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Sharif SA, Mohammadzadeh A, Heidari MM, Por RE. A case report of Bart syndrome. Clin Case Rep 2023; 11:e7612. [PMID: 37384233 PMCID: PMC10293584 DOI: 10.1002/ccr3.7612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/30/2023] Open
Abstract
Bart syndrome is a rare condition characterized by epidermolysis bullosa (EB), aplasia cutis (AC), and nail abnormalities. Aplasia cutis congenita type VI was first described in 1966 by Bart et al. This article reports a case of Bart syndrome with ear malformation in a male Afghan newborn. To the authors' knowledge, this is the first case of Bart syndrome reported in an Afghan family.
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Affiliation(s)
| | | | | | - Rasoul Etesam Por
- Student Research CommitteeKashan University of Medical SciencesKashanIran
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2
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Coi A, Barisic I, Garne E, Pierini A, Addor MC, Aizpurua Atxega A, Ballardini E, Braz P, Broughan JM, Cavero-Carbonell C, de Walle HEK, Draper ES, Gatt M, Häusler M, Kinsner-Ovaskainen A, Kurinczuk JJ, Lelong N, Luyt K, Mezzasalma L, Mullaney C, Nelen V, Odak L, O'Mahony MT, Perthus I, Randrianaivo H, Rankin J, Rissmann A, Rouget F, Schaub B, Tucker D, Wellesley D, Wiśniewska K, Yevtushok L, Santoro M. Epidemiology of aplasia cutis congenita: A population-based study in Europe. J Eur Acad Dermatol Venereol 2023; 37:581-589. [PMID: 36300660 DOI: 10.1111/jdv.18690] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aplasia cutis congenita (ACC) is a rare congenital anomaly characterized by localized or widespread absence of skin at birth, mainly affecting the scalp. Most information about ACC exists as individual case reports and medium-sized studies. OBJECTIVES This study aimed to investigate the epidemiology of ACC, using data from a large European network of population-based registries for congenital anomalies (EUROCAT). METHODS Twenty-eight EUROCAT population-based registries in 16 European countries were involved. Poisson regression models were exploited to estimate the overall and live birth prevalence, to test time trends in prevalence between four 5-year periods and to evaluate the impact of the change of coding for ACC from the unspecific ICD9-BPA code to the specific ICD10 code. Proportions of ACC cases associated with other anomalies were reported. RESULTS Five hundred cases were identified in the period 1998-2017 (prevalence: 5.10 per 100,000 births). Prevalence across 5-year periods did not differ significantly and no significant differences were evident due to the change from ICD9 to ICD10 in ACC coding. Heterogeneity in prevalence was observed across registries. The scalp was the most common site for ACC (96.4%) and associated congenital anomalies were present in 33.8% of cases. Patau and Adams-Oliver syndromes were the most frequent among the associated chromosomal anomalies (88.3%) and the associated genetic syndromes (57.7%), respectively. 16% of cases were associated with limb anomalies and 15.4% with congenital heart defects. A family history of ACC was found in 2% of cases. CONCLUSION To our knowledge, this is the only population-based study on ACC. The EUROCAT methodologies provide reliable prevalence estimates and proportions of associated anomalies.
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Affiliation(s)
- Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Ingeborg Barisic
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Marie-Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | - Amaia Aizpurua Atxega
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, Donostia-San Sebastian, Spain
| | - Elisa Ballardini
- Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Paula Braz
- Epidemiology Department, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - Jennifer M Broughan
- National Congenital Anomaly and Rare Disease Registration Service, National Disease Registration Service, NHS Digital, Leeds, UK
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Hermien E K de Walle
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elizabeth S Draper
- Department Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, G'Mangia, Malta
| | | | | | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nathalie Lelong
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Paris, France
| | - Karen Luyt
- South West Congenital Anomaly Register, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lorena Mezzasalma
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Carmel Mullaney
- Department of Public Health, HSE South East, Lacken, Kilkenny, Ireland
| | - Vera Nelen
- Provincial Institute of Hygiene, Antwerp, Belgium
| | - Ljubica Odak
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Mary T O'Mahony
- Department of Public Health, HSE South (Cork & Kerry), Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Hanitra Randrianaivo
- Register of Congenital Malformations Isle of Reunion Island, CHU St Pierre, la Reunion, Reunion, France
| | - Judith Rankin
- National Congenital Anomaly and Rare Disease Registration Service, National Disease Registration Service, NHS Digital, Leeds, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Bruno Schaub
- French West Indies Registry, Registre des Malformations des Antilles (REMALAN), Maison de la Femme de la Mère et de l'Enfant, University Hospital of Martinique, Fort-de-France, France
| | - David Tucker
- Congenital Anomaly Register & Information Service for Wales (CARIS), Public Health Wales, Swansea, UK
| | - Diana Wellesley
- University Hospital Southampton, Faculty of Medicine and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Katarzyna Wiśniewska
- Epidemiology Unit, Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Lyubov Yevtushok
- OMNI-Net Ukraine Birth Defects Program and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
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Li G, Zhang A, Yang S, Lin N, Fang X. Type VII Aplasia Cutis Congenita in Neonates Related to Maternal HBV Infection? Case Report and Literature Review. Clin Cosmet Investig Dermatol 2023; 16:499-504. [PMID: 36855651 PMCID: PMC9968420 DOI: 10.2147/ccid.s396071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/28/2023] [Indexed: 02/24/2023]
Abstract
Aplasia cutis congenita (ACC) is a rare disease with an unclear pathogenic mechanism. ACC has been suggested to result from the disrupted development or degeneration of skin in the uterus. This study describes two cases that may have underlying pathogenic cause that have not been previously reported. Two neonates who were admitted to the neonatal intensive care unit due to "skin lesions on the limbs" without other deformities or complications were diagnosed with type VII ACC by dermatologist. The mothers showed positivity for hepatitis B virus (HBV) surface antigen and elevated level of HBV DNA copies, which may be related to ACC. But this association could be a coincidence. Both neonates were treated with antibacterial dressings and achieved satisfactory healing.
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Affiliation(s)
- Guanming Li
- Department of Neonatology, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China
| | - Airun Zhang
- Department of Neonatology, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China
| | - Silan Yang
- Department of Neonatology, First Affiliated Hospital, Shantou University Medical College, Shantou, People’s Republic of China
| | - Niyang Lin
- Department of Neonatology, First Affiliated Hospital, Shantou University Medical College, Shantou, People’s Republic of China
| | - Xiaoyi Fang
- Department of Neonatology, Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China
- Correspondence: Xiaoyi Fang, Department of Neonatology, Seventh Affiliated Hospital, Sun Yat-sen University, No. 628, Zhenyuan Road, Guangming District, Shenzhen, Guangdong, 518107, People’s Republic of China, Tel +86-18923451061, Email
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Usman SA, Taslim LO, Habib MI, Lily MT, Kudirat OE, Lamidi AI. Aplasia cutis congenita of extremities (group VII): case report from North-Western Nigeria. Sudan J Paediatr 2023; 23:234-238. [PMID: 38380406 PMCID: PMC10876273 DOI: 10.24911/sjp.106-1670856184] [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: 12/12/2022] [Accepted: 01/03/2023] [Indexed: 02/22/2024]
Abstract
Aplasia cutis congenita (ACC) is a rare congenital disorder characterised by localised or widespread absence of skin mainly affecting the scalp. Bilateral involvement of both the upper and lower extremities is uncommon. This is a case report of a rare congenital disorder. The patient was a 26-hour-old male baby admitted with extensive absence of skin on the lower and upper extremities. He was co-managed conservatively with the plastic surgical team for ACC group VII. The lesions were healing satisfactorily until 12 days into the admission when the parents signed against medical advice despite counselling. ACC with involvement of both upper and lower extremities is a rare presentation that responds to conservative treatment. The report emphasises the need for a legal framework for physicians to override the decision of the caregiver not in the best interest of a child.
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Affiliation(s)
- Sanni Abiola Usman
- Department of Paediatrics, Federal Medical Centre, Birnin Kebbi, Nigeria
| | | | | | | | | | - Audu Isah Lamidi
- Department of Paediatrics, Kaduna State University/Barau Dikko Teaching Hospital, Kaduna, Nigeria
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Zulli A, Martin A, Facchini F, Coletta R, Tamburini A, Oranges T, Filippeschi C, Bassi A, Buccoliero AM, Morabito A. A Unique Case of Primary Cutaneous Adenoid Cystic Carcinoma Associated with Aplasia Cutis Congenita in a Four-Year-Old Female: A Case Report. CHILDREN 2022; 9:children9020292. [PMID: 35205012 PMCID: PMC8870953 DOI: 10.3390/children9020292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022]
Abstract
Introduction: Primary cutaneous adenoid-cystic carcinoma (PCACC) is a rare malignant tumour reported in only about 450 cases in the literature, with only two adolescent cases reported. PCACC seems to occur between the fifth and seventh decade of life, and the most frequent regions involved are head and neck (46%). Aplasia cutis congenita (ACC) has an incidence of 1:10,000, and it seems to be rarely associated with neoplastic lesions. Interestingly, the association between PCACC and ACC has, so far, never been described. Methods: We report a case of PCACC in the scalp associated with ACC in a four-year-old patient. Discussion: The patient was under follow-up at the dermatology unit, but suddenly a red lesion appeared within the ACC. This red, ulcerated area increased rapidly over six months, so it was surgically removed, and the pathological examination results were suggestive for cribriform PCACC. According to the guidelines for skin tumours, the patient underwent widening resection, and an advancement-sliding skin flap was performed to recreate the scalp. After one year of follow-up, the patient has no local or widespread recurrence of the PCACC, and the surgical scar appears to have healed well. Conclusions: This clinical case is the first known patient with PCACC associated with ACC. A skin excision biopsy should be performed with wide margins to avoid a second widening resection of skin in a similar scenario. Genetic studies may help to identify the origin of this rare association.
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Affiliation(s)
- Andrea Zulli
- Department of Pediatric Surgery, Meyer Children’s Hospital, 50139 Florence, Italy; (A.M.); (F.F.); (R.C.); (A.M.)
- Correspondence:
| | - Alessandra Martin
- Department of Pediatric Surgery, Meyer Children’s Hospital, 50139 Florence, Italy; (A.M.); (F.F.); (R.C.); (A.M.)
| | - Flavio Facchini
- Department of Pediatric Surgery, Meyer Children’s Hospital, 50139 Florence, Italy; (A.M.); (F.F.); (R.C.); (A.M.)
| | - Riccardo Coletta
- Department of Pediatric Surgery, Meyer Children’s Hospital, 50139 Florence, Italy; (A.M.); (F.F.); (R.C.); (A.M.)
| | - Angela Tamburini
- Department of Hematology-Oncology, Meyer Children’s Hospital, 50139 Florence, Italy;
| | - Teresa Oranges
- Dermatology Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (T.O.); (C.F.); (A.B.)
| | - Cesare Filippeschi
- Dermatology Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (T.O.); (C.F.); (A.B.)
| | - Andrea Bassi
- Dermatology Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (T.O.); (C.F.); (A.B.)
| | | | - Antonino Morabito
- Department of Pediatric Surgery, Meyer Children’s Hospital, 50139 Florence, Italy; (A.M.); (F.F.); (R.C.); (A.M.)
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Ngeow A, Hui C, Chua AWC, Koh M, Ong YS, Poon WB. Challenges in the management of extensive aplasia cutis congenita. BMJ Case Rep 2022; 15:e246627. [PMID: 35165127 PMCID: PMC8845208 DOI: 10.1136/bcr-2021-246627] [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] [Accepted: 01/20/2022] [Indexed: 11/04/2022] Open
Abstract
Aplasia cutis congenita (ACC) is a rare group of congenital disorders characterised by focal or widespread absence of skin, predominantly affecting the scalp. A Malay female infant was born at 37 weeks with extensive ACC, affecting 37% of total body surface area, including her scalp and trunk. There is no consensus on the management of ACC given the rarity and variable presentation. A multi-disciplinary team comprising neonatologists, paediatric dermatologists, plastic surgeons and medical laboratory scientists at the skin bank, employed a more aggressive surgical approach with the aim of avoiding potentially catastrophic morbidity, including sagittal sinus haemorrhage and brain herniation. Out of several surgical options, the team used a staged artificial dermal matrix (Integra) and cultured epithelial autograft application, followed by regular wound dressing, and eventually allowed the child to achieve complete epithelialisation of her trunk, and most of scalp before she was discharged from hospital.
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Affiliation(s)
- Alvin Ngeow
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore
| | - Cheryl Hui
- Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
| | | | - Mark Koh
- Department of Dermatology, KK Women's and Children's Hospital, Singapore
| | - Yee Siang Ong
- Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
| | - Woei Bing Poon
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore
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Kalavar M, Echegaray JJ, Ashkenazy N, McKeown C, Berrocal AM. Choroidal calcifications in two cases of aplasia cutis congenita and oculoectodermal syndrome. Ophthalmic Genet 2021; 43:258-261. [PMID: 34895016 DOI: 10.1080/13816810.2021.1998552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe choroidal calcifications as an ophthalmic feature in aplasia cutis congenita (ACC) with oculoectodermal syndrome (OES). OBSERVATIONS Two cases of ACC/OES with characteristic echographic evidence of choroidal calcifications are described. CONCLUSIONS AND IMPORTANCE The ophthalmic manifestations of ACC/OES may be expanded to include choroidal calcifications. The presence of a choroidal calcification with B-scan ultrasound in a case suspicious for ACC/OES may facilitate a more timely diagnosis and inform future follow-up regimens to monitor ophthalmic and systemic manifestations of this disease.
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Affiliation(s)
- Meghana Kalavar
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jose J Echegaray
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Noy Ashkenazy
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Craig McKeown
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Audina M Berrocal
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Brockman SE, Ottolini KM, Schulz EV. Lumbar Skin Lesion in a Term Infant. Pediatr Rev 2021; 42:624-627. [PMID: 34725223 DOI: 10.1542/pir.2020-001834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Shannon E Brockman
- United States Navy Medicine Readiness and Training Command Okinawa, Okinawa, Japan.,Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD
| | - Katherine M Ottolini
- Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD.,Department of Neonatology, 18th Healthcare Operations Squadron, Kadena AB, Okinawa, Japan
| | - Elizabeth V Schulz
- Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD.,Department of Neonatology, 18th Healthcare Operations Squadron, Kadena AB, Okinawa, Japan
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Mukhtar-Yola M, Mshelia L, Mairami AB, Otuneye AT, Yawe ET, Igoche P, Audu LI. Aplasia cutis congenita: a report of two cases from National Hospital Abuja, Nigeria and review of the literature. Pan Afr Med J 2020; 36:291. [PMID: 33117485 PMCID: PMC7572678 DOI: 10.11604/pamj.2020.36.291.24523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023] Open
Abstract
Aplasia cutis congenita is a rare congenital abnormality first described in 1767 by cordon. It mostly appears as a solitary lesion involving various layers of the skin and sometimes the bone on the scalp, limbs or abdomen. Genetics, environmental and exogenous causes have been implicated as potential causes. Only about 500 cases have been reported globally as of 2013. Two cases of Aplasia Cutis Congenita (ACC) who presented with scalp and bone defects at birth are reported, one in a syndromic child delivered to a consanguineous family, with associated cardiac, skin and nail anomalies (likely Adams Oliver syndrome) and the other as an isolated scalp lesion. Both were large defects managed conservatively by a multidisciplinary team. The challenges of investigating and managing such complex scalp anomalies in sub-Saharan Africa are highlighted.
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Affiliation(s)
| | - Lauretta Mshelia
- Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
| | | | | | | | - Patricia Igoche
- Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
| | - Lamidi Isah Audu
- Department of Paediatrics, National Hospital Abuja, Abuja, Nigeria
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Mariath LM, Santin JT, Frantz JA, Doriqui MJR, Schuler-Faccini L, Kiszewski AE. Genotype-phenotype correlations on epidermolysis bullosa with congenital absence of skin: A comprehensive review. Clin Genet 2020; 99:29-41. [PMID: 32506467 DOI: 10.1111/cge.13792] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/25/2020] [Accepted: 05/30/2020] [Indexed: 02/06/2023]
Abstract
Congenital absence of skin (CAS) is a clinical sign associated with the main types of epidermolysis bullosa (EB). Very few studies have investigated the genetic background that may influence the occurrence of this condition. Our objective was to investigate genotype-phenotype correlations on EB with CAS through a literature revision on the pathogenic variants previously reported. A total of 171 cases (49 EB simplex, EBS; 23 junctional EB, JEB; and 99 dystrophic EB, DEB), associated with 132 pathogenic variants in eight genes, were included in the genotype-phenotype analysis. In EBS, CAS showed to be a recurrent clinical sign in EBS with pyloric atresia (PA) and EBS associated with kelch-like protein 24; CAS was also described in patients with keratins 5/14 alterations, particularly involving severe phenotypes. In JEB, this is a common clinical sign in JEB with PA associated with premature termination codon variants and/or amino acid substitutions located in the extracellular domain of integrin α6β4 genes. In DEB with CAS, missense variants occurring close to non-collagenous interruptions of the triple-helix domain of collagen VII appear to influence this condition. This study is the largest review of patients with EB and CAS and expands the spectrum of known variants on this phenomenon.
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Affiliation(s)
- Luiza Monteavaro Mariath
- Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Tosetto Santin
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jeanine Aparecida Frantz
- Faculty of Medicine, Universidade Regional de Blumenau, Blumenau, Brazil.,Board of Directors, Debra-Brasil, Blumenau, Brazil
| | | | - Lavínia Schuler-Faccini
- Postgraduate Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Genetics, Universidade Federal do Rio Grande do Sul and Instituto Nacional de Ciência e Tecnologia de Genética Médica Populacional (INaGeMP), Porto Alegre, Brazil
| | - Ana Elisa Kiszewski
- Section of Dermatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.,Section of Pediatric Dermatology, Hospital da Criança Santo Antônio, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
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