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Dalave K, Deoghare S, Buccha Y. Unilateral Hyperpigmented Facial Lesion Since Birth. Cureus 2023; 15:e47901. [PMID: 38034188 PMCID: PMC10683709 DOI: 10.7759/cureus.47901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 12/02/2023] Open
Abstract
Facial hyperpigmented lesions that are unilateral are a rare and challenging dermatological anomaly since birth which can be genetic and non-genetic. This paper seeks to provide an exhaustive overview of the etiology, clinical presentation, differential diagnosis, and management strategies for these congenital lesions. Unilateral facial hyperpigmented lesions can be caused by a number of conditions, such as congenital melanocytic nevi, Becker's nevus, nevus of Ota, linear epidermal nevi, and café-au-lait macules. Accurate diagnosis requires meticulous examination, dermoscopy, and histopathological evaluation. Observation, topical therapies, surgical excision, and laser therapy are among the available treatment options. Treatment decisions should be influenced by factors such as lesion characteristics, aesthetic concerns, and patient preferences. Long-term supervision and psychosocial support are indispensable elements of comprehensive management. We present a case of a 12-year-old patient with a progressively growing hyperpigmented lesion on the right side of the face, present since birth with an intermittent area of normal skin in between. Dermoscopy unveiled an irregular, dark brown pigment network, and histopathological evaluation showed an increased number of melanocytes in the dermis. This case highlights the diagnostic challenges of such lesions and underscores the significance of a multidisciplinary approach for accurate evaluation and management. This paper aims to cover existing knowledge gaps regarding unilateral facial hyperpigmented lesions since birth and direct future research efforts for diagnostic and therapeutic interventions.
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Affiliation(s)
- Kalyan Dalave
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Shreya Deoghare
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Yash Buccha
- Department of Dermatology, Venereology and Leprosy, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Aveiro A, Graça B, Gomes J. Inflammatory linear verrucous epidermal nevus—A rare variant of epidermal nevus. Semergen 2023; 49:101954. [DOI: 10.1016/j.semerg.2023.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 11/29/2022] [Indexed: 03/31/2023]
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3
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Salavastru CM, Butacu AI, Fritz K, Eren S, Tiplica GS. [Benign skin neoplasms in children]. Hautarzt 2022; 73:127-137. [PMID: 35029698 DOI: 10.1007/s00105-021-04935-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
There are many different types of skin neoplasms in children and most are benign. Dermatologists should be able to differentiate between the various types of benign skin neoplasms and be able to recommend optimal treatment to concerned patients. Surgical removal of benign skin neoplasms is often the only treatment option. The aim of this paper is to provide a general overview of epidermal lesions (e.g., inflammatory linear verrucous epidermal nevus [ILVEN], nevus sebaceous), tumors of the epidermal appendages (e.g. pilomatrixoma), cutaneous neoplasms (e.g. angiofibroma), fibromatoses (e.g., knuckle pads), tumors comprised of fat, muscle, or bone tissue (e.g., osteoma cutis, subungual exostosis), epidermal cysts and pseudocysts, and pathologic fibrosis reactions after dermal injury (keloid). Scientific data are scarce and only in the last decade has it been possible to perform histopathological examinations and genetic studies together with detailed phenotyping to gain new understanding of the pathogenetic mechanisms.
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Affiliation(s)
- Carmen Maria Salavastru
- Pädiatrische Dermatologie, Dermatoonkologisches Forschungungslabor, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Bukarest, Rumänien
| | - Alexandra-Irina Butacu
- Dermatologie II, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Stefan cel Mare Street 19-21, 020125, Bukarest, Rumänien.
| | - Klaus Fritz
- Dermatologie II, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Stefan cel Mare Street 19-21, 020125, Bukarest, Rumänien.,Hautärzte und Laserzentrum Landau, Landau, Deutschland
| | - Seher Eren
- Hautärzte und Laserzentrum Landau, Landau, Deutschland
| | - George-Sorin Tiplica
- Dermatologie II, Colentina Klinik, Carol-Davila-Universität für Medizin und Pharmazie, Stefan cel Mare Street 19-21, 020125, Bukarest, Rumänien
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Green TE, MacGregor D, Carden SM, Harris RV, Hewitt CA, Berkovic SF, Penington AJ, Scheffer IE, Hildebrand MS. Identification of a recurrent mosaic KRAS variant in brain tissue from an individual with nevus sebaceous syndrome. Cold Spring Harb Mol Case Stud 2021; 7:mcs.a006133. [PMID: 34649968 PMCID: PMC8751419 DOI: 10.1101/mcs.a006133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
Nevus sebaceous syndrome (NSS) is a rare, multisystem neurocutaneous disorder, characterized by a congenital nevus, and may include brain malformations such as hemimegalencephaly or focal cortical dysplasia, ocular, and skeletal features. It has been associated with several eponyms including Schimmelpenning and Jadassohn. The isolated skin lesion, nevus sebaceous, is associated with postzygotic variants in HRAS or KRAS in all individuals studied. The RAS proteins encode a family of GTPases that form part of the RAS/MAPK signaling pathway, which is critical for cell cycle regulation and differentiation during development. We studied an individual with nevus sebaceous syndrome with an extensive nevus sebaceous, epilepsy, intellectual disability, and hippocampal sclerosis without pathological evidence of a brain malformation. We used high-depth gene panel sequencing and droplet digital polymerase chain reaction (PCR) to detect and quantify RAS/MAPK gene variants in nevus sebaceous and temporal lobe tissue collected during plastic and epilepsy surgery, respectively. A mosaic KRAS c.34G > T; p.(Gly12Cys) variant, also known as G12C, was detected in nevus sebaceous tissue at 25% variant allele fraction (VAF), at the residue most commonly substituted in KRAS. Targeted droplet digital PCR validated the variant and quantified the mosaicism in other tissues. The variant was detected at 33% in temporal lobe tissue but was absent from blood and healthy skin. We provide molecular confirmation of the clinical diagnosis of NSS. Our data extends the histopathological spectrum of KRAS G12C mosaicism beyond nevus sebaceous to involve brain tissue and, more specifically, hippocampal sclerosis.
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Affiliation(s)
| | - Duncan MacGregor
- Anatomical Pathology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan M Carden
- Department of Ophthalmology, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Ophthalmology, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia ; Department of Paediatrics, University of Melbourne,
| | - Rebekah V Harris
- Epilepsy Research Centre, Department of Medicine (Austin Hospital), University of Melbourne, Heidelberg, Victoria, Australia
| | - Chelsee A Hewitt
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Samuel F Berkovic
- Epilepsy Research Centre, Department of Medicine (Austin Hospital), University of Melbourne, Heidelberg, Victoria, Australia
| | - Anthony J Penington
- Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Murdoch Children's Research Institute ; Plastic and Maxillofacial Surgery Department, The Royal Children's Hospital
| | - Ingrid E Scheffer
- Epilepsy Research Centre, Department of Medicine (Austin Hospital), University of Melbourne, Heidelberg, Victoria, Australia ; Departments of Paediatrics and Neurology, Austin Health, Heidelberg, Victoria, Australia
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine (Austin Hospital), University of Melbourne, Heidelberg, Victoria, Australia; Murdoch Children Research Institute, Parkville, Victoria, Australia
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Song J, Bustillo J, Meledathu S. An Unusual Pigmented Plaque in a Newborn. Pediatr Rev 2021; 42:122-126. [PMID: 34470891 DOI: 10.1542/pir.2018-0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jena Song
- Department of Internal Medicine and Pediatrics, Newark Beth Israel Medical Center and Children's of New Jersey, Newark, NJ
| | - Jose Bustillo
- Department of Internal Medicine and Pediatrics, Newark Beth Israel Medical Center and Children's of New Jersey, Newark, NJ
| | - Sherin Meledathu
- Department of Internal Medicine and Pediatrics, Newark Beth Israel Medical Center and Children's of New Jersey, Newark, NJ
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Chikani UN, Ohuche IN, Bisi-Onyemaechi AI. Becker's nevus syndrome: a case report. J Med Case Rep 2021; 15:395. [PMID: 34365967 PMCID: PMC8351151 DOI: 10.1186/s13256-021-02996-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Becker's nevus syndrome is a syndrome characterized by the presence of a Becker's nevus with ipsilateral breast hypoplasia or hypoplastic defects of the muscle, skin, or skeleton. The nevus usually consists of a circumscribed, unilateral, irregularly shaped hyperpigmented macule, commonly occurring around the anterior upper trunk, with/without hypertrichosis and/or acneiform lesions. This rare syndrome has not been reported in our locality to the best of our knowledge. CASE PRESENTATION We report the case of a 15-year-old Igbo female patient who presented to our pediatric endocrinology clinic, University of Nigeria Teaching Hospital, Enugu, with complaints of asymmetry of the breasts and hyperpigmented macules on the side. Based on her symptoms, diagnosis of Becker's nevus syndrome was made. The diagnosis of Becker's nevus syndrome is mostly clinical, based on the presence of a Becker's nevus with ipsilateral breast hypoplasia or hypoplastic defects of the muscle, skin, or skeleton. In our patient, there was a Becker's nevus with ipsilateral breast hypoplasia. This syndrome, belonging to the class of epidermal nevus syndromes, is very rare, and is usually benign. She was placed on spironolactone tablets 50 mg daily, which have been associated with an improvement in the size of the hypoplastic breast, and her fears were allayed. CONCLUSION This syndrome has not been reported in our locality to the best of our knowledge and, therefore, has a propensity for misdiagnosis by clinicians because of its rarity. We therefore report this to create awareness among clinicians regarding this condition that is associated with much psychosocial trauma among patients, and that can be easily managed with oral spironolactone.
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Affiliation(s)
- Ugo N Chikani
- Endocrine unit, Department of Paediatrics, University of Nigeria, Ituku Ozalla, Enugu, Nigeria.
| | - Ijeoma N Ohuche
- Endocrine unit, Department of Paediatrics, University of Nigeria, Ituku Ozalla, Enugu, Nigeria
| | - Ada I Bisi-Onyemaechi
- Endocrine unit, Department of Paediatrics, University of Nigeria, Ituku Ozalla, Enugu, Nigeria
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Cauliflower scare. J Paediatr Child Health 2021; 57:1144. [PMID: 34216165 DOI: 10.1111/jpc.2_15318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 11/30/2022]
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8
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Marques J, Barroso R. Cauliflower scare. J Paediatr Child Health 2021:jpc.15318. [PMID: 34004051 DOI: 10.1111/jpc.15318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Joana Marques
- Neonatal Intensive and Special Care Unit, Pediatrics Department, Hospital Prof. Doutor Fernando Fonseca, EPE, Portugal
| | - Rosalina Barroso
- Neonatal Intensive and Special Care Unit, Pediatrics Department, Hospital Prof. Doutor Fernando Fonseca, EPE, Portugal
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Renal Involvement in Linear Nevus Sebaceous Syndrome-An Underrecognized Feature. Pediatr Rep 2021; 13:203-209. [PMID: 34062947 PMCID: PMC8163158 DOI: 10.3390/pediatric13020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/29/2021] [Accepted: 04/29/2021] [Indexed: 11/17/2022] Open
Abstract
Linear nevus sebaceous syndrome (LNSS) is a rare neurocutaneous disorder. It is characterized by the presence of nevus sebaceous, ocular anomalies, neurological deficits, and convulsion. Renal involvement was not commonly reported. We report a 10-year-old girl with LNSS who had concomitant cystic kidney disease and diffuse aortopathy with bilateral renal artery stenosis, leading to hypertension requiring oral anti-hypertensive medications. The girl presented with chorioretinal coloboma and multiple nevus sebaceous at birth. She had aortic coarctation and received surgical repair at one week of life. She had persistent hypertension during her follow-up. Further investigations were performed to look for causes of hypertension apart from possible re-coarctation. Her magnetic resonance angiogram revealed diffuse aortopathy, which extended from the aortic arch to the abdominal aorta. Branches of the aorta, including the celiac trunk, superior mesenteric arteries, and renal arteries, were also narrowed. Multiple renal cysts were also identified in her right kidney. Interventional angioplasty over the renal arteries was not feasible due to diffuse narrowing of the aorta, especially at the origins of renal arteries. The blood pressure was controlled with oral anti-hypertensive medications. Our case illustrated that pediatricians should be aware of the possible renal involvements in LNSS, which impose a significant impact on the management and long-term prognosis of these patients.
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Abstract
Background/aim Verrucous epidermal nevi are cutaneous hamartomas with many clinical variants. Dermoscopic features of verrucous epidermal nevus have rarely been investigated. We aimed to identify dermoscopic findings of the entity which will facilitate the diagnostic process by reducing the use of invasive diagnostic methods. Materials and methods The study included the patients with histopathologically approved verrucous epidermal nevus. Clinical, dermoscopic, and histopathological features of the patients were retrospectively reviewed and the findings identified were recorded. Dermoscopic examination was performed with a polarized-light handheld dermoscope with 10-fold magnification. Results The most common dermoscopic features were thick brown circles, thick brown branched lines, and terminal hairs. The most common vessel pattern was dotted vessels. Branched thick brown lines, brown globules, brown dots forming lines, serpiginous brown dots, white and brown exophytic papillary structures, fine scale, thick adherent scale, and cerebriform structures were the other findings. Conclusion We observed many vascular and nonvascular dermoscopic findings which were not described previously for the entity. Dermoscopic examination of the verrucous epidermal nevi may lead to more reliable clinical interpretation and thus may reduce the need for histopathological investigation.
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Affiliation(s)
- Ömer Faruk Elmas
- Department of Dermatology and Veneorology, Faculty of Medicine, Ahi Evran University, Kırşehir, Turkey
| | - Necmettin Akdeniz
- Department of Dermatology and Veneorology, Faculty of Medicine, İstanbul Medeniyet University, İstanbul, Turkey
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Ancer-Arellano J, Ocampo-Candiani J, Lopez-Olmos PA, Villarreal-Villarreal CD, Vazquez-Martínez O. Nevus unius lateris: Electrofulguration as a therapeutic approach. J Dermatol 2018; 45:e342-e344. [PMID: 29855083 DOI: 10.1111/1346-8138.14479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jesus Ancer-Arellano
- Department of Dermatology, Faculty of Medicine, University Hospital "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo León, Monterrey, México
| | - Jorge Ocampo-Candiani
- Department of Dermatology, Faculty of Medicine, University Hospital "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo León, Monterrey, México
| | - Patricia Aide Lopez-Olmos
- Department of Dermatology, Faculty of Medicine, University Hospital "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo León, Monterrey, México
| | - Cesar Daniel Villarreal-Villarreal
- Department of Dermatology, Faculty of Medicine, University Hospital "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo León, Monterrey, México
| | - Osvaldo Vazquez-Martínez
- Department of Dermatology, Faculty of Medicine, University Hospital "Dr. Jose Eleuterio Gonzalez", Universidad Autonoma de Nuevo León, Monterrey, México
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Picosecond 532-nm neodymium-doped yttrium aluminum garnet laser—a promising modality for the management of verrucous epidermal nevi. Lasers Med Sci 2018; 33:597-601. [DOI: 10.1007/s10103-017-2427-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
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14
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Becker nevus syndrome and ipsilateral breast hypoplasia: a systematic literature review. EUROPEAN JOURNAL OF PLASTIC SURGERY 2017. [DOI: 10.1007/s00238-017-1327-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kerwin KB, Menter MA. Evaluation and Management of an Unusual Congenital Nevus. Proc (Bayl Univ Med Cent) 2017; 30:211-212. [DOI: 10.1080/08998280.2017.11929590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ullah W, Abdullah HMA, Shahzad MA, Sadiq MA, Ahmad E, Khan S. First Reported Case of 'Epidermal Nevus Syndrome' with a Triad of Central Nervous System Deformities. Cureus 2016; 8:e916. [PMID: 28083460 PMCID: PMC5218882 DOI: 10.7759/cureus.916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Epidermal nevus syndrome (ENS) is a term used to describe the occurrence of an epidermal nevus in association with other extra-cutaneous developmental anomalies, most commonly involving the nervous and musculoskeletal systems. The nevus is classified on the basis of the main component which may be keratinocytic, sebaceous, follicular, apocrine, or eccrine. Most patients who present with ENS is at the time of birth, though some become apparent later in life. This case describes a young female who presented with seizures and cognitive impairment along with a linear epidermal nevus on the midline of her face. The presence of the nevus prompted brain imaging which showed cortical dysplasia, multiple hamartomas in the temporal lobe, thalamus, and periventricular regions along with cerebellar atrophy and Dandy-Walker variant. To our knowledge, this is the first case in which three different types of brain lesions were found in the same patient.
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Affiliation(s)
- Waqas Ullah
- Internal Medicine, University of Arizona, Tucson, AZ
| | | | | | | | - Ejaz Ahmad
- Internal Medicine, Nishtar Hospital, Multan, Pakistan
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Bhat YJ, Hassan I, Sajad P, Yaseen A, Mubashir S, Akhter S, Wani R. Evaluation of Carbon Dioxide Laser in the Treatment of Epidermal Nevi. J Cutan Aesthet Surg 2016; 9:183-187. [PMID: 27761089 PMCID: PMC5064683 DOI: 10.4103/0974-2077.191646] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Epidermal naevi are benign hamartomatous growths of the skin which are generally asymptomatic with a benign course but are cosmetically disagreeable. Topical treatments such as steroids, calcipotriol, 5 fluorouracil, podophyllin, retinoids and cryotherapy are ineffective and surgical excision results in scar formation. Therapy is often challenging. AIM OF THE STUDY To study the response of carbon dioxide (CO2) laser in the management of epidermal naevi. SUBJECTS AND METHODS We conducted a study of CO2 laser treatment on 15 patients of epidermal naevi, eight with verrucous epidermal naevi and seven with sebaceous naevi. A thorough history and examination was done to rule out any epidermal naevus syndrome. The diagnosis was confirmed by histopathology. The number of treatment sessions varied from 1 to 8. RESULTS Response was excellent (>90% reduction in lesion size) in three patients, very good (>75% reduction) in five, good (>50% reduction in lesion size) in five and poor (<50% reduction in lesion size) in two patients. The side effects were hyperpigmentation and scarring. Long-term follow-up over a period of 10 months showed a recurrence rate of 20%. CONCLUSION We conclude that CO2 laser treatment might be an effective option with long-term safety, minimal discomfort and rapid recovery.
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Affiliation(s)
- Yasmeen Jabeen Bhat
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Iffat Hassan
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Peerzada Sajad
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Atiya Yaseen
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Syed Mubashir
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Saniya Akhter
- Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Roohi Wani
- Department of Pathology, Government Medical College, University of Kashmir, Srinagar, Jammu and Kashmir, India
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Ayala D, Ramón M, Martín J, Jordá E. Atypical Phacomatosis Pigmentokeratotica as the Expression of a Mosaic RASopathy With the BRAF-Glu586Lys Mutation. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ayala D, Ramón M, Martín J, Jordá E. Facomatosis pigmentoqueratótica atípica como expresión de rasopatía en mosaicismo con mutación en gen BRAF Glu586Lys. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:344-6. [DOI: 10.1016/j.ad.2015.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/07/2015] [Accepted: 07/28/2015] [Indexed: 01/15/2023] Open
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Abstract
Neurocutaneous disorders are a heterogeneous group of conditions (mainly) affecting the skin [with pigmentary/vascular abnormalities and/or cutaneous tumours] and the central and peripheral nervous system [with congenital abnormalities and/or tumours]. In a number of such disorders, the skin abnormalities can assume a mosaic patterning (usually arranged in archetypical patterns). Alternating segments of affected and unaffected skin or segmentally arranged patterns of abnormal skin often mirror similar phenomena occurring in extra-cutaneous organs/tissues [eg, eye, bone, heart/vessels, lung, kidney and gut]. In some neurocutaneous syndromes the abnormal mosaic patterning involve mainly the skin and the nervous system configuring a (true) mosaic neurocutaneous disorder; or an ordinary trait of a neurocutaneous disorder is sometimes superimposed by a pronounced linear or otherwise segmental involvement; or, lastly, a neurocutaneous disorder can occur solely in a mosaic pattern. Recently, the molecular genetic and cellular bases of an increasing number of neurocutaneous disorders have been unravelled, shedding light on the interplays between common intra- and extra-neuronal signalling pathways encompassing receptor-protein and protein-to-protein cascades (eg, RAS, MAPK, mTOR, PI3K/AKT and GNAQ pathways), which are often responsible of the mosaic distribution of cutaneous and extra-cutaneous features. In this article we will focus on the well known, and less defined mosaic neurocutaneous phenotypes and their related molecular/genetic bases, including the mosaic neurofibromatoses and their related forms (ie, spinal neurofibromatosis and schwannomatosis); Legius syndrome; segmental arrangements in tuberous sclerosis; Sturge-Weber and Klippel-Trenaunay syndromes; microcephaly/megalencephaly-capillary malformation; blue rubber bleb nevus syndrome; Wyburn-Mason syndrome; mixed vascular nevus syndrome; PHACE syndrome; Incontinentia pigmenti; pigmentary mosaicism of the Ito type; neurocutaneous melanosis; cutis tricolor; speckled lentiginous syndrome; epidermal nevus syndromes; Becker's nevus syndrome; phacomatosis pigmentovascularis and pigmentokeratotica; Proteus syndrome; and encephalocraniocutaneous lipomatosis.
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Affiliation(s)
- Martino Ruggieri
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy.
| | - Andrea D Praticò
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Rizzo R, Pavone P. Nevus Sebaceous and Its Association With Neurologic Involvement. Semin Pediatr Neurol 2015; 22:302-9. [PMID: 26706017 DOI: 10.1016/j.spen.2015.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Several terms are widely used to define cutaneous lesions affecting the epidermis in association with extracutaneous lesions. Recently, based on the wide spectrum of cutaneous epidermal lesions, the various underlying molecular mechanisms and patterns of associated features have led to improved definitions of these disorders. Nevus sebaceous syndrome has been placed under the umbrella term of epidermal nevus syndrome, in which the nevus sebaceous, a congenital hamartomatous lesion of the epidermis, is associated with anomalies involving the brain, eyes, and bones. Nevus sebaceous and neurologic manifestations were evaluated particularly based on their degree of intellectual delay, seizure type, treatment response, and electroencephalography and neuroradiological findings. A review of the literature in this topic is reported.
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Affiliation(s)
- Renata Rizzo
- *Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Piero Pavone
- University Hospital Policlinico-Vittorio Emanuele, Catania, Italy.
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Juan YH, Nagpal P, Saboo SS, Lin YC, Khandelwal A. Vascular manifestations and post-treatment changes of epidermal nevus syndrome. QJM 2015; 108:135-7. [PMID: 24757097 DOI: 10.1093/qjmed/hcu089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y-H Juan
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - P Nagpal
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - S S Saboo
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - Y-C Lin
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
| | - A Khandelwal
- From the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan and Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Taoyuan, Taiwan
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23
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Phenotype/genotype correlations in epidermal nevus syndrome as a neurocristopathy. HANDBOOK OF CLINICAL NEUROLOGY 2015; 132:9-25. [DOI: 10.1016/b978-0-444-62702-5.00002-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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24
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Pezoa XE, Nicklas Díaz C, Cárdenas de la Torre C, Romero Gallardo W, Schäffer Villalobos F, González Bombardiere S. Porokeratotic eccrine ostial and dermal duct nevus with linear verrucous epidermal nevus: an unusual association. Int J Dermatol 2014; 53:625-7. [PMID: 24877174 DOI: 10.1111/j.1365-4632.2011.05076.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Therapeutic effects of CO2 laser therapy of linear nevus sebaceous in the course of the Schimmelpenning-Feuerstein-Mims syndrome. Postepy Dermatol Alergol 2013; 30:320-3. [PMID: 24353494 PMCID: PMC3858662 DOI: 10.5114/pdia.2013.38363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 01/21/2013] [Accepted: 02/10/2013] [Indexed: 11/17/2022] Open
Abstract
The Schimmelpenning-Feuerstein-Mims (SFM) syndrome is a rare phakomatosis which comprises a nevus sebaceous of Jadassohn, seizures and developmental delay associated with a wide spectrum of extracutaneous abnormalities including neurological, skeletal, ocular, cardiovascular and urogenital defects. We are presenting a case of an 18-year-old patient with systemic features of the SFM syndrome and an extensive linear nevus sebaceous partially removed with a carbon dioxide (CO2) laser. The treatment options of skin lesions in patients with SFM are discussed.
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Dhombres F, Kolanska K, Garel C, Aubry JP, Gonzales M, Jouannic JM. Prenatal diagnosis of exophytic nevus sebaceous of the scalp. Prenat Diagn 2013; 33:1305-7. [PMID: 24122891 DOI: 10.1002/pd.4252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 09/28/2013] [Accepted: 09/30/2013] [Indexed: 11/10/2022]
Abstract
Nevus sebaceous is a complex hamartoma most commonly found on the scalp, face, and neck and is often present at birth, although some may be diagnosed later in infancy. We report the first prenatal diagnosis of isolated nevus sebaceous that presented at 19 weeks' gestation as a large and exophytic tumor of the scalp. This case emphasizes the crucial role of ultrasound examination performed with high-frequency probes, which revealed associated diffuse lesions of the face. Identification of such a facial involvement could have a dramatic prognostic impact.
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Affiliation(s)
- Ferdinand Dhombres
- Service de Gynécologie-Obstétrique et Centre Pluridisciplinaire de Diagnostic Prénatal de l' Est Parisien, Hôpital Armand Trousseau, APHP, Paris, France
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27
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Colletti G, Allevi F, Moneghini L, Rabbiosi D, Bertossi D, Frau I, Biglioli F, Tadini G. Epidermal nevus and ameloblastoma: a rare association. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 117:e275-9. [PMID: 23969333 DOI: 10.1016/j.oooo.2013.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 05/29/2013] [Accepted: 06/05/2013] [Indexed: 11/16/2022]
Abstract
Epidermal nevi are clinical manifestations of a malformation affecting the embryonic ectoderm. They appear as linear verrucous lesions and are more often located in the skin of the trunk or the extremities. Rarely, verrucous lesions affect the oral mucosa. Epidermal nevi can be a component of epidermal nevus syndrome (ENS), which is characterized by malformations involving several organs, such as the central nervous system. ENS is rarely associated with other solid tumors. We present the case of a patient affected by ENS who developed maxillary and mandibular ameloblastomas. Epidermal nevi were located in the left middle and lower third of the face and in the left cervical region, whereas the ameloblastomas arose within the left maxillary mucosa and within the left mandibular ramus. Features of the syndrome are described and the relevant literature is reviewed.
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Affiliation(s)
- Giacomo Colletti
- Assistant Professor, Department of Maxillofacial Surgery, University of Milan, San Paolo Hospital, Milan, Italy.
| | - Fabiana Allevi
- Assistant Professor, Department of Maxillofacial Surgery, University of Milan, San Paolo Hospital, Milan, Italy
| | - Laura Moneghini
- Assistant Professor, Division of Pathology, Department of Health Sciences, University of Milan, San Paolo Hospital, Milan, Italy
| | - Dimitri Rabbiosi
- Assistant Professor, Department of Maxillofacial Surgery, University of Milan, San Paolo Hospital, Milan, Italy
| | - Dario Bertossi
- Associate Professor, Department of Oral and Maxillofacial Surgery, University of Verona, Italy
| | | | - Federico Biglioli
- Associate Professor, Department of Maxillofacial Surgery, University of Milan, San Paolo Hospital, Milan, Italy
| | - Gianluca Tadini
- Consultant Professor, Centro Malattie Cutanee Ereditarie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano and Pediatric Clinic 1, Milan, Italy
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28
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Boente MDC, Asial R, Primc NB, Happle R. Angora hair nevus. A further case of an unusual epidermal nevus representing a hallmark of angora hair nevus syndrome. J Dermatol Case Rep 2013; 7:49-51. [PMID: 23858341 DOI: 10.3315/jdcr.2013.1138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 01/27/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND The association of Blaschko lines with genetic mosaicism has lead to the concept that this pattern represents the manifestation of genetically abnormal skin tissue contrasting with the genetically normal skin. Various mosaic defects affecting not only the skin but also extracutaneous tissues have lead to the description of different types of epidermal nevus syndromes. We present a further case of an unusual organoid epidermal nevus characterized by depigmented hypertrichosis. MAIN OBSERVATIONS We describe a 2-year-old boy with a systematized angora hair nevus being characterized by bands covered with soft white hair arranged along Blaschko's lines, involving the scalp, face, and trunk. A biopsy obtained from a scalp lesion showed mild epidermal acanthosis and increased pigmentation of the basal layer. Trichoscopy the affected scalp hair demonstrated fine light coloured shafts. The boy had slight macrocephaly and body asymmetry, a sacral pit, and koilonychia of the big toes. CONCLUSIONS The angora hair nevus is a peculiar type of organoid epidermal nevus, representing the cutaneous hallmark of a distinctive syndrome, the angora hair nevus syndrome (Schauder syndrome). In cases of epidermal nevi showing hypertrichosis, this unusual entity should be borne in mind for differential diagnosis.
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Affiliation(s)
- María Del Carmen Boente
- Department of Dermatology, Hospital del Niño Jesús, San Miguel de Tucumán, Tucumán, Argentina
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29
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Akelma AZ, Cizmeci MN, Kanburoglu MK, Mete E. A diagnostic dilemma: inflammatory linear verrucous epidermal nevus versus linear psoriasis. J Pediatr 2013; 162:879-879.e1. [PMID: 23149170 DOI: 10.1016/j.jpeds.2012.10.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 10/04/2012] [Indexed: 11/16/2022]
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30
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Zheng LQ, Huang Y, Qu YJ, Zhang YH, Han XC. Multiple basal cell carcinomas arising in a verrucous epidermal nevus. J Dermatol 2013; 40:482-3. [PMID: 23488626 DOI: 10.1111/1346-8138.12110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Poretti A, Meoded A, Rossi A, Raybaud C, Huisman TAGM. Diffusion tensor imaging and fiber tractography in brain malformations. Pediatr Radiol 2013; 43:28-54. [PMID: 23288476 DOI: 10.1007/s00247-012-2428-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 04/09/2012] [Indexed: 01/19/2023]
Abstract
Diffusion tensor imaging (DTI) is an advanced MR technique that provides qualitative and quantitative information about the micro-architecture of white matter. DTI and its post-processing tool fiber tractography (FT) have been increasingly used in the last decade to investigate the microstructural neuroarchitecture of brain malformations. This article aims to review the use of DTI and FT in the evaluation of a variety of common, well-described brain malformations, in particular by pointing out the additional information that DTI and FT renders compared with conventional MR sequences. In addition, the relevant existing literature is summarized.
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Affiliation(s)
- Andrea Poretti
- Division of Pediatric Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Nelson Basement, B-173, Baltimore, MD 21287-0842, USA
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32
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Abstract
Epidermal nevus syndrome (ENS) is an inclusive term for a heterogeneous group of congenital disorders characterized by the presence of epidermal nevi associated with systemic involvement. These disorders, as are all primary neurocutaneous syndromes, are neurocristopathies. The epidermal nevi that follow the lines of Blaschko and most systemic anomalies in skeletal, ocular, cardiovascular, endocrine, and orodental tissues, as well as lipomas, are due to defective neural crest. The most important and frequent anomaly in the brain in all forms of epidermal nevus syndromes (ENSs) is hemimegalencephaly (HME). This malformation often is not recognized, despite being the principal cause of neurological manifestations in ENSs. They consist mainly of epilepsy and developmental delay or intellectual disability. The onset of epilepsy in ENS usually is in early infancy, often as infantile spasms. Several syndromic forms have been delineated. I propose the term "Heide's syndrome" for those distinctive cases with the typical triad of hemifacial epidermal nevus, ipsilateral facial lipoma, and hemimegalencephaly. Most ENSs are sporadic. The mechanism is thought to be genetic mosaicism with a lethal autosomal dominant gene. Specific genetic mutations (PTEN, FGFR3, PIK3CA, and AKT1) have been documented in some patients. The large number of contributors for over more than a century and a half to the description of these disorders precludes the use of new author eponyms.
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Affiliation(s)
- Flores-Sarnat Laura
- Departments of Clinical Neurosciences and Paediatrics, Division of Paediatric Neurology, University of Calgary, Alberta Children's Hospital, Calgary, Canada.
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33
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Groesser L, Herschberger E, Ruetten A, Ruivenkamp C, Lopriore E, Zutt M, Langmann T, Singer S, Klingseisen L, Schneider-Brachert W, Toll A, Real FX, Landthaler M, Hafner C. Postzygotic HRAS and KRAS mutations cause nevus sebaceous and Schimmelpenning syndrome. Nat Genet 2012; 44:783-7. [DOI: 10.1038/ng.2316] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/08/2012] [Indexed: 12/14/2022]
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34
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Thomas C, Hardy C, Goga D, Laure B. [A vertex lesion]. ACTA ACUST UNITED AC 2012; 113:393-4. [PMID: 22244054 DOI: 10.1016/j.stomax.2011.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 12/12/2011] [Indexed: 11/25/2022]
Affiliation(s)
- C Thomas
- Service de Chirurgie Maxillo-faciale et Plastique de la Face, Hôpital Trousseau, avenue de la République, 37044 Tours cedex, France
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35
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36
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Meibodi NT, Nahidi Y, Javidi Z. Epidermolytic hyperkeratosis in inflammatory linear verrucous epidermal nevus. Indian J Dermatol 2011; 56:309-12. [PMID: 21772595 PMCID: PMC3132911 DOI: 10.4103/0019-5154.82488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Epidermolytic hyperkeratosis presents with perinuclear vacuolization of the keratinocytes in spinous and granular layers, keratinocytes with ill-defined limits, which leads to a reticulate appearance of the epidermis, an increased number of variously shaped and sized basophilic keratohyalin granules and the same sized eosinophilic trichohyalin granules, at any level of epidermis, mainly in the stratum granulosum, and compact hyperkeratosis. This minor reactive pathologic reaction pattern of skin is found in large variety of diseases. This paper is the first case report of such pattern in inflammatory linear verrucous epidermal nevus. Our case is of a 23-year-old man with pruritic verrucous lesions of trunk and extremities initiated since 13 years ago. Physical examination revealed white linear hyperkeratotic lesions, some of them on erythematous background and also classic epidermal nevus. No skeletal, ophthalmic, and nervous system involvement was detected. Microscopic study of pruritic verrucous lesions showed psoriasiform acanthosis, mild papillomatous, hyperkeratosis, and epidermolytic hyperkeratotic changes in hair follicles and acrosyrinx accompanied with moderate perivascular inflammation.
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Affiliation(s)
- Naser Tayyebi Meibodi
- Departments of Pathology and Dermatology, Mashhad University of Medical Sciences, Mashhad, Iran
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37
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Adams D, Athalye L, Schwimer C, Bender B. A profound case of linear epidermal nevus in a patient with epidermal nevus syndrome. J Dermatol Case Rep 2011; 5:30-3. [PMID: 21894253 DOI: 10.3315/jdcr.2011.1069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 05/14/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Epidermal nevus syndrome is a multi-system disease with a wide spectrum of clinical presentation. Numerous specialists may be required to address its extra cutaneous manifestations. MAIN OBSERVATIONS We report a severe case of epidermal nevus syndrome involving the oral cavity, pharynx, and central nervous system in addition to disfiguring skin lesions. CONCLUSIONS Dermatologists are in a unique position to first render the diagnosis of epidermal nevus syndrome for young patients and ensure appropriate follow-up.
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Affiliation(s)
- Derrick Adams
- Vita Dermatology and Laser Institute, Red Bluff, CA, USA
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38
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Bygum A, Fagerberg CR, Clemmensen OJ, Fiebig B, Hafner C. Systemic epidermal nevus with involvement of the oral mucosa due to FGFR3 mutation. BMC MEDICAL GENETICS 2011; 12:79. [PMID: 21639936 PMCID: PMC3119182 DOI: 10.1186/1471-2350-12-79] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Accepted: 06/05/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND Epidermal nevi (EN) represent benign congenital skin lesions following the lines of Blaschko. They result from genetic mosaicism, and activating FGFR3 and PIK3CA mutations have been implicated. CASE PRESENTATION We report a female patient with a systemic keratinocytic nevus also involving the oral mucosa. Molecular genetic analysis revealed a mosaicism of the FGFR3 hotspot mutation R248C in the EN lesions of the skin and of the oral mucosa. The detection of the R248C mutation in a proportion of blood leukocytes and a slight scoliosis suggest an EN syndrome. CONCLUSIONS Our results show that activating FGFR3 mutations can also affect the oral mucosa and that extracutaneous manifestations of EN syndrome can be subtle. We highlight the theoretical risk of the patient having an offspring with thanatophoric dysplasia as gonadal mosaicism for the R248C mutation cannot be excluded.
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Affiliation(s)
- Anette Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, 5000 Odense, Denmark.
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39
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Shahgholi E, Mollaian M, Haghshenas Z, Honarmand M. Congenital rhabdomyosarcoma, central precocious puberty, hemihypertrophy and hypophosphatemic rickets associated with epidermal nevus syndrome. J Pediatr Endocrinol Metab 2011; 24:1063-6. [PMID: 22308867 DOI: 10.1515/jpem.2011.378] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a newborn girl with right-sided extended epidermal nevus, congenital rhabdomyosarcoma of the inguinal area at birth who had developed central precocious puberty, hemihypertrophy and vitamin D3-responsive hypophosphatemic rickets at the age of 14 months. Our patient demonstrates a much broader and polymorphic spectrum of organ systems involvement in epidermal nevus syndrome at a very early age of her life.
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Affiliation(s)
- Elham Shahgholi
- Division of Pediatric Hematology Oncology, Tehran University of Medical Sciences, Tehran, Iran.
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40
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Cosendey FE, Martinez NS, Bernhard GA, Dias MFRG, Azulay DR. Becker nevus syndrome. An Bras Dermatol 2010; 85:379-84. [PMID: 20676475 DOI: 10.1590/s0365-05962010000300015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 11/27/2009] [Indexed: 11/21/2022] Open
Abstract
Becker nevus syndrome is a phenotype characterized by the fundamental presence of Becker's nevus with ipsilateral hypoplasia of the breast or other skin, skeletal and/or muscular disorders. This syndrome generally originates at birth, intensifies significantly in adolescence and is one of the syndromes that constitute epidermal nevus syndrome. To the best of our knowledge, this is the first case published in the Brazilian literature of Becker nevus syndrome associated with Becker's nevus, ipsilateral breast hypoplasia and scoliosis in a 14-year-old girl.
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41
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Rijntjes-Jacobs EG, Lopriore E, Steggerda SJ, Kant SG, Walther FJ. Discordance for Schimmelpenning-Feuerstein-Mims syndrome in monochorionic twins supports the concept of a postzygotic mutation. Am J Med Genet A 2010; 152A:2816-9. [DOI: 10.1002/ajmg.a.33635] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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42
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Abstract
Nevi or nests of cells may be made up of a variety of cell types. The cell types that live in the epidermis include epidermal cells or keratinocytes, sebaceous glands, hair follicles, apocrine and eccrine glands, and smooth muscle cells. This article discusses epidermal or keratinocyte nevi, nevus sebaceous, nevus comedonicus, smooth muscle hamartomas, and inflammatory linear verrucous epidermal nevi. Syndromes associated with epidermal nevi are also reviewed.
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43
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Happle R. The group of epidermal nevus syndromes Part II. Less well defined phenotypes. J Am Acad Dermatol 2010; 63:25-30; quiz 31-2. [PMID: 20542175 DOI: 10.1016/j.jaad.2010.01.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 04/23/2009] [Accepted: 01/19/2010] [Indexed: 11/16/2022]
Abstract
UNLABELLED In addition to the well established epidermal nevus syndromes, such as Schimmelpenning, Becker, Proteus, CHILD, or nevus comedonicus syndromes, the group of less well defined phenotypes associated with epidermal nevi presently includes nevus trichilemmocysticus syndrome, didymosis aplasticosebacea, SCALP syndrome (sebaceous nevus, central nervous system malformations, aplasia cutis congenita, limbal dermoid,and pigmented nevus), Gobello syndrome, Bäfverstedt syndrome, NEVADA syndrome (nevus epidermicus verrucosus with angio-dysplasia and aneurysms), and CLOVE syndrome (congenital lipomatous overgrowth, vascular malformations, and epidermal nevus). These syndromes can thus far be regarded as being in limbo. Future clinical and molecular research may show which of these disorders can be added to the list of well defined nosologic entities. LEARNING OBJECTIVES After completing this learning activity, participants should be able to understand why the list of distinct epidermal nevus syndromes can thus far not be regarded as being complete; why clinicians, when seeing a patient with an epidermal nevus syndrome that is difficult to categorize, should bear in mind the group of less well defined epidermal nevus syndromes; and how practical dermatologists can help recognize rare forms of epidermal nevus syndromes and categorize them appropriately.
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Affiliation(s)
- Rudolf Happle
- Department of Dermatology, University of Marburg, Marburg, Germany.
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44
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Happle R. The group of epidermal nevus syndromes Part I. Well defined phenotypes. J Am Acad Dermatol 2010; 63:1-22; quiz 23-4. [PMID: 20542174 DOI: 10.1016/j.jaad.2010.01.017] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 01/09/2010] [Accepted: 04/23/2009] [Indexed: 11/20/2022]
Abstract
UNLABELLED The epidermal nevus syndromes represent a group of distinct disorders that can be distinguished by the type of associated epidermal nevus and by the criterion of presence or absence of heritability. Well defined syndromes characterized by organoid epidermal nevi include Schimmelpenning syndrome, phacomatosis pigmentokeratotica, nevus comedonicus syndrome, angora hair nevus syndrome, and Becker nevus syndrome. The molecular basis of these disorders has so far not been identified. By contrast, the group of syndromes characterized by keratinocytic nevi comprises three phenotypes with a known molecular etiology in the form of CHILD (congenital hemidysplasia with ichthyosiform nevus and limb defects) syndrome, type 2 segmental Cowden disease, and fibroblast growth factor receptor 3 epidermal nevus syndrome (García-Hafner-Happle syndrome), whereas Proteus syndrome is still of unknown origin. From this overview, it is clear that a specific type of these disorders cannot be classified by the name "epidermal nevus syndrome" nor by the terms "organoid nevus syndrome" or "keratinocytic nevus syndrome." LEARNING OBJECTIVES After completing this learning activity, participants should be able to distinguish nine different epidermal nevus syndromes by their characteristic features, understand the practical significance of avoiding terms like "epidermal nevus syndrome" or "keratinocytic nevus syndrome" to define any specific entity within this group of disorders, and differentiate between nonhereditary traits and those bearing a genetic risk because of either Mendelian or non-Mendelian inheritance.
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Affiliation(s)
- Rudolf Happle
- Department of Dermatology, University of Marburg, Marburg, Germany.
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45
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Amato C, Elia M, Schepis C. Schimmelpenning syndrome: a kind of craniofacial epidermal nevus associated with cerebral and ocular MR imaging abnormalities. AJNR Am J Neuroradiol 2010; 31:E47-8. [PMID: 20299435 DOI: 10.3174/ajnr.a2062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Miyagawa Y, Nakazawa M, Kudoh T. Epidermal nevus syndrome associated with anterior scleral staphyloma and ectopic bone and cartilaginous intraocular tissue. Jpn J Ophthalmol 2010; 54:15-8. [DOI: 10.1007/s10384-009-0760-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 09/01/2009] [Indexed: 10/19/2022]
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47
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Eisen DB, Michael DJ. Sebaceous lesions and their associated syndromes: part II. J Am Acad Dermatol 2009; 61:563-78; quiz 579-80. [PMID: 19751880 DOI: 10.1016/j.jaad.2009.04.059] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 04/09/2009] [Accepted: 04/12/2009] [Indexed: 01/31/2023]
Abstract
Sebaceous lesions are associated with two syndromes with widespread multisystem disorders and tumors. Linear sebaceous nevus syndrome has been traditionally known as the triad of sebaceous nevus of Jadassohn, seizures, and mental retardation. This syndrome encompasses a much broader spectrum of multisystem disorders, which is explored below. Muir-Torre syndrome is described as the presence of sebaceous tumors or keratoacanthomas with an underlying visceral malignancy. It is caused by mutations in DNA mismatch repair genes. We discuss its relationship with Lynch syndrome and suggest a comprehensive algorithm on how to screen patients with sebaceous neoplasms for Muire-Torre syndrome. We also provide suggested intensive cancer screening guidelines based on recommendations for patients with Lynch syndrome that may also be of value for patients with Muir-Torre syndrome.
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Affiliation(s)
- Daniel B Eisen
- Department of Dermatology at the School of Medicine, University of California, Davis, Sacramento, California 95816, USA.
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De Niro JE, de Alba Campomanes AG, Bloomer MM, London NM, Stamper RL. Congenital narrow-angle glaucoma and iris nevi in a neonate with epidermal nevus syndrome. J AAPOS 2009; 13:292-5. [PMID: 19541271 DOI: 10.1016/j.jaapos.2009.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 01/27/2009] [Accepted: 01/27/2009] [Indexed: 12/01/2022]
Abstract
Epidermal nevus syndrome (ENS) is a neurocutaneous disorder characterized by epidermal hamartomas and abnormalities of the brain, eye, and other systems. We report the occurrence of congenital angle closure glaucoma in a patient with epidermal nevus syndrome. Intraoperative use of ultrasound biomicroscopy was essential in making the diagnosis.
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Affiliation(s)
- Jennifer E De Niro
- Department of Ophthalmology, University of California, San Francisco, California 94143, USA
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