1
|
Ribeiro A, Decaup PH, Andriantavy M, Couture C, Garot E. Skeletal indicators of pathology in the context of early tooth loss in children: A systematic literature review. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2024; 46:37-49. [PMID: 39029336 DOI: 10.1016/j.ijpp.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE To provide an evidence-based resource for paleopathologists to consider multiple skeletal indicators of pathology associated with early tooth loss in children to aid in diagnosis. MATERIALS Three databases (Cochrane Library, MedLine, and Scopus) were used for a review. METHODS According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, a systematic review guideline, 85 articles were selected. RESULTS A total of 189 children had a syndrome or disease associated with early tooth loss. Our review, based on 25 diseases, lists the bone and dental lesions observable in archeological remains. CONCLUSIONS Based on a review of the literature, a synthesis of 25 diseases and syndromes that may be associated with premature loss of permanent or deciduous teeth in children was developed for paleopathologists. It highlights the importance of a thorough dental examination by paleopathologists to further assess past health conditions. SIGNIFICANCE This paper provides an extensive resource addressing early tooth loss in childhood to assist researchers with differential diagnosis. LIMITATIONS The articles included in this review are case reports based on living populations. SUGGESTIONS FOR FURTHER RESEARCH Further studies into diseases and their association with early tooth loss would complement this work, as would utilizing the differential diagnoses on archeological individuals to clarify its value and limitations.
Collapse
Affiliation(s)
- Ana Ribeiro
- Univ. de Bordeaux, UFR des Sciences odontologiques, Bordeaux, France; Pôle de médecine et chirurgie bucco-dentaire, C.H.U de Bordeaux, France
| | - Pierre-Hadrien Decaup
- Univ. de Bordeaux, UFR des Sciences odontologiques, Bordeaux, France; Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France; Centre de Compétence des Maladies Rares Orales et Dentaires, CCMR O-Rares, C.H.U. de Bordeaux, France
| | | | - Christine Couture
- Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France
| | - Elsa Garot
- Univ. de Bordeaux, UFR des Sciences odontologiques, Bordeaux, France; Université de Bordeaux, CNRS, Ministère de la Culture, PACEA, UMR 5199, Pessac, France; Centre de Compétence des Maladies Rares Orales et Dentaires, CCMR O-Rares, C.H.U. de Bordeaux, France.
| |
Collapse
|
2
|
Raja Rajeswari K, Almansour R, Alrajhi F, Fahad Binmeqren A, Shayan Albaqami M, abdullah Albarrak R. Papillon-Lefèvre syndrome in dental pediatric patient: A comprehensive review. Saudi Dent J 2024; 36:682-687. [PMID: 38766300 PMCID: PMC11096607 DOI: 10.1016/j.sdentj.2024.02.003] [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: 12/16/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Papillon-Lefèvre syndrome (PLS) is an autosomal recessive genetic disorder characterized by the presence of palmoplantar hyperkeratosis on the hands and feet, as well as severe periodontal disease affecting both the primary and permanent teeth, which can lead to premature tooth loss. Aims This review aimed to characterize the etiology, clinical manifestations, diagnosis, and recent dental management strategies of pediatric patients with PLS. Material and Methods A comprehensive search of the electronic literature was conducted using specific keywords such as "Papillon-Lefèvre syndrome in dentistry," "Etiology of Papillon-Lefèvre syndrome," "Oral manifestations of Papillon-Lefèvre syndrome," "Management of Papillon-Lefèvre syndrome," and "Papillon-Lefèvre syndrome." A total of 47 publications that provided relevant information and discussed the various aspects of PLS were identified. Conclusion The management of PLS necessitates a multidisciplinary approach, including the active involvement of a dental surgeon, dermatologist, and pediatrician to ensure comprehensive care. Extraction of primary teeth and administration of antibiotics is a successful treatment strategy, while placement of removable partial denture is the best option for pediatric patients.
Collapse
Affiliation(s)
- Kaminedi Raja Rajeswari
- Department of pediatric dentistry, college of dentistry, king Saud university, Riyadh, Saudi Arabia
| | - Rahaf Almansour
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Farah Alrajhi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
3
|
Alzoubi F, Wong A. Fixed prosthetic rehabilitation of a patient with Papillon-Lefevre syndrome supported by a Quad Zygoma Approach: A clinical report. SPECIAL CARE IN DENTISTRY 2023; 43:240-249. [PMID: 35802392 DOI: 10.1111/scd.12750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Abstract
Papillon-Lefevere syndrome (PLS) is a rare disorder with severe oral manifestations resulting in premature tooth loss at an early stage of life. As a result, extensive bone resorption pattern in the maxilla negates conventional implant treatment in the majority of cases. This clinical report describes a prosthetic rehabilitation revision of a 26-year-old female diagnosed with PLS using an implant supported fixed complete denture with a quad zygoma approach. A 1 year follow-up is also presented.
Collapse
Affiliation(s)
- Fawaz Alzoubi
- Department of General Dental Practice, Faculty of Dentistry, Kuwait University, Jabriya, Kuwait
| | - Allen Wong
- AEGD Program Director Hospital Dentistry Program, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, USA
| |
Collapse
|
4
|
Ramkumar N, Sankar H. Multidisciplinary management of Papillon-Lefevre syndrome as a result of consanguineous marriage. BMJ Case Rep 2022; 15:e252992. [PMID: 36572452 PMCID: PMC9806059 DOI: 10.1136/bcr-2022-252992] [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] [Indexed: 12/27/2022] Open
Abstract
Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive syndrome, and consanguinity has been reported in 20%-40% of cases. It is characterised by palmoplantar hyperkeratosis associated with severe early-onset periodontitis and premature loss of primary and permanent teeth. This report describes a case of PLS in a female patient with consanguineously married parents. The patient reported mobile upper front teeth. Clinical examination revealed presence of marked palmoplantar hyperkeratosis.Symmetric, well-demarcated, yellowish, keratotic and confluent plaques were seen on the skin of her palms and soles. Intraoral periodontal examination revealed erythematous gingiva with generalised periodontal pockets. Generalised mobility of teeth was present with clinically missing lower anterior teeth. Based on clinical and radiographic feature and the patient's medical, dental and family history, a diagnosis of PLS was made.
Collapse
Affiliation(s)
- Narayane Ramkumar
- Periodontology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India
| | - Hanumanth Sankar
- Orthodontics and Dentofacial Orthopedics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India
| |
Collapse
|
5
|
Abdul NS, Dagriri LK, Shenoy M. Papillon-Lefévre Syndrome: A Rare Case Report and a Brief Review of Literature. Cureus 2022; 14:e26163. [PMID: 35891843 PMCID: PMC9306443 DOI: 10.7759/cureus.26163] [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: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Palmar-plantar hyperkeratosis and severe early-onset periodontitis are the hallmarks of the uncommon autosomal recessive Papillon-Lefévre syndrome (PLS), which may cause both primary and permanent teeth to be lost at an early age. The cause and pathophysiology of the disorder involve several factors, including genetic, immunological, and microbial factors. Aim: The purpose of this case study is to provide insight into the fascinating role of consanguinity in the aetiology of this unusual illness. Case Presentation: An unusual PLS case report in a household with two consanguineously married parents was provided. A 17-year-old Saudi boy visited the dental clinic at Riyadh Elm University because he was having problems with loose teeth and pain while chewing, as well as irritated and friable gums. He may be suffering from a genetic condition that has been effectively treated in the past by his elder brother, who is now 26 years old. In this instance, severe extensive periodontitis contributed to the early loss of primary teeth as well as permanent teeth, resulting in PLS. On the lateral surface of the soles, the distinctive skin lesions revealed hyperkeratosis with regions of persistent thickening, flaking, and scaling. There were erythematous patches on the palms, but no hyperkeratosis was seen. Conclusion: When it comes to Papillon-Lefévre syndrome (PLS), this is an extremely unusual instance since two siblings in the same family were both afflicted. Patients who are stigmatised because of their condition will benefit from early discovery and multidisciplinary treatment.
Collapse
|
6
|
Premedication with a cathepsin C inhibitor alleviates early primary graft dysfunction in mouse recipients after lung transplantation. Sci Rep 2019; 9:9925. [PMID: 31289357 PMCID: PMC6616352 DOI: 10.1038/s41598-019-46206-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/25/2019] [Indexed: 12/31/2022] Open
Abstract
Neutrophil serine proteases (NSPs), like proteinase 3 (PR3) and neutrophil elastase (NE) are implicated in ischemia-reperfusion responses after lung transplantation (LTx). Cathepsin C (CatC) acts as the key regulator of NSP maturation during biosynthesis. We hypothesized that CatC inhibitors would reduce vascular breakdown and inflammation during reperfusion in pretreated lung transplant recipients by blocking NSP maturation in the bone marrow. An orthotopic LTx model in mice was used to mimic the induction of an ischemia-reperfusion response after 18 h cold storage of the graft and LTx. Recipient mice were treated subcutaneously with a chemical CatC inhibitor (ICatC) for 10 days prior to LTx. We examined the effect of the ICatC treatment by measuring the gas exchange function of the left lung graft, protein content, neutrophil numbers and NSP activities in the bone marrow 4 h after reperfusion. Pre-operative ICatC treatment of the recipient mice improved early graft function and lead to the disappearance of active NSP protein in the transplanted lung. NSP activities were also substantially reduced in bone marrow neutrophils. Preemptive NSP reduction by CatC inhibition may prove to be a viable and effective approach to reduce immediate ischemia reperfusion responses after LTx.
Collapse
|
7
|
Korkmaz B, Caughey GH, Chapple I, Gauthier F, Hirschfeld J, Jenne DE, Kettritz R, Lalmanach G, Lamort AS, Lauritzen C, Łȩgowska M, Lesner A, Marchand-Adam S, McKaig SJ, Moss C, Pedersen J, Roberts H, Schreiber A, Seren S, Thakker NS. Therapeutic targeting of cathepsin C: from pathophysiology to treatment. Pharmacol Ther 2018; 190:202-236. [DOI: 10.1016/j.pharmthera.2018.05.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
8
|
Yousry YM, El-Latif AEA, El-Gawad RYA. Case Report: Clinical manifestation and dental management of Papillon-Lefèvre syndrome. F1000Res 2018; 7:1420. [PMID: 30356436 PMCID: PMC6178905 DOI: 10.12688/f1000research.16042.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Papillon-Lefèvre syndrome (PLS) is considered a rare syndrome, which is characterized by the presence of palmar-plantar hyperkeratosis and aggressively progressing periodontitis that finally leads to premature loss of both deciduous and permanent teeth. Case report: A four-year-old Egyptian boy presented with a maternal complaint that her child suffers from early loss of many teeth, presence of loose teeth along with an asymptomatic swelling related to the upper anterior area. The patient was diagnosed with PLS. A symptomatic management and prevention program was followed and the swelling was excised; afterwards diagnosed as peripheral ossifying fibroma. Conclusion: Early recognition and intervention for patients with PLS is essential to avoid the threat of being edentulous if left unmanaged.
Collapse
Affiliation(s)
- Yasmin Mohamed Yousry
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amr Ezzat Abd El-Latif
- Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | |
Collapse
|
9
|
AIBarrak ZM, Alqarni AS, Chalisserry EP, Anil S. Papillon-Lefèvre syndrome: a series of five cases among siblings. J Med Case Rep 2016; 10:260. [PMID: 27658951 PMCID: PMC5034476 DOI: 10.1186/s13256-016-1051-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 09/01/2016] [Indexed: 11/12/2022] Open
Abstract
Background Papillon–Lefèvre syndrome is a rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and aggressively progressing periodontitis leading to premature loss of deciduous and permanent dentition. The etiopathogenesis of the syndrome is relatively obscure, and immunologic, genetic, or possible bacterial etiologies have been proposed. Case presentation A series of five cases of Papillon–Lefèvre syndrome among the siblings in a family is presented here: a 3-year-old Arab girl, a 4-year-old Arab boy, a 11-year-old Arab boy, a 12-year-old Arab boy, and a 14-year-old Arab boy. The patients presented with severe gingival inflammation and mobility of teeth. The clinical manifestations were typical of Papillon–Lefèvre syndrome and the degree of involvement of the oral and skin conditions varied among them. Conclusions This case series stresses the consanguinity in the family as an etiologic factor. All siblings in the family were affected with Papillon–Lefèvre syndrome which makes this a rare case. A multidisciplinary approach with the active participation of a dental surgeon, dermatologist, and pediatrician is essential for the management of cases of Papillon–Lefèvre syndrome.
Collapse
Affiliation(s)
- Zyad M AIBarrak
- King Abdulaziz Medical City, Ministry of Health, Riyadh, Saudi Arabia.
| | - Adel S Alqarni
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, 153, AIkharj, 11942, Riyadh, Saudi Arabia
| | - Elna P Chalisserry
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, 82943, Saudi Arabia
| | - Sukumaran Anil
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, 153, AIkharj, 11942, Riyadh, Saudi Arabia
| |
Collapse
|
10
|
Iqtadar S, Mumtaz SU, Abaidullah S. Papillon-Lèfevre syndrome with palmoplantar keratoderma and periodontitis, a rare cause of pyrexia of unknown origin: a case report. J Med Case Rep 2015; 9:288. [PMID: 26683691 PMCID: PMC4684603 DOI: 10.1186/s13256-015-0773-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 11/22/2015] [Indexed: 11/30/2022] Open
Abstract
Introduction Papillon-Lefèvre Syndrome is a rare autosomal recessive disorder characterized by diffuse, transgradient palmoplantar keratoderma, destructive periodontitis beginning in childhood, premature loss of primary teeth, and frequent cutaneous and systemic pyogenic infections. Pyogenic liver abscess is an uncommon presentation of the disease present in this case. Case presentation A 16-year-old Punjabi, Pakistani boy presented to the outpatient department of a tertiary-care hospital of Lahore with high-grade fever of 2 months duration. He had been treated for a pyogenic liver abscess 2 years back with antibiotics followed by incision and drainage. He had poor orodental hygiene, palmoplantar keratoderma and periodontitis. His parents had history of consanguinity. His brother and two cousins had similar skin lesions and were edentulous. An orthopentogram showed atrophy of the alveolar bone. He was treated with broad-spectrum antibiotics, and antipyretics for systemic infection. Multivitamins, topical steroids, topical keratolytics and emollients were used for his dermatological issues. Conclusions Our patient was successfully treated. His fever settled and his skin lesions improved with antibiotics, topical steroids and keratolytics. He was sent home and was asked to return for follow-up on a monthly basis.
Collapse
Affiliation(s)
- Somia Iqtadar
- North Medical Ward,Mayo Hospital, King Edward Medical University, Lahore, Pakistan.
| | - Sami Ullah Mumtaz
- North Medical Ward,Mayo Hospital, King Edward Medical University, Lahore, Pakistan.
| | - Sajid Abaidullah
- North Medical Ward,Mayo Hospital, King Edward Medical University, Lahore, Pakistan.
| |
Collapse
|
11
|
Jijin MJ, Jaishankar HP, Narayaran VS, Rangaswamy K, Puthaswamy KA. Papillon-Lefevre Syndrome In An Adolescent Female: A Case Study. J Clin Diagn Res 2015; 9:ZD23-5. [PMID: 26155583 DOI: 10.7860/jcdr/2015/12780.5921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 04/08/2015] [Indexed: 11/24/2022]
Abstract
Papillon-Lefevre Syndrome (PLS) is a rare inherited autosomal-recessive condition with one-third of the patients' showing consanguinity of the parents. Lesions are characterised by palmar-plantar hyperkeratosis and hyperhidrosis. Early onset of periodonditis, severe periodontal destruction in both primary and permanent dentitions, and calcification of the duramater form the three important features of this disease. Here, we present a case of a 14-year-old female who presented to the Department of Oral Medicine and Radiology with a complaint of mobility of the teeth since four months. Oral examination of the patient showed generalised mobility of the teeth. General physical examination of the patient showed dry scaly skin on dorsum of bilateral feet, hands, and knee. The patient had familial history positive for consanguinity. The patient was medically diagnosed as positive for PLS. The patients with PLS show combination of dermatological and dental lesions and it requires the dentist to assume a more prominent role in early treatment and rehabilitation. There is a need for symbiotic and synergetic approach between the two specialties for effective management of this rare disease.
Collapse
Affiliation(s)
- M J Jijin
- Post Graduate, Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences , Virajpet, Karnataka, India
| | - H P Jaishankar
- Professor, Department of Oral Medicine and Radiology, JSS Dental College , Mysore, Karnataka, India
| | - Veena Sathya Narayaran
- Professor, Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences , Virajpet, Karnataka, India
| | - Krupashankar Rangaswamy
- Reader, Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences , Virajpet, Karnataka, India
| | | |
Collapse
|
12
|
Sreeramulu B, Shyam NDVN, Ajay P, Suman P. Papillon-Lefèvre syndrome: clinical presentation and management options. Clin Cosmet Investig Dent 2015; 7:75-81. [PMID: 26203280 PMCID: PMC4507741 DOI: 10.2147/ccide.s76080] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder, characterized by diffuse palmoplantar keratoderma and precocious aggressive periodontitis, leading to premature loss of deciduous and permanent dentition at a very young age. Various etiopathogenic factors are associated with the syndrome, like immunologic alterations, genetic mutations, and the role of bacteria. Dentists play a significant role in the diagnosis and management of PLS as there are characteristic manifestations like periodontal destruction at an early age and an early eruption of permanent teeth. Here, we are presenting an elaborate review of PLS, its etiopathogenesis, clinical presentation, and management options.
Collapse
Affiliation(s)
- Basapogu Sreeramulu
- Department of Prosthodontics, Government Dental College and Hospital, Hyderabad, Telangana State, India
| | - Naragani DVN Shyam
- Department of Oral Pathology, Government Dental College and Hospital, Hyderabad, Telangana State, India
| | - Pilla Ajay
- Department of Prosthodontics, Government Dental College and Hospital, Hyderabad, Telangana State, India
| | - Pathipaka Suman
- Department of Prosthodontics, Government Dental College and Hospital, Hyderabad, Telangana State, India
| |
Collapse
|
13
|
Sreeramulu B, Haragopal S, Shalini K, Sudha MD, Kiran G. The prosthodontic management of a young edentulous patient with the papillon lefevre syndrome-a rare case report. J Clin Diagn Res 2013; 6:1808-11. [PMID: 23373060 DOI: 10.7860/jcdr/2012/4884.2607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 09/06/2012] [Indexed: 11/24/2022]
Abstract
The Papillon Lefevre syndrome is an autosomal recessive disorder which is characterized by various dermatological manifestations and periodontitis as a manifestation of a systemic disease. Its aetiopathogenesis is thought to be secondary to the mutation of the Cathepsin C gene. Various studies have shown that the immune related cells like the polymorphonuclear leucocytes and the macrophages and their precursors were affected.This report elicits about an edentulous male with this syndrome, who was treated with a modified complete denture prosthesis (hollow, maxillary, complete denture), considering his young age and low socioeconomic status.
Collapse
Affiliation(s)
- B Sreeramulu
- Assistant Professor, Department of Prosthodontics, GDCH , Hyderabad. A.P., India
| | | | | | | | | |
Collapse
|
14
|
Kord Valeshabad A, Mazidi A, Kord Valeshabad R, Imani E, Kord H, Koohkan M, Sayinar Z, Al-Talib K. Papillon-lefèvre syndrome: a series of six cases in the same family. ISRN DERMATOLOGY 2012; 2012:139104. [PMID: 23251811 PMCID: PMC3518962 DOI: 10.5402/2012/139104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 11/07/2012] [Indexed: 11/25/2022]
Abstract
Papillon-Lefèvre syndrome (PLS) is a rare, autosomal recessive heterogeneous disorder, which is characterized by palmoplantar hyperkeratosis, early loss of primary and permanent teeth, and associated calcification of the dura mater. Herein we described six cases of PLS in the same family. In this series, six cases (two females and four males) with the mean age of 15.6 ± 10.4 years were recruited. Palmoplantar hyperkeratosis was detected in all of the cases, leading to a difficult and painful walking in two cases due to lesions on the soles. Skin lesions were sharply distinct from adjacent normal skin in all cases. Other skin lesions were located in the external malleolus (5/6), knee (4/6), elbow (4/6), toe and dorsal fingers (3/6), and the thighs (2/6). In three cases, all permanent teeth were exfoliated. In three others, no primary teeth remained. Severe gingivitis was observed in three patients. Radiologic study confirmed alveolar bone destruction in five cases. Delayed diagnosis and insufficient treatment of PLS patients can affect patient's life of by causing edentulism at a young age and may impose PLS patients to increased risk of social, psychological, and economical burdens.
Collapse
Affiliation(s)
- Ali Kord Valeshabad
- Division of Gastroenterology and Hepatology, School of Medicine, The Johns Hopkins University, 1800 Orleans Street, Sheikh Zayed Building, Room 7125 B, Baltimore, MD 21287, USA
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Khan FY, Jan SM, Mushtaq M. Papillon-Lefèvre syndrome: Case report and review of the literature. J Indian Soc Periodontol 2012; 16:261-5. [PMID: 23055596 PMCID: PMC3459510 DOI: 10.4103/0972-124x.99273] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 01/09/2012] [Indexed: 11/04/2022] Open
Abstract
Papillon-Lefèvre syndrome is a very rare syndrome of autosomal recessive inheritance characterized by palmar-plantar hyperkeratosis and early onset of a severe destructive periodontitis leading to premature loss of both primary and permanent dentitions. Various etiopathogenic factors are associated with the syndrome; but a recent report has suggested that the condition is linked to mutations of the cathepsin C gene. Two cases of Papillon-Lefèvre syndrome in the same family, having all of the characteristic features are presented. An 11-year-old girl, and her elder sister, a 13-year-old girl complained of loose teeth and discomfort in chewing along with recurrently swollen and friable gums. Both patients also had premature shedding of their deciduous teeth. The family history revealed consanguineous marriage of the parents. Both patients presented with persistent thickening, flaking and scaling of the skin of palms and soles. Severe generalized periodontal destruction with mobility of teeth was evident on intraoral examination; orthopantomograph examination showed severe generalized loss of alveolar bone in both the patients.
Collapse
Affiliation(s)
- Fayiza Yaqoob Khan
- Department of Periodontics and Oral Implantology, Government Dental College and Hospital, Srinagar, Jammu and Kashmir, India
| | | | | |
Collapse
|
16
|
Ahmadian L, Monzavi A, Arbabi R, Hashemi HM. Full-Mouth Rehabilitation of an Edentulous Patient with Papillon-Lefèvre Syndrome Using Dental Implants: A Clinical Report. J Prosthodont 2011; 20:643-8. [DOI: 10.1111/j.1532-849x.2011.00768.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
17
|
Korkmaz B, Horwitz MS, Jenne DE, Gauthier F. Neutrophil elastase, proteinase 3, and cathepsin G as therapeutic targets in human diseases. Pharmacol Rev 2011; 62:726-59. [PMID: 21079042 DOI: 10.1124/pr.110.002733] [Citation(s) in RCA: 581] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Polymorphonuclear neutrophils are the first cells recruited to inflammatory sites and form the earliest line of defense against invading microorganisms. Neutrophil elastase, proteinase 3, and cathepsin G are three hematopoietic serine proteases stored in large quantities in neutrophil cytoplasmic azurophilic granules. They act in combination with reactive oxygen species to help degrade engulfed microorganisms inside phagolysosomes. These proteases are also externalized in an active form during neutrophil activation at inflammatory sites, thus contributing to the regulation of inflammatory and immune responses. As multifunctional proteases, they also play a regulatory role in noninfectious inflammatory diseases. Mutations in the ELA2/ELANE gene, encoding neutrophil elastase, are the cause of human congenital neutropenia. Neutrophil membrane-bound proteinase 3 serves as an autoantigen in Wegener granulomatosis, a systemic autoimmune vasculitis. All three proteases are affected by mutations of the gene (CTSC) encoding dipeptidyl peptidase I, a protease required for activation of their proform before storage in cytoplasmic granules. Mutations of CTSC cause Papillon-Lefèvre syndrome. Because of their roles in host defense and disease, elastase, proteinase 3, and cathepsin G are of interest as potential therapeutic targets. In this review, we describe the physicochemical functions of these proteases, toward a goal of better delineating their role in human diseases and identifying new therapeutic strategies based on the modulation of their bioavailability and activity. We also describe how nonhuman primate experimental models could assist with testing the efficacy of proposed therapeutic strategies.
Collapse
Affiliation(s)
- Brice Korkmaz
- INSERM U-618 Protéases et Vectorisation Pulmonaires, Université François Rabelais, Faculté de médecine, 10 Boulevard Tonnellé, Tours, France.
| | | | | | | |
Collapse
|
18
|
Sadik CD, Noack B, Schacher B, Pfeilschifter J, Mühl H, Eickholz P. Cytokine production by leukocytes of Papillon-Lefèvre syndrome patients in whole blood cultures. Clin Oral Investig 2011; 16:591-7. [PMID: 21380503 DOI: 10.1007/s00784-011-0532-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 02/18/2011] [Indexed: 12/18/2022]
Abstract
Papillon-Lefèvre syndrome (PLS) is characterised by aggressively progressive periodontitis combined with palmo-plantar hyperkeratosis. It is caused by "loss of function" mutations in the cathepsin C gene. The hypothesis behind this study is that PLS patients' polymorphonuclear leukocytes (PMNs) produce more proinflammatory cytokines to compensate for their reduced capacity to neutralize leukotoxin and to eliminate Aggregatibacter actinomycetemcomitans. Production of more interleukin (IL)-8 would result in the attraction of more PMNs. The aim of this study was to evaluate the cytokine profile in PLS patients' blood cultures. Blood was sampled from eight PLS patients (one female) from six families (antiinfective therapy completed: six; edentulous: two) with confirmed cathepsin C mutations and deficient enzyme activity. Nine healthy males served as controls. Whole blood cultures were stimulated with highly pure lipopolysaccharide (LPS) from Escherichia coli R515 and IL-1β plus tumor necrosis factor (TNF)-α. Thereafter, release of IL-1β (stimulation: LPS and LPS plus adenosine triphosphate), IL-6, IL-8, interferon-inducible protein (IP)-10, and interferon (IFN)-γ (stimulation: LPS, IL-1β/TNFα) were detected by ELISA. Medians of cytokine release were, with the exception of IP-10, slightly higher for PLS than for controls' cultures. None of these differences reached statistical significance. Increased production of IL-1β, IL-6, IL-8, IP-10, or IFNγ as a significant means to compensate for diminished activity and stability of polymorphonuclear leukocyte-derived proteases could not be confirmed in this study. Cytokine profiles in blood cultures may not be used to identify PLS patients.
Collapse
Affiliation(s)
- Christian D Sadik
- Institute of General Pharmacology and Toxicology, Center for Pharmacology, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | | | | | | | | | | |
Collapse
|
19
|
Rathod VJ, Joshi NV. Papillon-Lefevre syndrome: A report of two cases. J Indian Soc Periodontol 2010; 14:275-8. [PMID: 21731257 PMCID: PMC3118082 DOI: 10.4103/0972-124x.76934] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 12/02/2010] [Indexed: 11/29/2022] Open
Abstract
Papillon-Lefevre syndrome is a rare (1-4 cases per million) autosomal recessive disorder showing predominantly oral and dermatological manifestations in the form of aggressive periodontitis affecting both primary and permanent dentition and palmoplantar hyperkeratosis. Genetic studies have shown that mutations in the major gene locus of chromosome 11q14 with loss of function of cathepsin C gene are responsible for Papillon-Lefevre syndrome. This report presents two siblings with classic signs and symptoms of Papillon-Lefevre syndrome. The exact cause for periodontal destruction in patients with Papillon-Lefevre syndrome is not known but it is thought to be due to defect in neutrophil function, immune suppression and mutations in cathepsin C gene.
Collapse
Affiliation(s)
- Varsha J. Rathod
- Department of Periodontology and Implant Dentistry, Bharati Vidyapeeth University Dental College and Hospital, Navi-Mumbai, Maharashtra, India
| | - Nilesh V. Joshi
- Department of Periodontology and Implant Dentistry, Bharati Vidyapeeth University Dental College and Hospital, Navi-Mumbai, Maharashtra, India
| |
Collapse
|
20
|
Dhanrajani PJ. Papillon-Lefevre syndrome: clinical presentation and a brief review. ACTA ACUST UNITED AC 2009; 108:e1-7. [DOI: 10.1016/j.tripleo.2009.03.016] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2008] [Revised: 03/07/2009] [Accepted: 03/09/2009] [Indexed: 11/16/2022]
|
21
|
Yacoub A, Hattab F. Oral and Dermatologic Findings in Two siblings with Papillon-Lefevre Syndrome: Review of the Literature. Qatar Med J 2008. [DOI: 10.5339/qmj.2008.2.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Papillon-Lefevre syndrome (PLS), first described in 1924, is a rare autosomal recessive disorder characterized by early onset palmoplanter hyperkeratosis and severe generalized destructive periodontitis leading to premature loss of both primary and permanent dentitions. PLS usually manifest itself between the ages of six months to four years, coinciding with the eruption of primary teeth. The proband becomes completely edentulous by the age of 15.
Collapse
Affiliation(s)
- A.A. Yacoub
- *Dental Department, Hamad Medical Corporation
| | | |
Collapse
|
22
|
de Freitas AC, Assed S, da Silva LAB, Silva RAB. Aggressive periodontitis associated with Papillon-Lefèvre syndrome: Report of a 14-year follow-up. SPECIAL CARE IN DENTISTRY 2007; 27:95-100. [PMID: 17658183 DOI: 10.1111/j.1754-4505.2007.tb01747.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This case report describes the periodontal management, therapeutic approach, and 14-year follow-up of a patient diagnosed with Papillon-Lefevre syndrome (PLS). A female child, diagnosed with PLS-associated periodontitis at the age of 9 years and 11 months, presented with hyperkeratosis of the palms and soles, as well as generalized aggressive periodontitis. The dental treatment comprised standard periodontal debridement, scaling and root planing, instructions on oral hygiene, restorations, extraction of hopelessly affected teeth and a therapeutic use of antibiotics. The concomitant supportive periodontal therapy and antibiotic coverage could not stop the loss of periodontal attachment and destruction of the alveolar bone. Four years after treatment was initiated, the last remaining teeth were extracted and complete dentures were constructed. The dentures have been periodically replaced and the patient continues to return for follow-up once a year. The combination of intensive periodontal treatment and antibiotic regimen only temporarily delayed periodontal disease progression and did not prevent loss of both primary and permanent teeth. The outcome of this long-term follow-up case report shows that management of PLS-associated periodontitis is further complicated when the patient is first seen in the mixed dentition stage or later. In these situations, the chances of controlling the progression of periodontal breakdown and minimizing tooth loss are greatly reduced.
Collapse
Affiliation(s)
- Aldevina C de Freitas
- Department of Pediatric Clinics, Preventive and Social Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
| | | | | | | |
Collapse
|
23
|
Schacher B, Baron F, Ludwig B, Valesky E, Noack B, Eickholz P. Periodontal therapy in siblings with Papillon?Lef�vre syndrome and tinea capitis: a report of two cases. J Clin Periodontol 2006; 33:829-36. [PMID: 16970621 DOI: 10.1111/j.1600-051x.2006.00992.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefèvre syndrome (PLS) and tinea capitis. METHODS Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for Actinobacillus actinomycetemcomitans (AA), Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Fusobacterium nucleatum, and Prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment. RESULTS Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to <or=5 mm. AA was not detected in any of the remaining teeth. CONCLUSION Even periodontally affected deciduous teeth of PLS patients can be treated successfully. Suppression of AA to below detection level seems to be of high significance.
Collapse
Affiliation(s)
- B Schacher
- Department of Periodontology, Center for Dental, Oral and Maxilllofacial Medicine, Hospital of the J.W. Goethe-University at Frankfurt, Germany.
| | | | | | | | | | | |
Collapse
|
24
|
Cagli NA, Hakki SS, Dursun R, Toy H, Gokalp A, Ryu OH, Hart PS, Hart TC. Clinical, genetic, and biochemical findings in two siblings with Papillon-Lefèvre Syndrome. J Periodontol 2006; 76:2322-9. [PMID: 16332247 DOI: 10.1902/jop.2005.76.12.2322] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Papillon-Lefèvre Syndrome (PLS) is an autosomal recessive disease characterized by palmoplantar hyperkeratosis and severe periodontitis affecting both primary and secondary dentitions. Cathepsin C (CTSC) gene mutations are etiologic for PLS. The resultant loss of CTSC function is responsible for the severe periodontal destruction seen clinically. METHODS A 4-year-old female (case 1) and her 10-year-old sister (case 2) presented with palmoplantar skin lesions, tooth mobility, and advanced periodontitis. Based on clinical findings, the cases were diagnosed with PLS. Mutational screening of the CTSC gene was conducted for the cases, and their clinically unaffected parents and brother. Biochemical analysis was performed for CTSC, cathepsin G (CTSG), and elastase activity in neutrophils for all members of the nuclear family. The initial treatment included oral hygiene instruction, scaling and root planing, and systemic amoxicillin-metronidazole therapy. RESULTS CTSC mutational screening identified a c.415G>A transition mutation. In the homozygous state, this mutation was associated with an almost complete loss of activity of CTSC, CTSG, and elastase. Although monthly visits, including scaling, polishing, and 0.2% chlorhexidine digluconate irrigation were performed to stabilize the periodontal condition, case 1 lost all her primary teeth. In case 2, some of the permanent teeth could be maintained. CONCLUSIONS This report describes two siblings with a cathepsin C gene mutation that is associated with the inactivity of cathepsin C and several neutrophil serine proteases. The failure of patients to respond to periodontal treatment is discussed in the context of these biological findings.
Collapse
Affiliation(s)
- N Arzu Cagli
- Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Abstract
Papillon-Lefévre syndrome (PLS) is characterized by severe periodontal disease extending to destruction of the alveolar bone surrounding deciduous teeth and palmoplantar hyperkeratosis of the skin. Increased susceptibility to infection has been reported among individuals with the cathepsin C (CTSC) gene mutation. This article reports a 7-year-old Japanese girl who presented with deciduous tooth mobility and was diagnosed as having PLS. Radiographic examination revealed loosening of deciduous incisors and the right second molar of the maxilla, and destruction of the alveolar bone around the residual deciduous dentition. However, there was no destruction of the alveolar bone around the permanent molars. The patient did not show the typical signs of CTSC polymorphism, which almost always negatively impacts certain activating enzymes. With respect to immune function, analysis of the patient's leukocytes indicated that H(2)O(2), chemotactic and phagocytotic functions were within the normal range. However, the special precautions normally applied to prevent infections in PLS patients undergoing dental treatment were taken.
Collapse
Affiliation(s)
- Atsushi Ikeshima
- Department of Radiology, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
| |
Collapse
|
26
|
Hattab FN, Amin WM. Papillon-Lefèvre syndrome with albinism: A review of the literature and report of 2 brothers. ACTA ACUST UNITED AC 2005; 100:709-16. [PMID: 16301152 DOI: 10.1016/j.tripleo.2004.08.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2004] [Revised: 06/23/2004] [Accepted: 08/27/2004] [Indexed: 10/23/2022]
Abstract
BACKGROUND Papillon-Lefèvre syndrome (PLS) is a very rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and severe early onset of destructive periodontitis leading to premature loss of both primary and permanent dentitions. The etiopathogenesis of the condition suggests that there is a genetic basis for susceptibility to specific virulent pathogens. Variation in the clinical presentation of PLS has recently been observed. OBJECTIVE The objective was to present the first report, which describes the concurrence of PLS and albinism. The etiology, pathology, and management of the condition were reviewed and genetic analysis was performed. SUBJECTS AND CLINICAL PRESENTATION: The probands are Jordanian brothers aged 13 and 20 years on their initial presentation. The parents were second cousins and not affected. The patients exhibited the typical clinical features of PLS with type 1 oculocutaneous albinism (OCA1). They also had increased susceptibility to infection manifested in recurrent tonsillitis, respiratory tract infection, pyoderma, onychogryphosis, and other pathosis. Skin biopsy demonstrated hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis. Ectopic calcification of the dura was noticed in one of the probands. Hematological parameters tested were within the normal limits. The probands were tested for mutations in the causative genes of PLS and OCA1, cathepsin C (CTSC), and tyrosinase, respectively. Independent mutations (c.318-1G>A and c.817G>C/p.W272C) were identified in CTSC and tyrosinase, respectively. The probands were homozygous and their sister who had only PLS was homozygous for the same (CTSC) mutation but heterozygous for tyrosinase gene. CONCLUSION We hope that this report of coinheritance PLS and albinism will initiate further investigations to disclose other possible variations that may enhance our knowledge on gene mutations of this intriguing syndrome.
Collapse
|
27
|
Lundgren T, Renvert S. Periodontal treatment of patients with Papillon-Lefevre syndrome: a 3-year follow-up. J Clin Periodontol 2004; 31:933-8. [PMID: 15491306 DOI: 10.1111/j.1600-051x.2004.00591.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Conventional mechanical periodontal treatment of Papillon-Lefevre syndrome (PLS) has often been reported to fail. This study describes the outcome of a non-surgical periodontal therapy including antimicrobial treatment of nine patients diagnosed with PLS. The patients originate from a total of 15 children and adolescents with PLS for which clinical characteristics are presented. METHODS Clinical examination including conventional periodontal measurements. Initial treatment including oral hygiene instruction, scaling and root planing and systemic amoxicillin-metronidazole therapy for 6 weeks. After that the patients were enrolled in a 3-month recall maintenance program. In addition to this mechanical supportive maintenance treatment, tetracycline was prescribed and used continuously for 1.5 years. RESULTS/CONCLUSION On five patients who were showing acceptable standard of oral hygiene and also compliance with the antibiotic medication, development of periodontitis on erupting teeth was prevented and disease activity on the previously periodontally involved teeth controlled during a 3-year period. Poor results of treatment were observed for three patients, all siblings. These patients failed to comply with the medication and also failed to improve their oral hygiene.
Collapse
Affiliation(s)
- T Lundgren
- Department of Periodontics, Loma Linda University, California 92354, USA.
| | | |
Collapse
|
28
|
Pilger U, Hennies HC, Truschnegg A, Aberer E. Late-onset Papillon-Lefèvre syndrome without alteration of the cathepsin C gene. J Am Acad Dermatol 2003; 49:S240-3. [PMID: 14576640 DOI: 10.1016/s0190-9622(03)01558-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mutations in the cathepsin C gene have recently been detected in Papillon-Lefèvre syndrome (PLS). Until now, 5 cases with the late-onset variation of this disease have been reported in the literature. The genetic background of this type of PLS is still unknown. We describe a 46-year-old woman with late-onset transgredient palmar hyperkeratosis and a 10-year history of severe periodontal disease. Histology of skin biopsy specimens revealed a psoriasiform pattern. Dental examination showed severe gingival inflammation with loss of alveolar bone. Dental plaque investigated by a polymerase chain reaction method revealed DNA signals of 5 different dental bacteria. DNA from EDTA blood was investigated for mutations in the cathepsin C gene by polymerase chain reaction analysis and direct sequencing. A silent variation in the codon for proline-459 was detected but interpreted as a polymorphism of this gene. All genetic linkage and mutation studies for PLS performed so far have shown that PLS is genetically homogeneous. Our patient with late-onset variation of PLS, however, did not show a mutation in the cathepsin C gene. Thus, we suspect that there is another genetic cause for the late-onset forms of PLS.
Collapse
Affiliation(s)
- Ulrike Pilger
- Department of Dermatology, Karl-Franzens University, Graz, Austria
| | | | | | | |
Collapse
|
29
|
Ullbro C, Crossner CG, Nederfors T, Alfadley A, Thestrup-Pedersen K. Dermatologic and oral findings in a cohort of 47 patients with Papillon-Lefèvre syndrome. J Am Acad Dermatol 2003; 48:345-51. [PMID: 12637913 DOI: 10.1067/mjd.2003.197] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Papillon-Lefèvre syndrome is an autosomal recessive disorder characterized by palmoplantar hyperkeratosis and early development of aggressive periodontal infection. The aims of this study were to rank the severity of dermatologic and oral affections using a semiquantitative scoring system, and to evaluate whether the severity of the dermatologic changes were correlated to age, degree of periodontal infection, or both. The study included 47 patients with Papillon-Lefèvre syndrome. With no exception both skin and oral changes developed early in life. The dermatologic involvement showed no correlation with age, whereas the periodontal infection was significantly worse in young children with deciduous teeth. A strong correlation was found between the condition of feet and hands, although the scores for the feet were significantly higher. No significant correlation could be demonstrated between the level of periodontal infection and severity of skin affections, supporting the concept that these 2 major components of Papillon-Lefèvre syndrome are unrelated to each other.
Collapse
Affiliation(s)
- Christer Ullbro
- Department of Dentistry, Section of Dermatology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | | | | | | | | |
Collapse
|
30
|
Almuneef M, Al Khenaizan S, Al Ajaji S, Al-Anazi A. Pyogenic liver abscess and Papillon-Lefèvre syndrome: not a rare association. Pediatrics 2003; 111:e85-8. [PMID: 12509601 DOI: 10.1542/peds.111.1.e85] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Papillon-Lefèvre syndrome is a rare, autosomal recessive disease comprising palmoplantar keratoderma and periodontitis. Pyogenic liver abscess is an increasingly recognized complication. We report a new case of this association and review the current literature.
Collapse
Affiliation(s)
- Maha Almuneef
- Department of Pediatrics, King Abdulaziz Medical City, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
| | | | | | | |
Collapse
|
31
|
Abstract
Papillon-Lefévre syndrome is a rare autosomal recessive disease comprising palmoplantar keratoderma and periodontitis. Palmoplantar keratoderma can be severe, necessitating systemic treatment. Different systemic retinoids were found to be highly efficacious. We describe the successful use of acitretin in one patient who had severe palmoplantar keratoderma, with maintenance of the improvement using topical treatment.
Collapse
Affiliation(s)
- Sultan Al-Khenaizan
- Division Of Dermatology/Department of Medicine, King Abdulaziz Medical City, King Fahad National Guard Hospital, Saudi Arabia.
| |
Collapse
|
32
|
Abstract
We report the first diagnosed case of Papillon-Lefevre syndrome in Thailand. The patient is the youngest child of consanguinous parents, and she has had symmetrical hyperkeratotic plaques on both plantar surfaces since birth with a history of chronic gingivitis, periodontitis, and premature loss of primary dentition. The histologic study revealed compact hyperkeratosis with epidermal acanthosis. Radiologic studies of the skull were normal. The radiographic panoramic view of the oral cavity revealed generalized severe vertical and horizontal alveolar bone loss. The immunologic analysis of polymorphonuclear leukocyte phagocytic function by nitrobluetetrazolium test (NBT test) showed decreasing response to latex stimulation. Serum parathyroid hormone, calcium, phosphate, and alkaline phosphatase levels were within normal limits. The skin lesions were temporary relieved with topical keratolytic agents. The oral lesions were improved by the extraction of hopeless teeth and conventional periodontal treatments.
Collapse
|
33
|
Cury VF, Costa JE, Gomez RS, Boson WL, Loures CG, De ML. A novel mutation of the cathepsin C gene in Papillon-Lefèvre syndrome. J Periodontol 2002; 73:307-12. [PMID: 11922261 DOI: 10.1902/jop.2002.73.3.307] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Papillon-Lefèvre syndrome (PLS) is a disorder that involves destruction of the periodontium and abnormal hyperkeratosis of the palms of the hands and soles of the feet. Mutations of the lysosomal protease cathepsin C gene (CTSC) have been associated with PLS. However, genotypic and phenotypic correlation has not been established. In the present study we investigated the CTSC gene in a Brazilian cohort affected by PLS. METHODS Eight consanguineous members of a kindred with PLS were studied. DNA was extracted and all exons of the gene amplified by the polymerase chain reaction (PCR) using specific primers. Mutations were identified by DNA sequencing of the coding region and introns of the CTSC gene. RESULTS Sequence analysis of CTSC from subjects affected by PLS identified a novel mutation (587T --> C) in exon 4, predicted to cause a Leu196Pro amino acid substitution. Three of 3 subjects were homozygous for cathepsin C mutations inherited from a common ancestor. One patient was heterozygous and showed plantar hyperkeratosis without periodontal disease. Two other family members were also heterozygous but did not present palmoplantar hyperkeratosis and/or periodontal disease. CONCLUSIONS This study describes a novel mutation of the cathepsin C gene in a Brazilian kindred with Papillon-Lefèvre syndrome.
Collapse
Affiliation(s)
- Vanessa F Cury
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | | | | |
Collapse
|
34
|
Clerehugh V, Tugnait A. Diagnosis and management of periodontal diseases in children and adolescents. Periodontol 2000 2001; 26:146-68. [PMID: 11452903 DOI: 10.1034/j.1600-0757.2001.2260108.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- V Clerehugh
- Department of Periodontology, Leeds Dental Institute, Leeds, England, United Kingdom
| | | |
Collapse
|
35
|
Robertson KL, Drucker DB, James J, Blinkhorn AS, Hamlet S, Bird PS. A microbiological study of Papillon-Lefévre syndrome in two patients. J Clin Pathol 2001; 54:371-6. [PMID: 11328836 PMCID: PMC1731428 DOI: 10.1136/jcp.54.5.371] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To analyse the microflora of subgingival plaque from patients with Papillon-Lefévre syndrome (PLS), which is a very rare disease characterised by palmar-plantar hyperkeratosis with precocious periodontal destruction. METHODS Bacterial isolates were identified using a combination of commercial identification kits, traditional laboratory tests, and gas liquid chromatography. Some isolates were also subjected to partial 16S rDNA sequencing. Plaque samples were also assayed for the presence of Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans in a quantitative enzyme linked immunosorbent assay (ELISA) using monoclonal antibodies. RESULTS The culture results showed that most isolates were capnophilic and facultatively anaerobic species-mainly Capnocytophaga spp and Streptococcus spp. The latter included S. constellatus, S. oralis, and S. sanguis. Other facultative bacteria belonged to the genera gemella, kingella, leuconostoc, and stomatococcus. The aerobic bacteria isolated were species of neisseria and bacillus. Anaerobic species included Prevotella intermedia, P. melaninogenica, and P. nigrescens, as well as Peptostreptococcus spp. ELISA detected P gingivalis in one patient in all sites sampled, whereas A. actinomycetemcomitans was detected in only one site from the other patient. Prevotella intermedia was present in low numbers. CONCLUSIONS Patients with PLS have a very complex subgingival flora including recognised periodontal pathogens. However, no particular periodontopathogen is invariably associated with PLS.
Collapse
Affiliation(s)
- K L Robertson
- Oral Microbiology Laboratory, University of Manchester Dental School, Higher Cambridge Street, Manchester M15 6FH, UK
| | | | | | | | | | | |
Collapse
|
36
|
Wang H, Zhao S, Zhao W, Feng G, Jiang S, Liu W, Li S, Xue H, He L. Congenital absence of permanent teeth in a six-generation Chinese kindred. ACTA ACUST UNITED AC 2000. [DOI: 10.1002/(sici)1096-8628(20000131)90:3<193::aid-ajmg3>3.0.co;2-r] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
37
|
Ghaffer KA, Zahran FM, Fahmy HM, Brown RS. Papillon-Lefèvre syndrome: neutrophil function in 15 cases fron 4 families in Egypt. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1999; 88:320-5. [PMID: 10503862 DOI: 10.1016/s1079-2104(99)70036-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The primary purpose of this study was to investigate the periodontal pathologic cause of Papillon-Lefèvre syndrome by comparing, with respect to neutrophil function, probands with Papillon-Lefèvre syndrome from 4 families in Egypt, unaffected siblings of the probands, and age-matched and gender-matched control subjects. STUDY DESIGN Family histories and clinical dermal and oral manifestations of Papillon-Lefèvre syndrome were evaluated for 15 affected members of 4 families with the syndrome, 10 siblings of the probands, and 7 age-matched and gender-matched controls. Phagocytic and intracellular killing (lytic activity) of polymorphonuclear neutrophils was evaluated for all subjects according to a modification of the method of Wilkinson; opsonization was evaluated according to a modification of the methods of Cutler et al. Data were analyzed by means of analysis of variance. RESULTS Family pedigrees were plotted, and consanguinity was noted in 3 of the 4 families with Papillon-Lefèvre syndrome. The means and SDs for phagocytic killing, lytic activity, and opsonization indices were as follows: probands, 4.76+/-1.99, 0.42+/-0.20, and 0.84+/-0.07; unaffected siblings, 10.4+/-1.3, 3.3+/-0.3, and 0.84+/-0.07; controls, 10.8+/-0.8, 3.5+/-0.6, and 0.85+/-0.05. The phagocytic killing and lytic activity indices demonstrated significance between the probands and both siblings and controls (P<.0005), whereas the opsonization index did not demonstrate significance between groups. CONCLUSIONS Significantly decreased neutrophil function in probands with Papillon-Lefèvre syndrome was demonstrated with respect to neutrophil phagocytotic and lytic activity but not with respect to opsonization. Therefore, specific neutrophil dysfunction appears to be etiologically involved in this disorder.
Collapse
Affiliation(s)
- K A Ghaffer
- Oral Medicine & Periodontology Department, Faculty of Oral & Dental Medicine, Cairo University, Egypt
| | | | | | | |
Collapse
|
38
|
Novo E, Garcia-MacGregor E, Viera N, Chaparro N, Crozzoli Y. Periodontitis and anti-neutrophil cytoplasmic antibodies in systemic lupus erythematosus and rheumatoid arthritis: a comparative study. J Periodontol 1999; 70:185-8. [PMID: 10102556 DOI: 10.1902/jop.1999.70.2.185] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This investigation was designed to determine and compare the distribution pattern of anti-neutrophil cytoplasmic antibodies (ANCA) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in the presence or absence of periodontal disease. METHODS Sera of 30 patients with SLE and 30 with RA were tested for ANCA utilizing an indirect enzyme immunosorbent assay (ELISA) directed to a neutrophil granular extract and 6 neutrophil granule proteins. A control group of 20 healthy individuals showing neither evidence of periodontal disease nor systemic compromise was also included in this study. RESULTS For RA, the number of ANCA-positive sera was very low but was evenly distributed among patients with and without periodontitis. Conversely, a high number of ANCA-positive sera in SLE was found mostly in individuals presenting periodontal compromise. A statistically significant association between ANCA and periodontitis in SLE patients was found (P <0.005, chi square test). CONCLUSIONS A marked difference in the number and distribution of ANCA with respect to periodontitis between RA and SLE was found. Hyperresponsiveness of B cells and polyclonal B activation to periodontopathic bacteria in SLE might be accountable for the high numbers of ANCA and the close association observed between those autoantibodies and periodontitis in SLE.
Collapse
Affiliation(s)
- E Novo
- Immunobiology Laboratory, Dental Research Institute, School of Dentistry, Universidad del Zulia, Maracaibo, Venezuela.
| | | | | | | | | |
Collapse
|
39
|
Porter SR. Gingival and periodontal aspects of diseases of the blood and blood-forming organs and malignancy. Periodontol 2000 1998; 18:102-10. [PMID: 10200716 DOI: 10.1111/j.1600-0757.1998.tb00142.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
40
|
|
41
|
Abstract
This paper reviews past and present applications of quantitative and molecular genetics to dental disorders. Examples are given relating to craniofacial development (including malocclusion), oral supporting tissues (including periodontal diseases) and dental hard tissues (including defects of enamel and dentine as well as dental caries). Future developments and applications to clinical dentistry are discussed. Early investigations confirmed genetic bases to dental caries, periodontal diseases and malocclusion, but research findings have had little impact on clinical practice. The complex multifactorial aetiologies of these conditions, together with methodological problems, have limited progress until recently. Present studies are clarifying previously unrecognized genetic and phenotypic heterogeneities and attempting to unravel the complex interactions between genes and environment by applying new statistical modelling approaches to twin and family data. Linkage studies using highly polymorphic DNA markers are providing a means of locating candidate genes, including quantitative trait loci (QTL). In future, as knowledge increases; it should be possible to implement preventive strategies for those genetically-predisposed individuals who are identified to be at risk.
Collapse
|
42
|
Firatli E, Gürel N, Efeoglu A, Badur S. Clinical and immunological findings in 2 siblings with Papillon-Lefèvre syndrome. J Periodontol 1996; 67:1210-5. [PMID: 8959572 DOI: 10.1902/jop.1996.67.11.1210] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Rapid and severe destruction of periodontal tissues in early childhood has been reported both in systemically healthy children and in children with systemic disorders. In this study, the clinical and immunological findings of two siblings in a family with Papillon-Lefèvre syndrome are presented. The peripheral blood lymphocytes were analyzed using a double colored flow cytometry and adequate monoclonal antibodies to CD2, CD3, CD4, CD5, CD8, CD11b, CD16, CD19, and HLA-DR receptors. CD11b expression was found to be higher in both siblings (35% and 37%). The elevated CD11b expression may be related to a defect in neutrophils. The expression of natural killer cells was found to be higher in one patient but the results were in normal range. The CD2+, CD3+, CD4+, CD5+, CD8+, and CD19+ lymphocytes were in normal range in both patients. We think that the depressed chemotaxis of peripheral neutrophils, and higher expression of HLA-DR and CD11b molecules in peripheral leukocytes were useful in explaining the pathogenesis of the Papillon-Lefèvre syndrome.
Collapse
Affiliation(s)
- E Firatli
- Department of Periodontology, School of Dentistry, University of Istanbul, Turkey
| | | | | | | |
Collapse
|
43
|
Abstract
Papillon-lefèvre syndrome (PLS) is described as the association of palmar-plantar hyperkeratosis with precocious periodontal disease which results in exfoliation of primary and permanent dentitions. This study was planned to assess the chemotaxis of peripheral blood neutrophils in 7 patients (3 females and 4 males) with Papillon-Lefevre syndrome. The neutrophil chemotaxis was analyzed using the zymosan activated serum (ZAS) assay. Chemotaxis and spontaneous migration measurements were compared to those of the healthy control subjects. The peripheral blood neutrophil chemotaxis and spontaneous migration were depressed in all patients with Papillon-Lefèvre syndrome. The decreased chemotaxis of peripheral blood neutrophils strongly suggests that the neutrophils may act as one of the important key determinants in the pathogenesis of severe periodontal destruction in patients with PLS.
Collapse
Affiliation(s)
- E Firatli
- Department of Periodontology, School of Dentistry, University of Istanbul, Turkey
| | | | | |
Collapse
|