De novo pericentric inversion of chromosome 4, inv(4)(p16q12) in a boy with piebaldism and mental retardation

[Leucoderma in children: Review of the literature]

BACKGROUND

Leucoderma is a frequent presenting complaint in children and it is sometimes difficult to make a definite diagnostic during the first consultation. The aim of this study is to analyse the diagnoses associated with leucoderma in children in order to propose a practical approach to their differential diagnosis.

MATERIAL AND METHODS

We performed a review of the literature using the keywords "leucoderma children review", "leucoderma Ito" and "nevus depigmentosus" in the Medline database. All relevant articles were included.

RESULTS

Four hundred and thirty-five articles were retrieved and 179 were analysed. A clinical approach was proposed in 6 articles and investigations in 15 articles.

DISCUSSION

Causal diagnosis of leucoderma may frequently be made on clinical grounds by determining the age of onset and distribution of lesions. Nevertheless, some situations require investigation. The literature is limited regarding clinical approaches and examinations in leucoderma. Herein, we present a systematic clinical and laboratory approach to the differential diagnosis of these skin disorders.

Piebaldism

Piebaldism is an uncommon autosomal dominantly inherited pigment anomaly characterized by a congenital white forelock and leukoderma on the frontal scalp, forehead, ventral trunk and extremities. It is caused by a loss-of-function mutation in the KIT gene. Genetic analyses reveal a consistent genotype-phenotype relationship in piebaldism. However, recently reported cases of piebaldism that are milder or severer than genetically expected indicate that other factors, such as a modifier gene of MC1R, influence skin and hair color. The KIT ligand/KIT that triggers the Ras/mitogen-activated protein kinase signaling pathway play essential functions in the migration, proliferation, survival, melanogenesis and melanosome transfer of the melanocytes. We summarize current research progress in piebaldism and related disorders.

Telomere-centromere-driven genomic instability contributes to karyotype evolution in a mouse model of melanoma

Aneuploidy and chromosomal instability (CIN) are hallmarks of most solid tumors. These alterations may result from inaccurate chromosomal segregation during mitosis, which can occur through several mechanisms including defective telomere metabolism, centrosome amplification, dysfunctional centromeres, and/or defective spindle checkpoint control. In this work, we used an in vitro murine melanoma model that uses a cellular adhesion blockade as a transforming factor to characterize telomeric and centromeric alterations that accompany melanocyte transformation. To study the timing of the occurrence of telomere shortening in this transformation model, we analyzed the profile of telomere length by quantitative fluorescent in situ hybridization and found that telomere length significantly decreased as additional rounds of cell adhesion blockages were performed. Together with it, an increase in telomere-free ends and complex karyotypic aberrations were also found, which include Robertsonian fusions in 100% of metaphases of the metastatic melanoma cells. These findings are in agreement with the idea that telomere length abnormalities seem to be one of the earliest genetic alterations acquired in the multistep process of malignant transformation and that telomere abnormalities result in telomere aggregation, breakage-bridge-fusion cycles, and CIN. Another remarkable feature of this model is the abundance of centromeric instability manifested as centromere fragments and centromeric fusions. Taken together, our results illustrate for this melanoma model CIN with a structural signature of centromere breakage and telomeric loss.

Centromeres in cell division, evolution, nuclear organization and disease

As the spindle fiber attachment region of the chromosome, the centromere has been investigated in a variety of contexts. Here, we will review current knowledge about this unique chromosomal region and its relevance for proper cell division, speciation, and disease. Understanding the three-dimensional organization of centromeres in normal and tumor cells is just beginning to emerge. Multidisciplinary research will allow for new insights into its normal and aberrant nuclear organization and may allow for new therapeutic interventions that target events linked to centromere function and cell division.