360 Clinic, 011273 Bucharest, Romania
- Dermatology Department, "Grigore Alexandrescu" Emergency Pediatric Hospital, 011743 Bucharest, Romania
| | | | - Raluca Radu
- Dermatology Department, Central Military Emergency Hospital "Dr.Carol Davila", 010242 Bucharest, Romania
| | - Georgiana Roxana Zaharia
- Dermatology Department, Central Military Emergency Hospital "Dr.Carol Davila", 010242 Bucharest, Romania
| | - Ionela Hulea
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Alice Brinzea
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Derma360 Clinic, 011273 Bucharest, Romania
- National Institute for Infectious Diseases "Prof. Dr. Matei Balș", 021105 Bucharest, Romania
| | - Lorena Manea
- Dermatology Department, Pitié-Salpêtrière University Hospital, Public Assistance-Paris Hosiptals-AP-HP-Charles Foix, 75013 Paris, France
| | - Mihaela Gherghiceanu
- Cellular, Molecular Biology & Histology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Ultrastructural Pathology and Bioimaging Lab, Victor Babeş National Institute of Pathology, 050096 Bucharest, Romania
| | - Daniela Ion
- Pathophysiology Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Michelerio A, Greco A, Tomasini D, Tomasini C. Galli-Galli Disease: A Comprehensive Literature Review. Dermatopathology (Basel) 2024; 11:79-100. [PMID: 38390850 PMCID: PMC10885078 DOI: 10.3390/dermatopathology11010008] [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: 11/21/2023] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
Galli-Galli disease (GGD) is a rare genodermatosis that exhibits autosomal dominant inheritance with variable penetrance. GGD typically manifests with erythematous macules, papules, and reticulate hyperpigmentation in flexural areas. A distinct atypical variant exists, which features brown macules predominantly on the trunk, lower limbs, and extremities, with a notable absence of the hallmark reticulated hyperpigmentation in flexural areas. This review includes a detailed literature search and examines cases since GGD's first description in 1982. It aims to synthesize the current knowledge on GGD, covering its etiology, clinical presentation, histopathology, diagnosis, and treatment. A significant aspect of this review is the exploration of the genetic, histopathological, and clinical parallels between GGD and Dowling-Degos disease (DDD), which is another rare autosomal dominant genodermatosis, particularly focusing on their shared mutations in the KRT5 and POGLUT1 genes. This supports the hypothesis that GGD and DDD may be different phenotypic expressions of the same pathological condition, although they have traditionally been recognized as separate entities, with suprabasal acantholysis being a distinctive feature of GGD. Lastly, this review discusses the existing treatment approaches, underscoring the absence of established guidelines and the limited effectiveness of various treatments.
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Affiliation(s)
- Andrea Michelerio
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Dermatology Unit, Ospedale Cardinal Massaia, 14100 Asti, Italy
| | - Antonio Greco
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Dario Tomasini
- Dermatology Unit, ASST Valle Olona, 21052 Busto Arsizio, Italy
| | - Carlo Tomasini
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Dermatology Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
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Seli D, Ellis KT, Goldust M, Shah K, Hu R, Zhou J, McNiff JM, Choate KA. Association of Somatic ATP2A2 Damaging Variants With Grover Disease. JAMA Dermatol 2023; 159:745-749. [PMID: 37195706 PMCID: PMC10193258 DOI: 10.1001/jamadermatol.2023.1139] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/21/2023] [Indexed: 05/18/2023]
Abstract
Importance Grover disease (GD), a truncal eruption that typically occurs in older individuals, is exacerbated by sweating, irradiation, cancers, medications, kidney failure, and organ transplantation. The pathobiology of GD remains unknown. Objective To determine if damaging somatic single-nucleotide variants (SNVs) are associated with GD. Design, Setting, and Participants In this retrospective case series, we identified consecutive patients from a dermatopathology archive over a 4-year period (January 2007 to December 2011) who had 1 biopsy with a clinical diagnosis of GD confirmed via histopathologic findings and another non-GD biopsy. Participant DNA was extracted from both biopsy tissues and sequenced to high depth with a 51-gene panel to screen for SNVs in genes previously associated with acantholysis and Mendelian disorders of cornification. Analysis took place between 2021 and 2023. Main Outcomes and Measures Comparative analysis of sequencing data from paired GD and control tissue was employed to identify SNVs predicted to affect gene function, which were exclusive to, or highly enriched in, GD tissue. Results Overall, 12 of 15 cases of GD (12 men and 3 women; mean [SD] age, 68.3 [10.0] years) were associated with C>T or G>A ATP2A2 SNVs in GD tissue; all were predicted to be highly damaging via combined annotation dependent depletion (CADD) scores, and 4 were previously associated with Darier disease. In 9 cases (75%), the GD-associated ATP2A2 SNV was absent from control tissue DNA, and in 3 cases (25%), ATP2A2 SNVs were enriched 4- to 22-fold in GD vs control tissue. Conclusions and Relevance In this case series study of 15 patients, damaging somatic ATP2A2 SNVs were associated with GD. This discovery expands the spectrum of acantholytic disorders associated with ATP2A2 SNVs and highlights the role of somatic variation in acquired disorders.
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Affiliation(s)
- Devin Seli
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Katharine T. Ellis
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Mohamad Goldust
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Khadim Shah
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Ronghua Hu
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Jing Zhou
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Jennifer M. McNiff
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Keith A. Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
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Mohaghegh F, Youssefian L, Galehdari H, Tavakoli N, Vahidnezhad H, Uitto J. Whole-transcriptome sequencing identifies postzygotic ATP2A2 mutations in a patient misdiagnosed with herpes zoster, confirming the diagnosis of very late-onset segmental Darier disease. Exp Dermatol 2022; 31:943-948. [PMID: 35246884 DOI: 10.1111/exd.14559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/07/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022]
Abstract
An 82-year-old female patient presented with a recent onset of painful skin lesions in unilateral distribution on the abdominal area following the lines of Blaschko; the initial diagnosis of Varicella-zoster infection was made. However, because the individual lesions appeared as hyperkeratotic papules and were unresponsive to antiviral therapy, a skin biopsy was performed, which revealed hyperkeratosis, suprabasal acantholysis and dyskeratosis with corps ronds and grains, consistent with acantholytic dyskeratotic acanthoma. Since this entity has been associated with Darier disease, whole transcriptome sequencing by RNA-Seq was performed on RNA isolated from a lesion as well as from adjacent normal appearing skin, and a recently developed bioinformatics pipeline that can identify both genomic sequence variants and the presence of any of over 900 viruses was applied. Two pathogenic missense mutations in the ATP2A2 gene were identified in the lesional but not in normal appearing skin, and no evidence of Varicella-Zoster infection was obtained. These findings confirm the diagnosis of segmental Darier disease due to postzygotic mutations in the ATP2A2 gene, and attest to the power of a novel single-step application of RNA-Seq in providing correct diagnosis in this rare genodermatosis.
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Affiliation(s)
- Fatemeh Mohaghegh
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Youssefian
- Department Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Hamid Galehdari
- Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Hassan Vahidnezhad
- Department Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jouni Uitto
- Department Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Clinical features and treatments of transient acantholytic dermatosis (Grover's disease): a systematic review. J Dtsch Dermatol Ges 2020; 18:826-833. [PMID: 32767513 DOI: 10.1111/ddg.14202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/07/2020] [Indexed: 01/27/2023]
Abstract
Grover's disease (GD) is an itchy acantholytic disorder occurring on the trunk of middle-aged men. Based on the best evidence, this study aimed to provide a summary of the clinical characteristics, disease course and treatments of GD. A systematic review was performed according to PRISMA guidelines for original articles published between 01.01.1970-08.15.2019, assessing clinical features and/or any type of intervention for GD. A total of 263 articles were retrieved, and 116 original reports that were deemed relevant and satisfied the inclusion criteria were included in the analysis (88 case reports, 26 case series and two retrospective reviews). From these articles, 317 patients were identified, with a male-to-female ratio of 3.95. The mean age was 59 years (range 11-92). Typical lesions were itchy papules and vesicle-papules, generally located on the trunk. Spontaneous resolution within one week to eight months was described in 42 % of cases. Topical corticosteroids (TCSs) were the most frequent treatment (response rate of 70 %) followed by systemic retinoids and corticosteroids with response rates of 86 % and 64 %, respectively. According to the results of this review, TCS appears to be the most frequently employed treatment, and we suggest TCS as first-line therapy. Second-line treatments could include systemic retinoids or systemic corticosteroids.
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Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Martina Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Klinische Merkmale und Behandlungen der transitorischen akantholytischen Dermatose (Morbus Grover): ein systematischer Review. J Dtsch Dermatol Ges 2020; 18:826-834. [DOI: 10.1111/ddg.14202_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - Martina Maurelli
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
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Gantz M, Butler D, Goldberg M, Ryu J, McCalmont T, Shinkai K. Atypical features and systemic associations in extensive cases of Grover disease: A systematic review. J Am Acad Dermatol 2017; 77:952-957.e1. [PMID: 28918973 DOI: 10.1016/j.jaad.2017.06.041] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 06/13/2017] [Accepted: 06/17/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Grover disease is an acantholytic disorder that typically occurs on the trunk of older individuals, primarily white men, in association with heat and xerosis. Cases with extensive and/or atypical distributions have been reported. OBJECTIVE To review the literature characterizing the population, morphology, associations, and disease course of extensive or atypical eruptions of Grover disease. METHODS A systematic literature review identified 50 articles with 69 cases. RESULTS Patient age ranged from 14 to 83 years (mean age, 56 ± 15), with 71% of patients being male and 29% female. Areas of involvement included the trunk (90%), upper and lower extremities (63% and 61%, respectively), face/scalp (28%), neck (21%), groin (11%), buttocks (8%), and axillae (6%). The most common associations included a history of malignancy (61%), recent chemotherapy (38%), and recent transplant (20%). LIMITATIONS Extensive cases with typical clinical morphology may not have been examined by biopsy or reported; thus, this review may have publication bias toward more severe or atypical presentations. CONCLUSIONS Greater variability exists among patients affected by extensive or atypical Grover disease than among those with typical disease. Malignancy is a common association, and there may be a role for immunosuppression in the pathogenesis of extensive or atypical Grover disease.
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Affiliation(s)
- Madeleine Gantz
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Daniel Butler
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Matthew Goldberg
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jubin Ryu
- Department of Dermatology, Palo Alto Medical Foundation, Palo Alto, California
| | - Timothy McCalmont
- Department of Dermatology, University of California, San Francisco, California; Department of Pathology, University of California, San Francisco, California
| | - Kanade Shinkai
- Department of Pathology, University of California, San Francisco, California.
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