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Wijsmans D, Spanoudi-Kitrimi I. Variable skin findings in two siblings with KDSR mutations manifesting in PERIOPTER syndrome. Pediatr Dermatol 2022; 40:330-332. [PMID: 36263748 DOI: 10.1111/pde.15155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/10/2022] [Indexed: 11/28/2022]
Abstract
Pathogenic variants in the KDSR gene give rise to a Mendelian disorder called PERIOPTER syndrome. The disease is caused by a disruption in ceramide synthesis, with an impact on both skin and bone marrow. Patients with PERIOPTER syndrome show intermittent thrombocytopenia and/or associated anemia as well as disorders of keratinization. We present two siblings with identical compound heterozygous pathogenic variants in the KDSR gene, but with different clinical manifestations.
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Affiliation(s)
- Daphne Wijsmans
- Department of Dermatology, University Hospital Leuven, Leuven, Belgium
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2
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Scoggins C, Nath N, Bellet JS. Progressive hyperpigmented rash in a 10-year-old boy. Pediatr Dermatol 2021; 38 Suppl 2:121-123. [PMID: 34850441 DOI: 10.1111/pde.14678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Neel Nath
- Department of Dermatology, Duke University School of Medicine, Durham, NC, USA
| | - Jane S Bellet
- Department of Dermatology, Duke University School of Medicine, Durham, NC, USA.,Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
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Croitoru D, Lu JD, Lara-Corrales I, Kannu P, Pope E. ELOVL4 with erythrokeratoderma: A pediatric case and emerging genodermatosis. Am J Med Genet A 2021; 185:1619-1623. [PMID: 33655653 DOI: 10.1002/ajmg.a.62136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/21/2021] [Accepted: 01/30/2021] [Indexed: 11/12/2022]
Affiliation(s)
- David Croitoru
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Justin D Lu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Irene Lara-Corrales
- Section of Pediatric Dermatology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Kannu
- Section of Genetics, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Pediatric Dermatology, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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4
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Kobayashi H, Shiohama T, Nakashima M, Saitsu H, Suga Y, Ebata R, Shimojo N. Fulminant myocarditis following recurrent generalized erythrokeratoderma in a child with a heterozygous GJA1 variant. Am J Med Genet A 2020; 182:1933-1938. [PMID: 32449269 DOI: 10.1002/ajmg.a.61626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/24/2020] [Accepted: 04/28/2020] [Indexed: 11/09/2022]
Abstract
Pathogenic germline variants in the gap junction protein alpha 1 (GJA1) gene have been identified in several congenital disorders affecting cutaneous, skeletal, and cardiac tissues. Here, we describe a 12-year-old patient with a GJA1 c.113G>A, p.(Gly38Glu) variant, who presented with fulminant myocarditis following recurrent generalized erythrokeratoderma. His mother and younger sister had the same clinical manifestations with the same GJA1 variant, but did not have cardiac dysfunction. GJA1 variants have been reported in patients with congenital cardiac malformations, while acute myocarditis in GJA1-related disorders has not been reported so far.
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Affiliation(s)
- Hironobu Kobayashi
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tadashi Shiohama
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mitsuko Nakashima
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasushi Suga
- Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Ryota Ebata
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Shimojo
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
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Patel N, Alkeraye S, Alobeid E, Alshidi T, Helaby R, Abdulwahab F, Shamseldin HE, Alkuraya FS. Confirming the recessive inheritance of PERP-related erythrokeratoderma. Clin Genet 2020; 97:661-665. [PMID: 31898316 DOI: 10.1111/cge.13699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/26/2019] [Indexed: 11/29/2022]
Abstract
Erythrokeratoderma (EK) is heterogeneous clinical entity characterized by excessive scaling with resulting erythrokeratotic plaques. Several genes have been linked to EK and they encode a number of proteins that are important for the integrity of the keratinocyte layer of the epidermis. PERP is a transcription factor that is activated by both p53 and p63. However, its deficiency in a mouse model appears to only recapitulate p63-mediated role in skin development and organization. We report an extended multiplex consanguineous family in which an EK phenotype with a striking similarity to that observed in Perp-/- mice, is mapped to an autozygous region on chromosome 6 that spans PERP. Whole-exome sequencing revealed a novel variant in PERP that fully segregated with the phenotype. Functional analysis of patient- and control-derived keratinocytes revealed a deleterious effect of the identified variant on the intracellular localization of PERP. A previous report showed that PERP mutation causes a dominant form of keratoderma but a single patient in that report with a homozygous variant in PERP suggests that recessive inheritance is also possible. Our results, therefore, support the establishment of an autosomal recessive PERP-related EK phenotype in humans.
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Affiliation(s)
- Nisha Patel
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Salim Alkeraye
- Dermatology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Eman Alobeid
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Tarfa Alshidi
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Rana Helaby
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Firdous Abdulwahab
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hanan E Shamseldin
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Boyden LM, Vincent NG, Zhou J, Hu R, Craiglow BG, Bayliss SJ, Rosman IS, Lucky AW, Diaz LA, Goldsmith LA, Paller AS, Lifton RP, Baserga SJ, Choate KA. Mutations in KDSR Cause Recessive Progressive Symmetric Erythrokeratoderma. Am J Hum Genet 2017; 100:978-984. [PMID: 28575652 DOI: 10.1016/j.ajhg.2017.05.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/08/2017] [Indexed: 11/18/2022] Open
Abstract
The discovery of new genetic determinants of inherited skin disorders has been instrumental to the understanding of epidermal function, differentiation, and renewal. Here, we show that mutations in KDSR (3-ketodihydrosphingosine reductase), encoding an enzyme in the ceramide synthesis pathway, lead to a previously undescribed recessive Mendelian disorder in the progressive symmetric erythrokeratoderma spectrum. This disorder is characterized by severe lesions of thick scaly skin on the face and genitals and thickened, red, and scaly skin on the hands and feet. Although exome sequencing revealed several of the KDSR mutations, we employed genome sequencing to discover a pathogenic 346 kb inversion in multiple probands, and cDNA sequencing and a splicing assay established that two mutations, including a recurrent silent third base change, cause exon skipping. Immunohistochemistry and yeast complementation studies demonstrated that the mutations cause defects in KDSR function. Systemic isotretinoin therapy has achieved nearly complete resolution in the two probands in whom it has been applied, consistent with the effects of retinoic acid on alternative pathways for ceramide generation.
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Affiliation(s)
- Lynn M Boyden
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Nicholas G Vincent
- Department of Microbiology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Jing Zhou
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Ronghua Hu
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Brittany G Craiglow
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Susan J Bayliss
- Division of Dermatology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Ilana S Rosman
- Division of Dermatology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Anne W Lucky
- Dermatologists of Southwest Ohio, Cincinnatti, OH 45247, USA
| | - Luis A Diaz
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC 27516, USA
| | - Lowell A Goldsmith
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC 27516, USA
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Richard P Lifton
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Susan J Baserga
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Molecular Biophysics and Biochemistry, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Keith A Choate
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Pathology, Yale University School of Medicine, New Haven, CT 06510, USA.
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Tarikci N, Göncü EK, Yüksel T, Singer R, Topal İO, Şahin İM. Progressive symmetrical erythrokeratoderma on the face: A rare condition and successful treatment with calcipotriol. JAAD Case Rep 2016; 2:70-1. [PMID: 27051833 PMCID: PMC4809449 DOI: 10.1016/j.jdcr.2015.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Emek Kocatürk Göncü
- Correspondence to: Emek Kocatürk Göncü, MD, Okmeydanı Training and Research Hospital, Department of Dermatology, Nadiraga Sok. No: 25/9 Göztepe, 34730, İstanbul, Turkey.Okmeydanı Training and Research HospitalDepartment of DermatologyNadiraga Sok. No: 25/9 Göztepeİstanbul34730Turkey
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Suga Y, Jarnik M, Attar PS, Longley MA, Bundman D, Steven AC, Koch PJ, Roop DR. Transgenic mice expressing a mutant form of loricrin reveal the molecular basis of the skin diseases, Vohwinkel syndrome and progressive symmetric erythrokeratoderma. J Cell Biol 2000; 151:401-12. [PMID: 11038186 PMCID: PMC2192631 DOI: 10.1083/jcb.151.2.401] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Mutations in the cornified cell envelope protein loricrin have been reported recently in some patients with Vohwinkel syndrome (VS) and progressive symmetric erythrokeratoderma (PSEK). To establish a causative relationship between loricrin mutations and these diseases, we have generated transgenic mice expressing a COOH-terminal truncated form of loricrin that is similar to the protein expressed in VS and PSEK patients. At birth, transgenic mice (ML.VS) exhibited erythrokeratoderma with an epidermal barrier dysfunction. 4 d after birth, high-expressing transgenic animals showed a generalized scaling of the skin, as well as a constricting band encircling the tail and, by day 7, a thickening of the footpads. Histologically, ML. VS transgenic mice also showed retention of nuclei in the stratum corneum, a characteristic feature of VS and PSEK. Immunofluorescence and immunoelectron microscopy showed the mutant loricrin protein in the nucleus and cytoplasm of epidermal keratinocytes, but did not detect the protein in the cornified cell envelope. Transfection experiments indicated that the COOH-terminal domain of the mutant loricrin contains a nuclear localization signal. To determine whether the ML.VS phenotype resulted from dominant-negative interference of the transgene with endogenous loricrin, we mated the ML.VS transgenics with loricrin knockout mice. A severe phenotype was observed in mice that lacked expression of wild-type loricrin. Since loricrin knockout mice are largely asymptomatic (Koch, P.K., P. A. de Viragh, E. Scharer, D. Bundman, M.A. Longley, J. Bickenbach, Y. Kawachi, Y. Suga, Z. Zhou, M. Huber, et al., J. Cell Biol. 151:389-400, this issue), this phenotype may be attributed to expression of the mutant form of loricrin. Thus, deposition of the mutant protein in the nucleus appears to interfere with late stages of epidermal differentiation, resulting in a VS-like phenotype.
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Affiliation(s)
- Y Suga
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas 77030, USA
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