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Cabrera-Borrego E, Montero-Vilchez T, Bermúdez-Jiménez FJ, Tercedor-Sánchez J, Tercedor-Sánchez L, Sánchez-Díaz M, Macías-Ruiz R, Molina-Jiménez M, Cañizares-García FJ, Fernández-Segura E, Fernandez-Flores A, Arias-Santiago S, Jiménez-Jáimez J. Heterozygous Arrhythmogenic Cardiomyopathy- desmoplakin Mutation Carriers Exhibit a Subclinical Cutaneous Phenotype with Cell Membrane Disruption and Lack of Intercellular Adhesion. J Clin Med 2021; 10:jcm10194608. [PMID: 34640625 PMCID: PMC8509745 DOI: 10.3390/jcm10194608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 01/20/2023] Open
Abstract
Genetic variants that result in truncation in desmoplakin (DSP) are a known cause of arrhythmogenic cardiomyopathy (AC). In homozygous carriers, the combined involvement of skin and heart muscle is well defined, however, this is not the case in heterozygous carriers. The aim of this work is to describe cutaneous findings and analyze the molecular and ultrastructural cutaneous changes in this group of patients. Four women and eight men with a mean age of 48 ± 14 years were included. Eight met definitive criteria for AC, one was borderline and three were silent carriers. No relevant macroscopic changes in skin and hair were detected. However, significantly lower skin temperature (29.56 vs. 30.97 °C, p = 0.036) and higher transepidermal water loss (TEWL) (37.62 vs. 23.95 g m 2 h 1, p = 0.028) were observed compared to sex- and age-matched controls. Histopathology of the skin biopsy showed widening of intercellular spaces and acantholysis of keratinocytes in the spinous layer. Immunohistochemistry showed a strongly reduced expression of DSP in all samples. Trichogram showed regular nodules (thickening) compatible with pseudomonilethrix. Therefore, regardless of cardiac involvement, heterozygous patients with truncation-type variants in DSP have lower skin temperature and higher TEWL, constant microscopic skin involvement with specific patterns and pseudomonilethrix in the trichogram.
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Affiliation(s)
- Eva Cabrera-Borrego
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | - Trinidad Montero-Vilchez
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
| | - Francisco José Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 28029 Madrid, CP, Spain
| | - Jesús Tercedor-Sánchez
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
| | - Luis Tercedor-Sánchez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | - Manuel Sánchez-Díaz
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
| | - Rosa Macías-Ruiz
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | - María Molina-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
| | | | - Eduardo Fernández-Segura
- Department of Histology, University of Granada, 18016 Granada, CP, Spain; (F.J.C.-G.); (E.F.-S.)
| | | | - Salvador Arias-Santiago
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
- Dermatology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain
- Correspondence:
| | - Juan Jiménez-Jáimez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, 18014 Granada, CP, Spain; (E.C.-B.); (F.J.B.-J.); (L.T.-S.); (R.M.-R.); (M.M.-J.); (J.J.-J.)
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18012 Granada, CP, Spain; (T.M.-V.); (J.T.-S.); (M.S.-D.)
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Stollberger C, Finsterer J. Prevent Sudden Death in Carvajal Syndrome With Left Ventricular Hypertrabeculation/Noncompaction. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e4258. [PMID: 27617069 PMCID: PMC4987763 DOI: 10.5812/ijp.4258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/21/2015] [Accepted: 12/30/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Claudia Stollberger
- Rudolfstiftung Hospital, Vienna, Austria
- Corresponding author: Claudia Stollberger, Rudolfstiftung Hospital, Juchgasse, Vienna, Austria. Tel: +43-6764031187, Fax: +43-1711652209, E-mail:
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