1
|
Porro AM, Arai Seque C, Miyamoto D, Vanderlei Medeiros da Nóbrega D, Simões E Silva Enokihara MM, Giuli Santi C. Hailey-Hailey disease: clinical, diagnostic and therapeutic update. An Bras Dermatol 2024; 99:651-661. [PMID: 38789364 DOI: 10.1016/j.abd.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 05/26/2024] Open
Abstract
Hailey-Hailey disease is a rare genodermatosis described in 1939, with an autosomal dominant inheritance pattern, characterized by compromised adhesion between epidermal keratinocytes. It has an estimated prevalence of 1/50,000, with no gender or race predilection. It results from a heterozygous mutation in the ATP2C1 gene, which encodes the transmembrane protein hSPA1C, present in all tissues, with preferential expression in keratinocytes. Mutations in the ATP2C1 gene cause changes in the synthesis of junctional proteins, leading to acantholysis. It usually begins in adulthood, with isolated cases at the extremes of life. It manifests as vesico-bullous lesions mainly in the flexural areas, which develop into erosions and crusts. Chronic lesions may form vegetative or verrucous plaques. Pruritus, a burning feeling and pain are common. It evolves with periods of remission and exacerbation, generally triggered by humidity, friction, heat, trauma and secondary infections. The diagnosis is based on clinical and histopathological criteria: marked suprabasal acantholysis, loosely joined keratinocytes, giving the appearance of a "dilapidated brick wall", with a few dyskeratotic cells. The acantholysis affects the epidermis and spares the adnexal epithelia, which helps in the differential diagnosis with pemphigus vulgaris. Direct immunofluorescence is negative. The main differential diagnoses are Darier disease, pemphigus vegetans, intertrigo, contact dermatitis, and inverse psoriasis. There is no cure and the treatment is challenging, including measures to control heat, sweat and friction, topical medications (corticosteroids, calcineurin inhibitors, antibiotics), systemic medications (antibiotics, corticosteroids, immunosuppressants, retinoids and immunobiologicals) and procedures such as botulinum toxin, laser and surgery. There is a lack of controlled clinical trials to support the choice of the best treatment.
Collapse
Affiliation(s)
- Adriana Maria Porro
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Camila Arai Seque
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Denise Miyamoto
- Department of Dermatology, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Claudia Giuli Santi
- Department of Dermatology, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
2
|
Ahuja R, Jain A, Gupta S. Long-Term Surgical Outcomes of Superficial Radiofrequency Ablation of Recalcitrant Hailey-Hailey Disease Affecting the Groin. Dermatol Surg 2024; 50:685-686. [PMID: 38512044 DOI: 10.1097/dss.0000000000004166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Affiliation(s)
- Rhea Ahuja
- All authors are affiliated with the Department of Dermatology and Venereology , AIIMS , New Delhi, India
| | | | | |
Collapse
|
3
|
Gabdrafike Z, Blazeviciute M, Janonyte U, Makstiene J, Valiukeviciene S. A case report of Hailey-Hailey disease treated with fractional carbon dioxide laser. Dermatol Reports 2023; 15:9658. [PMID: 37860724 PMCID: PMC10582650 DOI: 10.4081/dr.2023.9658] [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: 12/27/2022] [Accepted: 01/10/2023] [Indexed: 10/21/2023] Open
Abstract
Hailey-Hailey disease (HHD), or familial benign pemphigus, is a rare genetic condition characterized by recurrent blisters and erosions with a predilection for intertriginous areas. There is no specific treatment for HHD. Topical and systemic treatments tend to provide temporary remission. Alternative treatment (surgical interventions such as dermabrasion, excision, and laser) has been shown to prolong remission. Considering the risk of complications associated with surgical modalities, laser is often preferred as an alternative for patients failing to respond to first-line therapies. We report a case of recalcitrant HHD successfully treated with a fractional ablative CO2 laser procedure (wavelength of 10600 nm, power of 7-10 W, 2-3 passes) on a 35-year-old female. The patient has a 7-year history of therapy-resistant HHD. A 2-month followup showed substantially resolved lesions, with mild erythema and post-inflammatory hyperpigmentation in treated areas.
Collapse
Affiliation(s)
- Zivile Gabdrafike
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Medicine Academy, Kaunas
- Department of Skin and Venereal Diseases, Hospital of the Lithuanian University of Health Sciences, Kauno Klinikos, Kaunas
| | - Monika Blazeviciute
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Medicine Academy, Kaunas
- Department of Skin and Venereal Diseases, Hospital of the Lithuanian University of Health Sciences, Kauno Klinikos, Kaunas
| | - Ugne Janonyte
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Medicine Academy, Kaunas
| | - Jurgita Makstiene
- Department of Pathology, Hospital of the Lithuanian University of Health Sciences, Kauno Klinikos, Kaunas, Lithuania
| | - Skaidra Valiukeviciene
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Medicine Academy, Kaunas
- Department of Skin and Venereal Diseases, Hospital of the Lithuanian University of Health Sciences, Kauno Klinikos, Kaunas
| |
Collapse
|
4
|
Saleem HA, Al-Natour O, Mahfouz IA, Assamen MA, Al-Natour S. Necrotizing fasciitis following episiotomy in a woman with Hailey-Hailey disease: A case report. Case Rep Womens Health 2022; 36:e00461. [DOI: 10.1016/j.crwh.2022.e00461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022] Open
|
5
|
Abstract
Hailey-Hailey disease is a rare blistering dermatosis first described in 1939 by the brothers Howard and Hugh Hailey. Its incidence is estimated at 1/50,000. The inheritance is autosomal dominant with complete penetrance, but a variable expressivity in affected family members. Clinically, Hailey-Hailey disease presents between the third and fourth decade as flaccid vesicles and blisters on erythematous skin, giving rise to erosions, fissures, and vegetations. Maceration and superinfections are frequent. The lesions are typically distributed symmetrically within intertriginous regions such as the retroauricular folds, lateral aspects of the neck, axillae, umbilicus, inguinal, and perianal regions. The disease is characterized by a chronic relapsing course with spontaneous remissions and multiple recurrences. Severe disease can be very frustrating and have a major psychological and social impact. Given the dearth of evidence-based guidelines and large clinical trials, the assessment of the efficacy and safety of treatments is difficult. Treatments include topical and systemic agents, and procedural therapy such as lasers and surgery. This review provides a systematic search of the literature with a focus on classical and emerging treatment options for Hailey-Hailey disease.
Collapse
|
6
|
Fransen F, Tio DCKS, Prinsen CAC, Haedersdal M, Hedelund L, Laubach HJ, Marini L, Paasch U, Passeron T, Wolkerstorfer A. A systematic review of outcome reporting in laser treatments for dermatological diseases. J Eur Acad Dermatol Venereol 2019; 34:47-53. [PMID: 31469447 DOI: 10.1111/jdv.15928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 08/14/2019] [Indexed: 11/30/2022]
Abstract
The standardization of outcome reporting is crucial for interpretation and comparison of studies related to laser treatment of skin disorders. In collaboration with the Cochrane Skin-Core Outcome Set Initiative (CS-COUSIN), a procedure has been proposed to find consensus on the most important generic outcome domains (what to measure) for implementation in the international Laser TrEAtment in Dermatology (LEAD) registry. As the first step in the development of a generic outcome set for the LEAD registry, we undertook a systematic review to identify outcomes, outcome measurement instruments, methods and definitions reported in recently published literature of laser treatments for skin disorders. A systematic search was conducted and generated a total of 707 papers. We assessed 150 studies including all types of studies involving laser treatments for the skin. Two researchers independently extracted the type, definition and frequency of all outcomes and used outcome measurement instruments. We identified 105 verbatim outcomes that were categorized into eight domains recommended by the COMET framework: appearance, long-term effects, physician and patient-reported physical signs, satisfaction, health-related quality of life, psychological functioning and adverse events. Heterogeneity in outcome reporting (e.g. categories and outcome measurement instruments) was high, and definitions were insufficiently reported. There was a clear under representation of life impact domains, including satisfaction (23%) quality of life (3%) and psychological functioning (1%). Outcome reporting concerning laser treatments for the skin is heterogeneous. Standardized outcomes are needed for improving evidence synthesis. Results of this review will be used in the next step to reach consensus between stakeholders on the outcome domains to be implemented in the LEAD registry.
Collapse
Affiliation(s)
- F Fransen
- Department of Dermatology, Amsterdam UMC, Amsterdam, The Netherlands
| | - D C K S Tio
- Department of Dermatology, Amsterdam UMC, Amsterdam, The Netherlands
| | - C A C Prinsen
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - M Haedersdal
- Massachusetts General Hospital, Harvard Medical School Boston, Boston, MA, USA.,Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - L Hedelund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - H J Laubach
- Department of Dermatology and Venereology, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - L Marini
- SDC - The Skin Doctors' Center, Trieste, Italy
| | - U Paasch
- Department of Dermatology, Venereology and Allergy, University of Leipzig, Leipzig, Germany
| | - T Passeron
- Department of Dermatology, University of Côte d'Azur, University Hospital Nice, Nice, France.,Centre Méditéranéen de Médecine Moléculaire (C3M), INSERM U1065, team 12, University of Côte d'Azur, Nice, France
| | - A Wolkerstorfer
- Department of Dermatology, Amsterdam UMC, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Abaca M, Flores L, Parra V. Narrowband UV-B Phototherapy in the Treatment of Generalized Hailey-Hailey Disease. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
8
|
Tratamiento de la enfermedad de Hailey-Hailey generalizada con fototerapia UVB de banda estrecha. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:924-927. [DOI: 10.1016/j.ad.2017.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/28/2017] [Accepted: 11/05/2017] [Indexed: 11/19/2022] Open
|
9
|
Leung N, Cardones AR, Larrier N. Long-term improvement of recalcitrant Hailey-Hailey disease with electron beam radiation therapy: Case report and review. Pract Radiat Oncol 2018; 8:e259-e261. [DOI: 10.1016/j.prro.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/13/2018] [Accepted: 02/21/2018] [Indexed: 12/01/2022]
|
10
|
Interventional treatments for Hailey–Hailey disease. J Am Acad Dermatol 2017; 76:551-558.e3. [DOI: 10.1016/j.jaad.2016.08.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/14/2016] [Accepted: 08/18/2016] [Indexed: 11/18/2022]
|
11
|
Affiliation(s)
- Nidhi Yadav
- Department of Dermatology, Venereology and Leprosy, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Sumit Kar
- Department of Dermatology, Venereology and Leprosy, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Kameshwar Prasad
- Department of Dermatology, Venereology and Leprosy, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Nitin Gangane
- Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| |
Collapse
|
12
|
Campuzano-García AE, Torres-Alvarez B, Hernández-Blanco D, Castanedo-Cázares JP. Hailey–Hailey disease improved by fractional CO2laser. J COSMET LASER THER 2015; 17:213-5. [DOI: 10.3109/14764172.2015.1007063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|