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Hong EJ, Yoon HJ, Lee SH, Park YL, Lee S. A Case of Generalized Xerotic Eczema in a Patient with Congenital Insensitivity to Pain with Anhidrosis. Ann Dermatol 2023; 35:S191-S194. [PMID: 38061701 PMCID: PMC10727887 DOI: 10.5021/ad.21.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/07/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2023] Open
Abstract
Congenital insensitivity to pain with anhidrosis (CIPA) is an extremely rare disease characterized by insensitivity to pain, anhidrosis, and intellectual disability. CIPA is caused by a genetic mutation in the neurotrophic tyrosine receptor kinase 1 (NTRK1) gene on chromosome 1. The anhidrosis leads to cutaneous changes such as skin dryness, lichenification, and impetiginization. Moreover, patients with CIPA may experience repeated trauma and recalcitrant eczema due to excessive scratching of wounds on their skin, because they do not feel any pain. Severe whole-body eczema in a patient with CIPA may be overlooked, leading these patients to be frequently diagnosed with atopic dermatitis and common eczema. Indeed, in patients with treatment-resistant or atypically distributed eczema and underlying anhidrosis, CIPA should be considered as a potential causative disease. Increased awareness of CIPA among dermatologists is necessary to ensure that patients receive an appropriate diagnosis. Herein, we report a rare case of generalized xerotic eczema in a patient with CIPA.
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Affiliation(s)
- Eun Ji Hong
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hee Jung Yoon
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sul Hee Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - SangHoon Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
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Zhang M, Hong Y, Wu W, Li N, Liu B, Sun J, Cao X, Ye T, Zhou L, Liu C, Yang C, Zhang X. Pivotal role of the gut microbiota in congenital insensitivity to pain with anhidrosis. Psychopharmacology (Berl) 2021; 238:3131-3142. [PMID: 34341834 DOI: 10.1007/s00213-021-05930-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/06/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Increasing evidence has shown that the occurrence and development of various human diseases are closely related to the gut microbiota. We compared the gut microbial communities of human subjects with congenital insensitivity to pain with anhidrosis (CIPA) and healthy controls (HCs) to assess whether fecal microbiota transplantation (FMT) into germ-free mice and mice in acute pain influenced the behaviors of the host. METHODS We utilized 16 s rRNA analysis to compare the gut microbial communities of CIPA subjects and HCs and assessed whether FMT into germ-free mice and mice in acute pain influenced the behaviors of the host. RESULTS In a 16 s RNA analysis, the CIPA group had significant decreases in the relative abundance of 11 bacteria, whereas 7 bacteria were significantly increased. In further animal experiments, the transplantation of fecal samples from CIPA patients to healthy mice significantly increased their scores on both the mechanical withdrawal test and the tail flick test; in an acute plantar incision model, scores were also significantly increased on the mechanical withdrawal test at 4 and 5 days after the operation. Moreover, pseudo-germ-free mice receiving fecal bacteria from patients with CIPA took significantly longer to escape and had a significantly longer path length on training days 1, 2, and 5 and also had fewer platform crossings and spent less time in the target quadrant in the probe trial. CONCLUSIONS Our results suggest that the gut microbiota in CIPA subjects plays a key role in behaviors. Therapeutic strategies for improving the gut microbiota might alleviate CIPA symptoms.
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Affiliation(s)
- Mi Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yishun Hong
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wenyao Wu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ningbo Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Baowen Liu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jiaoli Sun
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xueqin Cao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ting Ye
- Department of Clinical Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ling Zhou
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Cunming Liu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Chun Yang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Xianwei Zhang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Navya MK, Pramod GV, Sujatha GP, Ashok L. Congenital insensitivity to pain in a 1-year-old boy. J Indian Soc Pedod Prev Dent 2019; 37:308-310. [PMID: 31584034 DOI: 10.4103/jisppd.jisppd_340_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Congenital insensitivity to pain (CIP) is a rare autosomal recessive genetic condition which causes reduced pain sensation, thermal sensation, and habit of self-mutilation. It is a life-threatening condition where due to reduced pain sensation, patient might not understand the severity of the injury which can eventually lead to death. Such people live a compromised life and can also affect them psychologically. Here, we are reporting a case of an infant with clinical features suggestive of CIP with a mutation in exon 5 of PRDM12 gene. The child has minimal response to pain along with self-mutilation and mental retardation.
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Affiliation(s)
- M K Navya
- Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - G V Pramod
- Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - G P Sujatha
- Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - L Ashok
- Department of Oral Medicine and Radiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Xue XM, Liu YQ, Pang P, Sun CF. Congenital Loss of Permanent Teeth in a Patient With Congenital Insensitivity to Pain With Anhidrosis due to 2 Novel Mutations in the NTRK1 Gene. J Oral Maxillofac Surg 2018; 76:2582.e1-2582.e9. [DOI: 10.1016/j.joms.2018.06.170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 01/24/2023]
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Varma AV, McBride L, Marble M, Tilton A. Congenital insensitivity to pain and anhidrosis: Case report and review of findings along neuro-immune axis in the disorder. J Neurol Sci 2016; 370:201-210. [DOI: 10.1016/j.jns.2016.09.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/30/2016] [Accepted: 09/20/2016] [Indexed: 12/19/2022]
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Eregowda NI, Yadav S, Parameshwarappa P, Basavraj RK. A Girl with No Pain: Congenital Insensitivity To Pain and Anhidrosis (HSAN) Type IV - A Case Report. J Clin Diagn Res 2016; 10:ZL01-2. [PMID: 27042602 DOI: 10.7860/jcdr/2016/16514.7317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/27/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Neena Indavara Eregowda
- Reader, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences , Pavilion Road, Davangere, Karnataka, India
| | - Sneha Yadav
- Post Graduate Student, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences , Pavilion Road, Davangere, Karnataka, India
| | - Poornima Parameshwarappa
- Professor and Head of Department, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences , Pavilion Road, Davangere, Karnataka, India
| | - Roopa Korishettar Basavraj
- Reader, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences , Pavilion Road, Davangere, Karnataka, India
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