Klassische und atypische Präsentation des Morbus Galli-Galli

Galli-Galli Disease: A Comprehensive Literature Review

Galli-Galli disease (GGD) is a rare genodermatosis that exhibits autosomal dominant inheritance with variable penetrance. GGD typically manifests with erythematous macules, papules, and reticulate hyperpigmentation in flexural areas. A distinct atypical variant exists, which features brown macules predominantly on the trunk, lower limbs, and extremities, with a notable absence of the hallmark reticulated hyperpigmentation in flexural areas. This review includes a detailed literature search and examines cases since GGD's first description in 1982. It aims to synthesize the current knowledge on GGD, covering its etiology, clinical presentation, histopathology, diagnosis, and treatment. A significant aspect of this review is the exploration of the genetic, histopathological, and clinical parallels between GGD and Dowling-Degos disease (DDD), which is another rare autosomal dominant genodermatosis, particularly focusing on their shared mutations in the KRT5 and POGLUT1 genes. This supports the hypothesis that GGD and DDD may be different phenotypic expressions of the same pathological condition, although they have traditionally been recognized as separate entities, with suprabasal acantholysis being a distinctive feature of GGD. Lastly, this review discusses the existing treatment approaches, underscoring the absence of established guidelines and the limited effectiveness of various treatments.

Exacerbation of Galli-Galli Disease Following Dialysis Treatment: A Case Report and Review of Aggravating Factors

Galli-Galli disease (GGD) is a rare genodermatosis that is an acantholytic variant of Dowling-Degos disease that presents as lentigo-like macules/papules with progressive reticulated hyperpigmentation. Heat, sweat, ultraviolet light exposure, and topical retinoids have been reported to exacerbate the lesions associated with GGD. Here, we present a 77-year-old woman with end-stage renal disease and GGD who reported a worsening of lesions during the summer months and following hemodialysis treatment. Despite the severity of her lesions following dialysis, she refused treatment with isotretinoin out of concern for its side effect profile. In this case report, we discuss some available treatment options for GGD and review the exacerbating factors for GGD currently reported in the literature.

Atypical Disseminated Variant of Galli-Galli Disease: A Review of the Literature

Galli-Galli disease (GGD) is a rare genodermatoses within the group of reticulated pigmentary disorders of the skin. Traditionally, its clinical presentation is identical to that of Dowling-Degos disease (DDD), with the additional feature of acantholysis on histopathological examination. We have reviewed the published cases of GGD to provide further support for the hypothesis that in fact, 2 phenotypes of GGD exist: the characteristic flexural GGD associated with KRT5 mutations and a disseminated variant with no mutation identified to date. A review of the literature revealed 53 reported cases of GGD. Fifteen atypical phenotype cases are described, and no KRT5 mutation has yet been identified. There is growing evidence that acantholysis is an underreported feature of DDD and that GGD and DDD are variations of the same disease, or in fact the same entity. This theory is supported by the identification of the c.418dupA missense mutation in both GGD and DDD. This review highlights that there is growing evidence that there are likely 2 clinical phenotypes of GGD with an associated genotypic correlation.

Atypical variant of galli-galli disease (grover-like eruption with lentiginous freckling) in a liver transplant patient

Galli-Galli disease is considered as a rare variant of Dowling-Degos disease, sharing the same clinical features of reticulate hyperpigmentation of the flexures. Histopathologically, there is acantholysis and suparabasal lacunae. Grover disease (transient acantholytic dermatosis) is a transient dermatosis which clinically presents as an eruption of erythematous excoriated papules located on the trunk and histologically with dyskeratosis and acantholysis. Grover disease has occasionally been reported in patients with chronic renal failure, human immunodeficiency virus infection, hematological malignancies, bone marrow allotransplantation, and renal transplantation. We report herein a case of atypical variant of Galli-Galli disease occurring in a liver transplant patient in whom the leading sign of reticulate hyperpigmentation of the large flexures was lacking. Instead, Grover-like, erythematous, keratotic, excoriated papules and lentigo-like macules with predilection for the trunk were found. Histopathology of both, an excoriated papule and a lentigo-like macule revealed the diagnostic features of Galli-Galli disease namely, elongated, pigmented, finger-like rete ridges, intraepidermal lacunae and acantholysis. However, serial sections of the lentigo-like macule were needed to reveal some suprabasal and subcorneal lacunae with minimal acantholysis. Thus, a good clinicopathological correlation is essential to make the right diagnosis of Galli-Galli disease. Although Grover disease has been described in the setting of solid organ transplantation and immunosuppression, this is the first report of an atypical variant of Galli-Galli disease occurring in a liver transplant patient.