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Belysheva T, Nasedkina T, Kletskaya I, Volchek D, Barinova I, Semenova V, Gadzhigoroeva A, Zelenova E, Valiev T, Sharapova E, Michenko A, Allenova A, Ponomareva D. Case report: Variability in clinical manifestations within a family with incontinentia pigmenti. Front Med (Lausanne) 2024; 11:1402577. [PMID: 39086952 PMCID: PMC11288940 DOI: 10.3389/fmed.2024.1402577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/28/2024] [Indexed: 08/02/2024] Open
Abstract
Diagnosing skin diseases in children can be a complex interdisciplinary problem. Incontinentia pigmenti (IP), also known as Bloch-Sulzberger syndrome, is a rare hereditary genodermatosis related to a mutation in the IKBKG gene. We present a family case of IP described from the perspective of various specialists, including dermatologists, oncologists, geneticists, dentists, and trichologists. The peculiarity of this case is the development of squamous cell carcinoma (SCC) on the shin of a 10-year-old female patient with IP. The patient had a positive family history: her mother and two sisters also displayed clinical manifestations of IP with involvement of skin, teeth and hair. The presence of exons 4-10 deletion in the IKBKG gene in all affected females was confirmed by detailed genetic evaluation using long-range PCR, and also high degree of X-chromosome inactivation skewing was demonstrated. The family underwent a comprehensive examination and was followed up for 2 years with successful symptomatic treatment of dermatologic manifestations. Recommendations were also made regarding dental and hair problems. By the end of the follow-up period, patients had stabilized, with the exception of a 36-year-old mother who developed generalized morphea. The study demonstrates the varying expressiveness of clinical symptoms among family members and emphasizes the importance of timely diagnosis for effective management of patients with IP.
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Affiliation(s)
- Tatiana Belysheva
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
| | - Tatiana Nasedkina
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Irina Kletskaya
- Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - Dana Volchek
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - Irina Barinova
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Vera Semenova
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Aida Gadzhigoroeva
- Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Ekaterina Zelenova
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
- Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences, Moscow, Russia
| | - Timur Valiev
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elena Sharapova
- N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia, Moscow, Russia
| | - Anna Michenko
- Federal State Budgetary Institution "Central State Medical Academy" of the Administrative Department of the President of the Russian Federation, Moscow, Russia
- Medical Scientific and Educational Center of Lomonosov Moscow State University, Moscow, Russia
- International Institute of Psychosomatic Health, Moscow, Russia
| | - Anastasiia Allenova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Cano-Rosás M, de Vicente-Jiménez J, Diosdado-Cano JM, Suárez-Quintanilla D, González-Sarmiento R, Curto D, Curto A. Oral Rehabilitation as Part of a Multidisciplinary Treatment in a Case Study of Pigmentary Incontinence. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1505. [PMID: 37761466 PMCID: PMC10529459 DOI: 10.3390/children10091505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023]
Abstract
We present the clinical course of a 9-year-old female patient with Bloch-Sulzberger syndrome and severe neurological deficit that met the major (classic cutaneous signs) and minor (dental anomalies and retinal pathology) diagnostic criteria of Landy and Donnai. Longitudinal multidisciplinary follow-up was carried out from birth to adulthood. Neurological involvement was assessed with electroencephalographic (EEG) and neuroimaging tests at different times during the patient's life. Cranio-maxillofacial involvement was evaluated using lateral skeletal facial and cephalometric analyses. The right and left facial widths were measured through frontal face analysis and using the vertical zygomatic-midline distance. Oral rehabilitation was performed through orthodontic treatment and major dental reconstruction using composite resins. This treatment aimed to improve the occlusion and masticatory function, relieve the transversal compression of the maxilla, and reconstruct the fractured teeth. We believe that, due to significant neurological and cognitive impairment, orthognathic surgery was not the best option for restoring function and improving oral health-related quality of life.
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Affiliation(s)
- Mónica Cano-Rosás
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (M.C.-R.); (J.d.V.-J.)
| | - Joaquín de Vicente-Jiménez
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (M.C.-R.); (J.d.V.-J.)
| | | | - David Suárez-Quintanilla
- Department of Surgery, Faculty of Medicine and Dentistry, University of Santiago de Compostela, San Francisco Street s/n, 15782 Santiago de Compostela, Spain;
| | - Rogelio González-Sarmiento
- Department of Medicine, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain;
| | - Daniel Curto
- Department of Patholoy, 12 de Octubre University Hospital, Córdoba Avenue s/n, 28041 Madrid, Spain;
| | - Adrián Curto
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (M.C.-R.); (J.d.V.-J.)
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Bodemer C, Diociaiuti A, Hadj-Rabia S, Robert MP, Desguerre I, Manière MC, de la Dure-Molla M, De Liso P, Federici M, Galeotti A, Fusco F, Fraitag S, Demily C, Taieb C, Valeria Ursini M, El Hachem M, Steffann J. Multidisciplinary consensus recommendations from a European network for the diagnosis and practical management of patients with incontinentia pigmenti. J Eur Acad Dermatol Venereol 2021; 34:1415-1424. [PMID: 32678511 DOI: 10.1111/jdv.16403] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/28/2020] [Accepted: 03/10/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Incontinentia pigmenti (IP) is a rare multisystemic X-linked dominant genetic disorder characterized by highly diagnostic skin lesions. The disease can be misdiagnosed in infants, and complications affecting the eyes and/or the brain can be severe. Our objective was to highlight the urgency of an appropriate diagnosis and management strategy, as soon as the first symptoms appear, and the need for a well-codified monitoring strategy for each child. METHODS An in-depth literature review using a large number of databases was conducted. The selection criteria for articles were literature review articles on the disease, case series and retrospective studies based on the disease, clinical studies (randomized or not) on treatment, articles discussing patient care and management (treatment, diagnosis, care pathways), and recommendations. The research period was from 2000 until 2018. A group of multidisciplinary experts in IP management was involved, issued from different healthcare providers of the European Network for Rare Skin Diseases (ERN-Skin). The final recommendations have been submitted to two patient representative associations and to a general practitioner and a neonatal specialist prior to their finalization. RESULTS AND CONCLUSION The diagnosis of IP must be promptly performed to detect potential extracutaneous manifestations, thus allowing the timely implementation of specific therapeutic and monitoring strategies. Eye involvement can be a therapeutic urgency, and central nervous system (CNS) involvement requires a very rigorous long-term follow-up. Assessments and patient support should take into account the possible co-occurrence of various symptoms (including motor, visual and cognitive symptoms).
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Affiliation(s)
- C Bodemer
- Department of Dermatology, Reference Centre for Genodermatoses (MAGEC) Necker Enfants Malades Hospital, Imagine Institute, FIMARAD, ERN-Skin, Paris Centre University, Paris, France
| | - A Diociaiuti
- Department of Dermatology, ERN-Skin, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Hadj-Rabia
- Department of Dermatology, Reference Centre for Genodermatoses (MAGEC) Necker Enfants Malades Hospital, Imagine Institute, FIMARAD, ERN-Skin, Paris Centre University, Paris, France
| | - M P Robert
- Department of Ophthalmology, Imagine Institute, Necker Enfants Malades Hospital, Paris Centre University France, Paris, France
| | - I Desguerre
- Department of Pediatric Neurology, Imagine Institute, Necker Enfants Malades Hospital, Paris Centre University France, Paris, France
| | - M-C Manière
- Department of Pediatric Odontology, Expert Centre (MAFACE), Strasbourg Hospital, Université de Chirurgie Dentaire, Strasbourg, France
| | - M de la Dure-Molla
- Expert Centre for Rare Face and Oral Cavity Malformations, Rothschild Cavity, Paris, France
| | - P De Liso
- Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Federici
- Ophthalmology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - A Galeotti
- Dentistry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - F Fusco
- Institute of Genetics and Biophysics 'Adriano Buzzati-Traverso', IGB-CNR, Naples, Italy
| | - S Fraitag
- Department of Pathology, Necker Enfants Malades Hospital, Paris, France
| | - C Demily
- Reference Centre Génopsy, CRMR Maladies Rares à Expression Psychiatrique, Centre Hospitalier Le Vinatier, Bron, France
| | - C Taieb
- National Network for Rare Diseases FIMARA, Necker Enfants Malades Hospital, Paris, France
| | - M Valeria Ursini
- Institute of Genetics and Biophysics 'Adriano Buzzati-Traverso', IGB-CNR, Naples, Italy
| | - M El Hachem
- Department of Dermatology, ERN-Skin, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - J Steffann
- Department of Genetics, Imagine Institute, Necker Enfants Malades Hospital, Paris Centre Université, Paris, France
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Santa Maria FD, Barros SE, Chiqueto K, Mariath LM, Schüler-Faccini L, Kiszewski AE. Development of dentofacial characteristics related to Incontinentia Pigmenti syndrome: A repeated cross-sectional study. Am J Orthod Dentofacial Orthop 2021; 160:66-76. [PMID: 33906773 DOI: 10.1016/j.ajodo.2020.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This research aimed to investigate the dentofacial characteristics of patients with Incontinentia Pigmenti (IP) (or Bloch-Sulzberger) syndrome in childhood, juvenile, and adulthood developmental stages. METHODS Fifteen female patients with a clinical diagnosis of IP, genetically confirmed by molecular testing, were included in this study. The records of 25 nonsyndromic females with Class I occlusion and lateral cephalograms obtained at similar developmental stages were selected from the American Association of Orthodontists Foundation Legacy Collection as a control group. Dentofacial features of subjects with IP and those in the control group were compared statistically using t test and Mann-Whitney rank-sum test (significance was defined as P <0.05). RESULTS In general, patients with IP had shorter maxillary and mandibular length, straight skeletal profile, hypodivergent growth pattern with a tendency to mandibular protrusion, shorter anterior facial height, Class III compensatory positioning of incisors, more retruded lips, and smaller maxillary incisor exposure. The degree of hypodontia severity had a significant impact on skeletal, dental, and soft-tissue features in patients with IP. CONCLUSIONS The results of this study showed that, since childhood, the dentofacial characteristics of patients with IP were progressively distancing from those of nonsyndromic patients with Class I occlusion, presenting their own orthodontic needs.
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Affiliation(s)
- Fernanda Diffini Santa Maria
- Postgraduate Program in the Health of Children and Adolescents, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sérgio Estelita Barros
- Faculty of Dentistry, Division of Orthodontics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Kelly Chiqueto
- Faculty of Dentistry, Division of Orthodontics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luiza Monteavaro Mariath
- Postgraduate Program in Genetics and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lavínia Schüler-Faccini
- Division of Genetics, Institute of Biosciences, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Elisa Kiszewski
- Division of Dermatology, Department of Medical Clinic, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Perks A, Bates TJ, Velangi S, Brown RM, Poveda-Gallego A. Probable etoricoxib-induced fixed drug eruption involving the oral mucosa: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:e100-e107. [PMID: 33468439 DOI: 10.1016/j.oooo.2020.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/15/2022]
Abstract
Fixed drug eruption (FDE) is a cutaneous adverse drug reaction characterized by recurrence of lesions at the same sites each time a specific drug is taken. Oral mucosal involvement is rare. Nonsteroidal anti-inflammatory drugs are one of the most common offending drug groups in FDE; however, selective cyclooxygenase-2 inhibitors, such as etoricoxib, are rarely implicated. We present a case of oral mucosal and cutaneous FDE induced by etoricoxib that, to the best of our knowledge, is the first reported case of this nature. We describe the diagnostic challenges and review the pertinent literature. The value of drug provocation testing and patch testing in FDE is also discussed.
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Affiliation(s)
- Alexandra Perks
- Oral Medicine, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK.
| | - Timothy John Bates
- Oral Pathology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Shireen Velangi
- Dermatology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Rachel M Brown
- Oral Pathology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Ana Poveda-Gallego
- Oral Medicine, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
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Khalil S, Eid E, Hamieh L, Bardawil T, Moujaes Z, Khalil W, Abbas O, Kurban M. Genodermatoses with teeth abnormalities. Oral Dis 2020; 26:1032-1044. [PMID: 32027427 DOI: 10.1111/odi.13295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/14/2020] [Accepted: 01/28/2020] [Indexed: 01/07/2023]
Abstract
Many genodermatoses exhibit abnormal teeth findings. Studies examining these entities are scarce and narrow in their scope. This paper reviews the evolution, development, and structure of the tooth and provides a summary of genodermatoses with aberrant dental findings. The latter are classified according to the abnormal dental findings: periodontal disease, anodontia/oligodontia/hypodontia, polydontia, enamel hypoplasia, natal teeth, dental pits, and others. Finally, we provide an algorithm that dermatologists and dentists can follow to better recognize genodermatoses with dental involvement.
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Affiliation(s)
- Samar Khalil
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Edward Eid
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Lamia Hamieh
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Tara Bardawil
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Ziad Moujaes
- Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Wael Khalil
- Faculty of Dentistry, Lebanese University, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut, Beirut, Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut, Beirut, Lebanon.,Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
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