Xeroderma pigmentosum and its dental implications

Xeroderma pigmentosum variant: squamous cell carcinoma of the lower lip harboring exon 11 mutation of POLH

Xeroderma pigmentosum (XP) is a rare inherited disease caused by deficiencies in DNA damage repair, which mainly results from the failure of nucleotide excision repair or defects in translesion DNA synthesis. The development of multiple malignancies is one of the most prominent features of this condition, which is clinically characterized by the occurrence of hyperpigmentation and lesions associated with sunlight exposure. Lip squamous cell carcinoma in patients with XP has rarely been reported, and information regarding the genetic analysis of these patients is limited. In this report, a case of a 20-year-old patient who developed squamous cell carcinoma in the lower lip is described. Although the tumor was surgically excised, the patient presented with recurrence a few months later. Targeted sequencing using a customized panel of DNA repair genes revealed a mutation in POLH, the gene encoding DNA polymerase eta. Therefore, molecular characterization is important to further improve the understanding of possible phenotype-genotype correlations and mechanisms involved in the pathogenesis of XP.

Ultrasonographic Evaluation of Maxillofacial Swelling in a Pediatric Patient with Xeroderma Pigmentosum

Background/Aim: Xeroderma pigmentosum (XP) is an autosomal recessive skin disease. Affected patients have skin problems, oral mucosa and neurologic symptoms. In these patients, erythematous, hyperpigmented or malignant skin lesions may occur in the sun-exposed areas. Leukoplakia, erythroplakia, and squamous cell carcinoma of the tip of the tongue and lips are common oral lesions associated with XP.

Case report: Treatment of the disease included protection from ultraviolet radiation, topical application to treat actinic keratitis, and multidisciplinary approaches by physicians.

Conclusions: Even though USG in dentistry is not very common, it is a non-invasive, cost-effective, readily available and repeatable diagnostic imaging method. Thus, USG should take place as a routine diagnostic tool in dentistry, especially for patients who are medically compromised.

Unusual intraoral cancer with unexpected outcome in a patient with xeroderma pigmentosum: An alert for antineoplastic treatment

Xeroderma pigmentosum (XP) is a rare autosomal disorder characterized by extreme sensitivity to ultraviolet radiation. DNA repair mechanisms are impaired, and minimal sun exposure can lead to the development of cutaneous neoplasms in very young patients. Intraoral carcinomas are uncommon and, when present, are located mainly at the tongue tip. We report an unprecedented case of squamous cell carcinoma (SCC) in the floor of mouth of a 23-year-old woman with XP. The patient was referred to the oncologist, and 2 months after surgical resection, she underwent a single session of chemotherapy plus radiotherapy. However, she died 73 hours after undergoing her first chemotherapy session. Considering the unexpected outcome of this case, we also investigated possible exacerbated adverse effects of antineoplastic treatments (especially cisplatin-based chemotherapy) in patients with XP and reviewed the main characteristics of the disease, especially cases with oral manifestations reported in the literature.

Management of dental trauma in a child with Xeroderma Pigmentosa

Xeroderma Pigmentosa is a rare dermatological autosomal recessive disorder that manifests itself early in life as severe sunburn usually after a short exposure to sunlight. The prime characteristic features include photosensitivity, hyperpigmentation and ichthyosis in sun exposed areas, and an increase in the risk of basocellular and squamous cell carcinomas and melanomas of the skin and eyes. The case report highlights the preventive treatment options along with all necessary precautions that should be taken to protect the patient from any iatrogenic inadvertent exposures that may be deleterious to his present state. The purpose of the report is also to discuss the important role of dental professionals when dealing with debilitating medical conditions.

Xeroderma pigmentosum at a tertiary care center in Saudi Arabia

BACKGROUND

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder caused by defective DNA repair that results in extreme sensitivity to ultraviolet (UV) rays. Depending on the type of XP, the disease may affect the skin, eyes and nervous system.

OBJECTIVES

Describe the dermatologic manifestations in patients suffering from XP.

DESIGN

Retrospective, descriptive review of medical records.

SETTING

Dermatology clinic at tertiary care center in Riyadh.

PATIENTS AND METHODS

This study included Saudi patients with clinically confirmed XP.

MAIN OUTCOME MEASURE(S)

Demographic and clinical data including pathology and associated conditions and outcomes.

RESULTS

Of 21 patients with XP, the most common manifestation was lentigines, affecting 18 patients (86%). The most common skin cancer was basal cell carcinoma followed by squamous cell carcinoma (SCC) affecting 15 (71.4%) and 9 (42.8%), respectively. Other skin findings included neurofibroma, trichilemmoma and seborrheic keratosis. Ocular involvement included photophobia, which was the most common finding followed by dryness and ocular malignancies. Two patients showed neurological involvement, which correlated with the type of mutation.

CONCLUSION

Considering that XP is a rare genetic disease, this description of our patient population will aid in early recognition and diagnosis.

LIMITATIONS

Retrospective and small number of patients. Genetic analyses were done for only 5 of the 21 patients.