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Iqneibi M, Al-Khawaga S, Wafi O, Steinhoff M. Successful treatment of pachyonychia congenita with simvastatin. J Eur Acad Dermatol Venereol 2024; 38:e356-e358. [PMID: 37994233 DOI: 10.1111/jdv.19630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Mariam Iqneibi
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Sara Al-Khawaga
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- School of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Omar Wafi
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- School of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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Chu HT, Dinh Duong TA, Le DH, Le TV, Nguyen BB, Dang CV, Vu QV. Phenotype and genotype features of Vietnamese children with pachyonychia congenita. Pediatr Neonatol 2023; 64:405-410. [PMID: 36658016 DOI: 10.1016/j.pedneo.2022.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/04/2022] [Accepted: 09/21/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Pachyonychia congenita (PC) is a group of autosomal dominant disorders caused by mutations in one of five keratin genes (KRT6A, KRT6B, KRT6C, KRT16, or KRT17). PC is an extremely rare condition. To our knowledge, this is the largest genotype-phenotype study of PC in a Vietnamese population to date. MATERIALS AND METHODS We investigated keratin gene mutations and clinical features of seven Vietnamese children with PC. RESULTS The seven Vietnamese patients were from six different families (two patients in the same family) from across Northern, Central, and Southern Vietnam. All children displayed PC symptoms before 1 year of age, but diagnosis was delayed in 4/7 patients. Thick fingernails, thick toenails, oral leukokeratosis, and follicular hyperkeratosis were the most common features recorded by all seven patients. Plantar keratoderma and thick fingernails were the clinical features associated with the most significant effect on daily function. All patients had mutations in KRT6A (PC-K6a) focused on the 1A and 2B domains. We found three distinct types of mutations (K6a R466P, K6a N171K, and K6a N172del). One mutation (N172del) was common to 5/7 (71.4%) of the patients. CONCLUSIONS Individuals displaying nail dystrophy, oral leukokeratosis, follicular hyperkeratosis, and plantar keratoderma should be referred for genetic testing given the high likelihood of a PC-K6a-related mutation in patients with this constellation of clinical signs.
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Affiliation(s)
- Ha Thi Chu
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Tung Anh Dinh Duong
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Doanh Huu Le
- National Hospital of Dermatology and Venereology, Hanoi, Vietnam
| | - Thieu Van Le
- Endoscopy and Exploration Functional Department, Viettiep Friendship Hospital, Haiphong, Vietnam
| | - Binh Bui Nguyen
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Chuc Van Dang
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam
| | - Quang Van Vu
- Department of Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, Vietnam; Pediatric Department, Green International Hospital, Haiphong, Vietnam.
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3
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Tiplica GS, Fritz K, Butacu AI, Ungureanu L, Sălăvăstru CM. Gutartige nichtmelanozytäre Hauttumoren bei Syndromen. Hautarzt 2022; 73:114-126. [DOI: 10.1007/s00105-022-04947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 12/24/2022]
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4
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Li Y, Wang Y, Ming Y, Chaolan P, Jia Z, Cheng N, Qiaoyu C, Li M, Tianyi X. A KRT6A mutation p.Ile462Asn in a Chinese family with pachyonychia congenita, and identification of maternal mosaicism: a case report. BMC Med Genomics 2021; 14:259. [PMID: 34724947 PMCID: PMC8559371 DOI: 10.1186/s12920-021-01109-4] [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: 06/17/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Pachyonychia congenita (PC, OMIM #167200, #167210, #615726, #615728, and #615735) is a rare autosomal dominant disorder caused by keratin gene mutations in KRT6A,KRT6B,KRT6C,KRT16 or KRT17. It is characterized with nail dystrophy and palmoplantar keratoderma (PPK). The most prominent manifestation is plantar pain. This is a further unusual case of parental mosaicism in PC. Although very rare, germ cell mosaicism should be considered when providing genetic counselling for unaffected parents of a child with PC. Case presentation We report the case of a 5-year-old boy with thickening nails and oral leukokeratosis at birth. He began to develop palmoplantar keratoderma at 2 years old and his sister has similar clinical manifestation characterized with nail discoloration and thickening. A previously reported heterozygous mutation, p.Ile462Asn, was identified in KRT6A in the proband and his affected sister. SNaPshot sequencing revealed mosaicism at a level of 2.5% and 4.7% in DNA from blood and hair bulbs from the unaffected mother. HiSeq deep sequencing demonstrated low-grade mosaicism in the patient’s younger sister and parents. Conclusion These findings indicate the ability of WES and SNaPshot sequencing to detect low-frequency mosaic mutations. Although very rare, germinal mosaicism should be considered when genetic counseling is given to families with presumed spontaneous cases of PC.
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Affiliation(s)
- Yue Li
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China.,Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yumeng Wang
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Yan Ming
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Pan Chaolan
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Zhang Jia
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ni Cheng
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Cao Qiaoyu
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Ming Li
- Departments of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China. .,Center for Rare Disease, Shanghai, China.
| | - Xu Tianyi
- Department of Obstetrics, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Henshan Road, Shanghai, 200030, China.
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5
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Zhang W, Liu M, Dupont RL, Huang K, Yu L, Liu S, Wang X, Wang C. Conservation and Identity Selection of Cationic Residues Flanking the Hydrophobic Regions in Intermediate Filament Superfamily. Front Chem 2021; 9:752630. [PMID: 34540811 PMCID: PMC8443778 DOI: 10.3389/fchem.2021.752630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022] Open
Abstract
The interplay between the hydrophobic interactions generated by the nonpolar region and the proximal functional groups within nanometers of the nonpolar region offers a promising strategy to manipulate the intermolecular hydrophobic attractions in an artificial molecule system, but the outcomes of such modulations in the building of a native protein architecture remain unclear. Here we focus on the intermediate filament (IF) coiled-coil superfamily to assess the conservation of positively charged residue identity via a biostatistical approach. By screening the disease-correlated mutations throughout the IF superfamily, 10 distinct hotspots where a cation-to-cation substitution is associated with a pathogenic syndrome have been identified. The analysis of the local chemical context surrounding the hotspots revealed that the cationic diversity depends on their separation distance to the hydrophobic domain. The nearby cationic residues flanking the hydrophobic domain of a helix (separation <1 nm) are relatively conserved in evolution. In contrast, the cationic residues that are not adjacent to the hydrophobic domain (separation >1 nm) tolerate higher levels of variation and replaceability. We attribute this bias in the conservation degree of the cationic residue identity to reflect the interplay between the proximal cations and the hydrophobic interactions.
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Affiliation(s)
- Wenbo Zhang
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Mingwei Liu
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Robert L Dupont
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, United States
| | - Kai Huang
- Shenzhen Bay Laboratory, Shenzhen, China
| | - Lanlan Yu
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Shuli Liu
- Department of Clinical Laboratory, Peking University Civil Aviation School of Clinical Medicine, Beijing, China
| | - Xiaoguang Wang
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, United States.,Sustainability Institute, The Ohio State University, Columbus, OH, United States
| | - Chenxuan Wang
- State Key Laboratory of Medical Molecular Biology, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
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Wu AG, Lipner SR. Distinctions in the Management, Patient Impact, and Clinical Profiles of Pachyonychia Congenita Subtypes. Skin Appendage Disord 2021; 7:194-202. [PMID: 34055907 DOI: 10.1159/000513340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Pachyonychia congenita (PC) is a rare dermatosis that confers lifelong physical and emotional morbidities in affected patients. However, the clinical findings, treatments, and psychosocial impact of this disease have not been adequately described. The International PC Research Registry (IPCRR), a multinational initiative to collect data on PC patients, has allowed an opportunity to distinguish the salient features of this disease. We aimed to characterize the breadth and extent of nail disease, treatments, and quality of life in PC patients, and to describe any significant differences in clinical presentation or treatment of PC subtypes. Methods The most recent IPCRR patient survey data consisting of an 857-response questionnaire and a 102-response addendum were analyzed in a retrospective analysis. The survey data were collected as part of a multinational, multicenter initiative and comprise the largest representative population of PC to date. Participants (survey respondents) were included in the study based on questionnaire responses and a genetic confirmation of having a PC subtype. Results A total of 857 survey responses were collected. Genetic variations among PC subtypes influence nail disease onset and severity of symptoms. Nail disease negatively impacts patients' emotional health, especially during the adolescent and young adult years. Nail treatment tools vary little in terms of effectiveness and acquired infection rates. Conclusion and Discussion Patients with different PC subtypes have distinct clinical nail presentations and psychosocial impact. Genetic testing should be used to confirm PC diagnoses. Further characterization of PC, especially the rarer subtypes, may allow for more individualized patient education.
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Affiliation(s)
- Albert G Wu
- New York Medical College, New York, New York, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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7
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Zhang Y, Wu Y, Jia W, Li W, Cheng P, Bu W, Li C. Novel keratin 16 mutation in a Chinese family with focal palmoplantar keratoderma. Int J Dermatol 2020; 60:e187-e189. [PMID: 33377179 DOI: 10.1111/ijd.15386] [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: 04/11/2020] [Revised: 11/26/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Yuanyuan Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yingda Wu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Weixue Jia
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Wenrui Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ping Cheng
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Wenbo Bu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Chengrang Li
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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8
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Pavlovsky M, Peled A, Samuelov L, Malki L, Malovitski K, Assaf S, Mohamad J, Meijers O, Eskin-Schwartz M, Sarig O, Sprecher E. Molecular epidemiology of pachyonychia congenita in the Israeli population. Clin Exp Dermatol 2020; 46:663-668. [PMID: 33190296 DOI: 10.1111/ced.14509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare autosomal dominant disorder featuring palmoplantar keratoderma, nail dystrophy, oral leucokeratosis, pilosebaceous cysts and natal teeth. PC results from dominant mutations in one of five genes (KRT6A, KRT6B, KRT6C, KRT16, KRT17) encoding keratin proteins. AIM To delineate the clinical and genetic features of PC in a series of Israeli patients. METHODS We used direct sequencing of genomic DNA, and also used cDNA sequencing where applicable. RESULTS We collected clinical information and molecular data in a cohort of Israeli families diagnosed with PC (n = 16). Most of the patients were Ashkenazi Jews and had a family history of PC. The most common clinical findings were painful focal plantar keratoderma (94%) accompanied by nail dystrophy (81%), pilosebaceous cysts (31%) and prenatal/natal teeth (13%). In contrast to the high prevalence of KRT6A mutations in other populations, we found that KRT16 mutations were the most common type among Israeli patients with PC (56%). Most (77%) of the Israeli patients with PC with KRT16 mutation carried the same variant (c.380G>A; p.R127H) and shared the same haplotype around the KRT16 locus, suggestive of a founder effect. CONCLUSION The data gleaned from this study emphasizes the importance of population-specific tailored diagnostic strategies.
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Affiliation(s)
- M Pavlovsky
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - A Peled
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - L Samuelov
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Malki
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Malovitski
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Assaf
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J Mohamad
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O Meijers
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - M Eskin-Schwartz
- Genetics Institute at Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - O Sarig
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - E Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Mathews J, Hansen CD, Chandrashekar L. Homozygous dominant missense mutation in Keratin 6b leading to severe pachyonychia congenita. Clin Exp Dermatol 2020; 46:410-412. [PMID: 33301203 DOI: 10.1111/ced.14494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/29/2020] [Accepted: 09/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- J Mathews
- Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, India
| | - C D Hansen
- Department of Dermatology, University of Utah College of Medicine, Salt Lake City, Utah, USA
| | - L Chandrashekar
- Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, India
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10
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Yoshida A, Yamamoto K, Ishida T, Omura T, Itoh T, Nishigori C, Sakane T, Yano I. Sunitinib decreases the expression of KRT6A and SERPINB1 in 3D human epidermal models. Exp Dermatol 2020; 30:337-346. [PMID: 33135264 DOI: 10.1111/exd.14230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 10/07/2020] [Accepted: 10/22/2020] [Indexed: 12/17/2022]
Abstract
Hand-foot skin reaction (HFSR) is a common side effect caused by several tyrosine kinase inhibitors, including sunitinib. However, the nature of the cornifying factors related to the molecular biological mechanisms underlying HFSR remains poorly understood. We used human keratinocyte models to investigate the key cornifying factors for dermatological and biological abnormalities induced by sunitinib. On the basis of the results of microarray analysis using the three-dimensional (3D) human epidermal model, keratin (KRT)6A, serine protease inhibitor (SERPIN)B1, KRT5, and SERPIN Kazal-type 6 were selected as candidate genes related to HFSR. Sunitinib treatment significantly decreased the expression of SERPINB1 and KRT6A in the immunohistochemical staining of the 3D epidermal model. In PSVK1 cells, but not in normal human epidermal keratinocyte cells, both of which are human normal keratinocyte cell lines, sunitinib decreased the expression of KRT6A with a concomitant decrease in levels of phosphorylated extracellular signal-regulated kinases (ERK)1/2 and phosphorylated p38 mitogen-activated protein kinase (MAPK). Inhibitors of the ERK and p38 MAPK signal pathways also significantly decreased KRT6A expression. Sunitinib-induced decrease in KRT6A expression was suppressed by the inhibition of glycogen synthase kinase-3β by enhancing ERK1/2 and p38 MAPK phosphorylation. Thus, sunitinib reduces the expression of KRT6A and SERPINB1 by inhibiting the ERK1/2 and p38 MAPK signalling pathways in the skin model. These changes in expression contribute to the pathology of HFSR.
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Affiliation(s)
- Ayaka Yoshida
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan.,Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | | | - Tomohiro Omura
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chikako Nishigori
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiyasu Sakane
- Department of Pharmaceutical Technology, Kobe Pharmaceutical University, Kobe, Japan
| | - Ikuko Yano
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
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11
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Stewart CL, Takeshita J, Hansen CD, Rubin AI. The histopathological features of the nail plate in pachyonychia congenita. J Cutan Pathol 2020; 47:357-362. [PMID: 31845382 DOI: 10.1111/cup.13630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/23/2019] [Accepted: 11/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare autosomal dominant disorder of keratinization mediated by genetic mutations in KRT6A, KRT6B, KRT6C, KRT16, or KRT17. While nail dystrophy in PC has a significant impact on quality of life, the histopathological features of the nail plate in PC have not been previously reported. We report the histopathological features of nail plates provided by 19 patients with genetically confirmed PC. METHODS Nineteen patients with genetically confirmed PC provided a total of 56 nail plates for histopathologic examination. The nail plates were examined for the presence of hyphae, yeast, bacteria, neutrophils, parakeratosis, plasma globules, and hemorrhage. Specimens with onychomycosis (three patients) were excluded from the analysis. RESULTS No specific histopathological feature was identified in PC nails. Parakeratosis and plasma globules were the most prominent features in both clinically affected and unaffected PC nails. There was a significant association between clinical dystrophy of all 20 nails and KRT6A mutations, and a lack of dystrophy of all 20 nails in KRT6B mutations. CONCLUSIONS Parakeratosis and plasma globules in the absence of other inflammatory disorders should raise PC in the histopathologic differential diagnosis. The presence of onychomycosis in a nail plate does not exclude a diagnosis of PC.
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Affiliation(s)
| | - Junko Takeshita
- Department of Dermatology, Perleman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Adam I Rubin
- Department of Dermatology, Perleman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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Goldberg I, Mashiah J, Kutz A, Derowe A, Warshauer E, Schwartz ME, Smith F, Sprecher E, Hansen CD. Symptomatic mucosal involvement in pachyonychia congenita: challenges in infants and young children. Br J Dermatol 2019; 182:708-713. [PMID: 31777952 DOI: 10.1111/bjd.18742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare autosomal dominant genodermatosis caused by a mutation in any one of five keratin genes (KRT6A, KRT6B, KRT6C, KRT16 or KRT17). Characteristic features of PC are painful palmoplantar keratoderma, variable nail dystrophy, cysts, follicular hyperkeratosis and often oral leukokeratosis. Although oral leukokeratosis can go unnoticed, mucosal involvement of the oral cavity and upper airways can manifest with pain during feeding, hoarseness, stridor and, occasionally, life-threatening obstruction. OBJECTIVES To characterize patients with PC with symptomatic mucosal involvement. METHODS We present a case series of nine children with PC with symptomatic mucosal involvement, all with heterozygous mutations in KRT6A. Seven patients complained of painful feeding problems. Four patients were diagnosed with failure to thrive, three of whom required a feeding tube. Simple feeding solutions were beneficial in most cases. Seven patients had laryngeal involvement and one patient died at 4 years of age from acute laryngeal obstruction. CONCLUSIONS It is important for dermatologists and otolaryngologists to be aware that symptomatic mucosal involvement, and very rarely laryngeal obstruction, can occur in patients with PC. Usually simple feeding solutions may prevent complications and failure to thrive. What's already known about this topic? Pachyonychia congenita (PC) is a rare autosomal dominant genodermatosis due to a mutation in any one of five keratin genes. Symptomatic mucosal involvement is an important clinical feature of PC and appears to be more pronounced in KRT6A mutation carriers. Only leukokeratosis is frequently seen in PC and can be one of the earliest signs of disease. Laryngeal involvement is a less common feature. It might be symptomatic but usually presents as hoarseness, stridor and, occasionally, as a life-threatening respiratory distress. What does this study add? In most cases of laryngeal involvement, there is no need for any intervention. Although pain and feeding difficulties are usually attributed to the oral leukokeratosis, they can be related to a phenomenon called 'first bite syndrome' (FBS). Symptomatic mucosal involvement with feeding difficulty is important but can be managed in most cases with simple feeding solutions (e.g. softer nipple with a larger hole, thicker formula and feeding with a syringe). Linked Comment: Youssefian and Vahidnezhad. Br J Dermatol 2020; 182:536-537.
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Affiliation(s)
- I Goldberg
- Department ofDermatology, Tel Aviv University, Tel Aviv, Israel
| | - J Mashiah
- Department ofDermatology, Tel Aviv University, Tel Aviv, Israel
| | - A Kutz
- Department ofDermatology, Tel Aviv University, Tel Aviv, Israel
| | - A Derowe
- Department ofOtolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Warshauer
- Pachyonychia Congenita Project, Holladay, UT, U.S.A
| | - M E Schwartz
- Pachyonychia Congenita Project, Holladay, UT, U.S.A
| | - F Smith
- Pachyonychia Congenita Project, Holladay, UT, U.S.A
| | - E Sprecher
- Department ofDermatology, Tel Aviv University, Tel Aviv, Israel
| | - C D Hansen
- Department of Dermatology, University of Utah, UT, U.S.A
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13
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Daroach M, Dogra S, Bhattacharjee R, Tp A, Smith F, Mahajan R. Pachyonychia congenita responding favorably to a combination of surgical and medical therapies. Dermatol Ther 2019; 32:e13045. [PMID: 31364784 DOI: 10.1111/dth.13045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 07/26/2019] [Accepted: 07/27/2019] [Indexed: 11/30/2022]
Abstract
Pachyonychia congenital (PC) is a rare genetic disorder of cornification and is classified into five types on the basis of keratin gene involved. There are no established treatment options available for PC. Sirolimus in both topical and oral form has been studied in management of PC. We report a young female with a novel genetic mutation in KRT6A gene who presented with painful palmoplantar hyperkeratosis and onychogryphosis, which was cosmetically disfiguring. She was prescribed oral sirolimus after all investigations. There was significant improvement in pain within a week. Pain relief was sustained at 1 year follow-up with topical treatment only. Serial nail avulsion surgeries were also done with showed significant cosmetic improvement in the nails. Medical therapies can be combined with surgery for a better cosmetic outcome and improvement in patient quality of life.
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Affiliation(s)
- Manju Daroach
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajsmita Bhattacharjee
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Afra Tp
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Frances Smith
- Chief Geneticist, Pachyonychia Congenita Project (PC Project), Holladay, Utah
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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14
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Xu Q, Zhang Q, Tang L, Jin L, Wang X, Kan L, Zheng X, Yang S. A
KRT16
mutation in the first Chinese pedigree with Pachyonychia congenita and review of the literatures. J Cosmet Dermatol 2019; 18:1930-1934. [PMID: 30859684 DOI: 10.1111/jocd.12905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/05/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Qiaohu Xu
- Department of Dermatology the First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
| | - Qun Zhang
- Department of Dermatology the First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
| | - Lili Tang
- Department of Dermatology the First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
| | - Ling Jin
- Department of Dermatology the First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
| | - Xiaomeng Wang
- Department of Dermatology the First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
| | - Lixin Kan
- School of Basic Medical Sciences Anhui Medical University Anhui China
- Department of Neurology Northwestern University Chicago Illinois
| | - Xiaodong Zheng
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
| | - Sen Yang
- Department of Dermatology the First Affiliated Hospital of Anhui Medical University Hefei Anhui China
- Key Laboratory of Dermatology of Ministry of Education Anhui Medical University Anhui China
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15
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Fustà-Novell X, Fatsini-Blanch V, Prat C, Vicente-Villa MA. Nail dystrophy and oral leukoplakia in a 3-year-old girl. Pediatr Dermatol 2019; 36:149-151. [PMID: 30675941 DOI: 10.1111/pde.13690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Carolina Prat
- Department of Dermatology, Hospital Sant Joan de Déu, Barcelona, Spain
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16
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Tous-Romero F, Vico-Alonso C, Calleja-Algarra A, Sánchez-Calvín MT, Palencia-Pérez S. Thick nails, plantar keratoderma, follicular hyperkeratosis, and leukokeratosis associated with a novel mutation in KRT6A gene. Int J Dermatol 2018; 58:E89-E90. [PMID: 30515758 DOI: 10.1111/ijd.14333] [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: 05/28/2018] [Revised: 09/18/2018] [Accepted: 11/14/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Fátima Tous-Romero
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Cristina Vico-Alonso
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Alba Calleja-Algarra
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - María T Sánchez-Calvín
- Department of Genetics, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
| | - Sara Palencia-Pérez
- Department of Dermatology, Hospital Universitario 12 de Octubre, I+12 Research Institute, Universidad Complutense, Madrid, Spain
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17
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Abdollahimajd F, Rajabi F, Shahidi-Dadras M, Saket S, Youssefian L, Vahidnezhad H, Uitto J. Pachyonychia congenita: a case report of a successful treatment with rosuvastatin in a patient with a KRT6A mutation. Br J Dermatol 2018; 181:584-586. [PMID: 30307612 DOI: 10.1111/bjd.17276] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2018] [Indexed: 11/30/2022]
Abstract
Pachyonychia congenita (PC) is a rare autosomal dominant disorder characterized by nail dystrophy and palmoplantar keratoderma with severe plantar pain affecting quality of life. There is no effective treatment. Heterozygous mutations in the keratin genes KRT6A, KRT6B, KRT6C, KRT16 and KRT17 have been reported as a cause of PC. Herein we present a female patient with an amino acid substitution mutation in KRT6A (c.1381G>A, p.Glu461Lys in exon 7) and classic features of PC associated with oral leucokeratosis and follicular hyperkeratosis. We also demonstrate successful treatment of the patient with rosuvastatin. A 3.6-mm reduction in plantar callosity thickness was demonstrated by sonography. Our patient also experienced significant pain relief that allowed her to increase physical activity (Children's Dermatology Life Quality Index score dropped nine points following treatment). Collectively, these improvements suggest that rosuvastatin may offer a promising treatment for PC. What's already known about this topic? Pachyonychia congenita (PC) is an autosomal dominant disease characterized by nail dystrophy and painful plantar keratoderma. Keratolytics, emollients, retinoids and steroids have been used for treatment but with limited benefits. What does this study add? A patient with PC who had a KRT6A mutation was treated with rosuvastatin with significant improvement in plantar hyperkeratosis and pain. Statins could be a promising treatment for PC with long-term safety, but further studies are needed.
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Affiliation(s)
| | | | | | - S Saket
- Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - L Youssefian
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, U.S.A.,Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Genetics, Genomics and Cancer Biology PhD Program, Thomas Jefferson University, Philadelphia, PA, U.S.A
| | - H Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, U.S.A.,Biotechnology Research Center, Department of Molecular Medicine, Pasteur Institute of Iran, Tehran, Iran
| | - J Uitto
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, U.S.A
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18
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Li M, Wu X, Guo X, Bao P, Ding X, Chu M, Liang C, Yan P. Comparative iTRAQ proteomics revealed proteins associated with horn development in yak. Proteome Sci 2018; 16:14. [PMID: 30061793 PMCID: PMC6056918 DOI: 10.1186/s12953-018-0141-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/31/2018] [Indexed: 01/15/2023] Open
Abstract
Background The practice of dehorning yak raises animal safety concerns, which have been addressed by selective breeding to obtain genetically hornless yak. The POLLED locus in yak has been studied extensively; however, little is known regarding the proteins that regulate horn bud development. Methods A differential proteomic analysis was performed to compare the skin from the horn bud region of polled yak fetuses and the horn bud tissue of horned yak fetuses using isobaric tags for relative and absolute quantitation (iTRAQ) technology coupled with 2D LC-MS/MS. Results One hundred differentially abundant proteins (DAPs) were identified. Of these, 29 were up-regulated and 71 were down-regulated in skin from the horn bud region of polled fetuses when compared to the horn bud tissue of horned fetuses. Bioinformatics analyses showed that the up-regulated DAPs were mainly associated with metabolic activities, while the down-regulated DAPs were significantly enriched in cell adhesion and cell movement activities. Conclusions We concluded that some important proteins were associated with cell adhesion, cell motility, keratinocyte differentiation, cytoskeleton organization, osteoblast differentiation, and fatty acid metabolism during horn bud development. These results advance our understanding of the molecular mechanisms underlying horn development.
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Affiliation(s)
- Mingna Li
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Xiaoyun Wu
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Xian Guo
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Pengjia Bao
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Xuezhi Ding
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Min Chu
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Chunnian Liang
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
| | - Ping Yan
- Key Laboratory for Yak Breeding Engineering of Gansu Province, Lanzhou Institute of Husbandry and Pharmaceutical Sciences, Chinese Academy of Agricultural Sciences, Lanzhou, 730050 People's Republic of China
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19
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Affiliation(s)
- María Victoria Sabogal Gómez
- Department of Dermatology, Fundación Universitaria Sanitas, Hospital Universitario, Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá, Colombia
| | - Victor González
- Department of Dermatology, Hospital Clínico Universitario, Valencia, Spain
| | - José M Martín
- Department of Dermatology, Hospital Clínico Universitario, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
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20
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Ghazawi FM, Hassani-Ardakani K, Henriques L, Jafarian F. Identification of a novel substitution mutation (R103C) in the rod domain of the keratin 17 gene associated with pachyonychia congenita type 2. Int J Dermatol 2018; 58:233-236. [PMID: 29904921 DOI: 10.1111/ijd.14082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/06/2018] [Accepted: 05/16/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Feras M Ghazawi
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Lisa Henriques
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Fatemeh Jafarian
- Division of Dermatology, McGill University Health Center, Montréal, Quebec, Canada
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21
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Teng JMC, Bartholomew FB, Patel V, Sun G. Novel treatment of painful plantar keratoderma in pachyonychia congenita using topical sirolimus. Clin Exp Dermatol 2018; 43:968-971. [DOI: 10.1111/ced.13686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2017] [Indexed: 12/30/2022]
Affiliation(s)
- J. M. C. Teng
- Department of Dermatology; School of Medicine; Stanford University; Palo Alto CA USA
| | - F. B. Bartholomew
- Department of Dermatology; School of Medicine; Columbia University; New York NY USA
| | - V. Patel
- Department of Dermatology; Baylor Medical School; Baylor University; Houston TX USA
| | - G. Sun
- Oxnard Dermatology Medical Group; Oxnard CA USA
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22
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Brill S, Sprecher E, Smith FJD, Geva N, Gruener H, Nahman-Averbuch H, Defrin R. Chronic pain in pachyonychia congenita: evidence for neuropathic origin. Br J Dermatol 2018; 179:154-162. [PMID: 29210461 DOI: 10.1111/bjd.16217] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare autosomal dominant skin disease, with chronic pain being the most prominent complaint. Histological studies showing alterations in sensory innervation, along with reports on alterations in mechanical sensitivity, suggest that PC may be a form of neuropathy. OBJECTIVES Here, for the first time, we aim to evaluate systematically the sensory function of patients with PC vs. controls, in order to investigate the pathophysiology of PC. METHODS Patients (n = 62) and controls (n = 45) completed the McGill and Douleur Neuropathique-4 (DN4) questionnaires. Sensory testing included detection and pain thresholds, pathological sensations, conditioned pain modulation (CPM) and temporal summation of pain. RESULTS A moderate-to-severe chronic pain in the feet, throbbing and stabbing in quality, was highly prevalent among patients with PC (86%) and was especially debilitating during weight bearing. In addition, the majority of patients had a DN4 score ≥ 4 (62%), static allodynia (55%) and tingling (53%) in the feet. Compared with controls, patients with PC exhibited thermal and mechanical hypoaesthesia and mechanical hyperalgesia in the feet. CPM was reduced among the patients, and was associated with more enhanced mechanical hyperalgesia in the feet. The specific gene and nature of the causative mutation did not affect any of these features. CONCLUSIONS Although thermal and mechanical hypoaesthesia may result from thicker skin, its presentation in painful regions, along with mechanical hyperalgesia and allodynia, point towards the possibility of neuropathic changes occurring in PC. The clinical features and DN4 scores support this possibility and therefore neuropathic pain medications may be beneficial for patients with PC.
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Affiliation(s)
- S Brill
- Center for Pain Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - E Sprecher
- Department of Dermatology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Department of Dermatology, Tel-Aviv University, Tel-Aviv, 69978, Israel
| | - F J D Smith
- Pachyonychia Congenita Project, School of Life Sciences, University of Dundee, Dundee, U.K
| | - N Geva
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, 69978, Israel
| | - H Gruener
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, 69978, Israel
| | - H Nahman-Averbuch
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, U.S.A
| | - R Defrin
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, 69978, Israel
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23
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Guerra L, Castori M, Didona B, Castiglia D, Zambruno G. Hereditary palmoplantar keratodermas. Part II: syndromic palmoplantar keratodermas - Diagnostic algorithm and principles of therapy. J Eur Acad Dermatol Venereol 2018; 32:899-925. [DOI: 10.1111/jdv.14834] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/05/2018] [Indexed: 12/19/2022]
Affiliation(s)
- L. Guerra
- Laboratory of Molecular and Cell Biology; Istituto Dermopatico dell'Immacolata-IRCCS; Rome Italy
| | - M. Castori
- Division of Medical Genetics; Casa Sollievo della Sofferenza-IRCCS; San Giovanni Rotondo Italy
| | - B. Didona
- Rare Skin Disease Center; Istituto Dermopatico dell'Immacolata-IRCCS; Rome Italy
| | - D. Castiglia
- Laboratory of Molecular and Cell Biology; Istituto Dermopatico dell'Immacolata-IRCCS; Rome Italy
| | - G. Zambruno
- Genetic and Rare Diseases Research Area and Dermatology Unit; Bambino Gesù Children's Hospital-IRCCS; Rome Italy
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24
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Porter RM, Bravo AA, Smith FJ. Management of Plantar Keratodermas Lessons from Pachyonychia Congenita. J Am Podiatr Med Assoc 2017; 107:428-435. [PMID: 29077501 DOI: 10.7547/16-043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Plantar keratodermas can arise due to a variety of genetically inherited mutations. The need to distinguish between different plantar keratoderma disorders is becoming increasingly apparent because there is evidence that they do not respond identically to treatment. Diagnosis can be aided by observation of other clinical manifestations, such as palmar keratoderma, more widespread hyperkeratosis of the epidermis, hair and nail dystrophies, or erythroderma. However, there are frequent cases of plantar keratoderma that occur in isolation. This review focuses on the rare autosomal dominant keratin disorder pachyonychia congenita, which presents with particularly painful plantar keratoderma for which there is no specific treatment. Typically, patients regularly trim/pare/file/grind their calluses and file/grind/clip their nails. Topical agents, including keratolytics (eg, salicylic acid, urea) and moisturizers, can provide limited benefit by softening the skin. For some patients, retinoids help to thin calluses but may lead to increased pain. This finding has stimulated a drive for alternative treatment options, from gene therapy to alternative nongenetic methods that focus on novel findings regarding the pathogenesis of pachyonychia congenita and the function of the underlying genes.
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Affiliation(s)
| | | | - Frances J.D. Smith
- Pachyonychia Congenita Project, School of Life Sciences, University of Dundee, Dundee Scotland
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25
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Smith FJD, McLean WHI. Keratin 6b variant p.Gly499Ser reported in delayed-onset pachyonychia congenita is a non-pathogenic polymorphism. J Dermatol 2017; 44:e312. [PMID: 28815691 PMCID: PMC5724482 DOI: 10.1111/1346-8138.14001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Frances J D Smith
- Pachyonychia Congenita Project, School of Life Sciences, University of Dundee, Dundee, UK.,Centre for Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, UK
| | - W H Irwin McLean
- Pachyonychia Congenita Project, School of Life Sciences, University of Dundee, Dundee, UK.,Centre for Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, UK
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26
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Rice RH, Durbin-Johnson BP, Salemi M, Schwartz ME, Rocke DM, Phinney BS. Proteomic profiling of Pachyonychia congenita plantar callus. J Proteomics 2017. [PMID: 28648685 DOI: 10.1016/j.jprot.2017.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Callus samples from the ball and the arch of the foot, collected on tape circles, were compared by shotgun proteomic profiling. Pachyonychia congenita subjects were sampled who exhibited a mutation in KRT6A, KRT6B, KRT6C, KRT16 or KRT17, and the proteins were digested and analyzed by tandem mass spectrometry. In comparison with samples from unaffected control subjects, those from subjects with KRT6A or KRT16 mutations displayed the most differences in profile from normal, while those from subjects with KRT6C or KRT17 mutations showed few differences from normal. The profiles from subjects with KRT6B mutations were intermediate in protein profile differences. Degree of departure from the normal profile could be estimated by expression of numerous proteins in callus from the ball of the foot that were consistently different. By contrast, the protein profile from the arch of the foot was hardly affected. The results provide a foundation for noninvasive monitoring of the efficacy of treatments with quantitative assessment of departure from the normal phenotype. SIGNIFICANCE Pachyonychia congenita is an orphan disease in which the connection between the basic defect (keratin mutation) and debilitating symptoms (severe plantar pain) is poorly understood. Present work addresses the degree to which the protein profile is altered in the epidermis where the severe pain originates. The results indicate that the mutated keratins differ greatly in the degree to which they elicit perturbations in protein profile. In those cases with markedly altered protein levels, monitoring the callus profile may provide an objective measure of treatment efficacy.
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Affiliation(s)
- Robert H Rice
- Department of Environmental Toxicology, University of California, Davis, CA.
| | - Blythe P Durbin-Johnson
- Division of Biostatistics, Department of Public Health Sciences, Clinical and Translational Science Center Biostatistics Core, University of California, Davis, CA
| | - Michelle Salemi
- Proteomics Core Facility, University of California, Davis, CA
| | | | - David M Rocke
- Division of Biostatistics, Department of Public Health Sciences, Clinical and Translational Science Center Biostatistics Core, University of California, Davis, CA
| | - Brett S Phinney
- Proteomics Core Facility, University of California, Davis, CA
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27
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Chiriac A, Rusu C, Murgu A, Chiriac AE, Wilson NJ, Smith FJD. First Report of Pachyonychia Congenita Type PC-K6a in the Romanian Population. MAEDICA 2017; 12:123-126. [PMID: 29090033 PMCID: PMC5649033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pachyonychia congenita (PC) is a rare autosomal dominant skin disorder, with unknown prevalence, although it is estimated there are between 2,000 and 10,000 cases of PC worldwide. The International PC Research Registry (IPCRR) has currently identified (as of November 2016) 746 individuals (in 403 families) with genetically confirmed PC. Heterozygous mutations, predominantly missense mutations, in any one of five keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17 cause PC. The predominant clinical findings include plantar keratoderma, plantar pain and variable dystrophy of some or all toenails and/ or fingernails. Oral leukokeratosis, follicular hyperkeratosis, cysts of various types and natal teeth may also be present. We report the first case of genetically confirmed PC from Romania due to a mutation in KRT6A, p.Arg466Pro.
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Affiliation(s)
- Anca Chiriac
- Department of Dermatology, Nicolina Medical Center, Iasi, Romania
| | - Cristina Rusu
- University of Medicine and Pharmacy "Grigore T Popa" Iasi, Romania
| | - Alina Murgu
- University of Medicine and Pharmacy "Grigore T Popa" Iasi, Romania
| | - Anca E Chiriac
- University of Medicine and Pharmacy "Grigore T Popa" Iasi, Romania
| | - Neil J Wilson
- Centre for Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, UK
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28
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Rittié L, Kaspar RL, Sprecher E, Smith FJD. Report of the 13th Annual International Pachyonychia Congenita Consortium Symposium. Br J Dermatol 2017; 176:1144-1147. [PMID: 28345191 DOI: 10.1111/bjd.15417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 11/29/2022]
Abstract
The International Pachyonychia Congenita Consortium (IPCC) is a group of physicians and scientists from around the world dedicated to developing therapies for pachyonychia congenita, a rare autosomal dominant skin disorder. The research presented at the 13th Annual Research Symposium of the IPCC, held on 10-11 May 2016, in Scottsdale, AZ, U.S.A., is reported here.
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Affiliation(s)
- L Rittié
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, U.S.A
| | - R L Kaspar
- TransDerm Inc., 2161 Delaware Ave, Santa Cruz, CA, 95060, U.S.A
| | - E Sprecher
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F J D Smith
- Pachyonychia Congenita Project, Salt Lake City, UT, U.S.A
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29
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Agarwala M, Salphale P, Peter D, Wilson NJ, Pulimood S, Schwartz ME, Smith FJD. Keratin 17 Mutations in Four Families from India with Pachyonychia Congenita. Indian J Dermatol 2017; 62:422-426. [PMID: 28794556 PMCID: PMC5527726 DOI: 10.4103/ijd.ijd_321_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pachyonychia congenita (PC) is a rare autosomal dominant genetic skin disorder due to a mutation in any one of the five keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17. The main features are palmoplantar keratoderma, plantar pain, and nail dystrophy. Cysts of various types, follicular hyperkeratosis, oral leukokeratosis, hyperhidrosis, and natal teeth may also be present. Four unrelated Indian families presented with a clinical diagnosis of PC. This was confirmed by genetic testing; mutations in KRT17 were identified in all affected individuals.
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Affiliation(s)
- Manoj Agarwala
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pankaj Salphale
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dincy Peter
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Neil J Wilson
- School of Life Sciences, Division of Biological Chemistry and Drug Discovery, Dermatology and Genetic Medicine, University of Dundee, Dundee, UK
| | - Susanne Pulimood
- Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Frances J D Smith
- School of Life Sciences, Division of Biological Chemistry and Drug Discovery, Dermatology and Genetic Medicine, University of Dundee, Dundee, UK
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Guo Z, Hu Q, Tian J, Yan L, Jing C, Xie HQ, Bao W, Rice RH, Zhao B, Jiang G. Proteomic profiling reveals candidate markers for arsenic-induced skin keratosis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 218:34-38. [PMID: 27552035 DOI: 10.1016/j.envpol.2016.08.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/20/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
Abstract
Proteomics technology is an attractive biomarker candidate discovery tool that can be applied to study large sets of biological molecules. To identify novel biomarkers and molecular targets in arsenic-induced skin lesions, we have determined the protein profile of arsenic-affected human epidermal stratum corneum by shotgun proteomics. Samples of palm and foot sole from healthy subjects were analyzed, demonstrating similar protein patterns in palm and sole. Samples were collected from the palms of subjects with arsenic keratosis (lesional and adjacent non-lesional samples) and arsenic-exposed subjects without lesions (normal). Samples from non-exposed healthy individuals served as controls. We found that three proteins in arsenic-exposed lesional epidermis were consistently distinguishably expressed from the unaffected epidermis. One of these proteins, the cadherin-like transmembrane glycoprotein, desmoglein 1 (DSG1) was suppressed. Down-regulation of DSG1 may lead to reduced cell-cell adhesion, resulting in abnormal epidermal differentiation. The expression of keratin 6c (KRT6C) and fatty acid binding protein 5 (FABP5) were significantly increased. FABP5 is an intracellular lipid chaperone that plays an essential role in fatty acid metabolism in human skin. This raises a possibility that overexpression of FABP5 may affect the proliferation or differentiation of keratinocytes by altering lipid metabolism. KRT6C is a constituent of the cytoskeleton that maintains epidermal integrity and cohesion. Abnormal expression of KRT6C may affect its structural role in the epidermis. Our findings suggest an important approach for future studies of arsenic-mediated toxicity and skin cancer, where certain proteins may represent useful biomarkers of early diagnoses in high-risk populations and hopefully new treatment targets. Further studies are required to understand the biological role of these markers in skin pathogenesis from arsenic exposure.
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Affiliation(s)
- Zhiling Guo
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Qin Hu
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Jijing Tian
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Li Yan
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Chuanyong Jing
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Heidi Qunhui Xie
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Wenjun Bao
- JMP Life Sciences, SAS Institute, Cary, NC 27513, USA
| | - Robert H Rice
- Department of Environmental Toxicology, University of California, Davis, CA 95616-8588, USA
| | - Bin Zhao
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
| | - Guibin Jiang
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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Ortega-Recalde O, Silgado D, Fetiva C, Fonseca DJ, Laissue P. Transcriptomic analysis of skin in a case of ichthyosis Curth-Macklin caused by a KRT1 mutation. Br J Dermatol 2016; 175:1372-1375. [PMID: 27518765 DOI: 10.1111/bjd.14969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- O Ortega-Recalde
- Centro de Investigación en Genética y Genómica-CIGGUR, Grupo GENIUROS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - D Silgado
- Centro de Investigación en Genética y Genómica-CIGGUR, Grupo GENIUROS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - C Fetiva
- Centro de Investigación en Genética y Genómica-CIGGUR, Grupo GENIUROS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - D J Fonseca
- Centro de Investigación en Genética y Genómica-CIGGUR, Grupo GENIUROS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - P Laissue
- Centro de Investigación en Genética y Genómica-CIGGUR, Grupo GENIUROS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
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Correction of Hair Shaft Defects through Allele-Specific Silencing of Mutant Krt75. J Invest Dermatol 2016; 136:45-51. [PMID: 26763422 PMCID: PMC4764097 DOI: 10.1038/jid.2015.375] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/10/2015] [Accepted: 09/12/2015] [Indexed: 11/25/2022]
Abstract
Dominant mutations in keratin genes can cause a number of inheritable skin disorders characterized by intraepidermal blistering, epidermal hyperkeratosis, or abnormalities in skin appendages, such as nail plate dystrophy and structural defects in hair. Allele-specific silencing of mutant keratins through RNA interference is a promising therapeutic approach for suppressing the expression of mutant keratins and related phenotypes in the epidermis. However, its effectiveness on skin appendages remains to be confirmed in vivo. In this study, we developed allele specific siRNAs capable of selectively suppressing the expression of a mutant Krt75, which causes hair shaft structural defects characterized by the development of blebs along the hair shaft in mice. Hair regenerated from epidermal keratinocyte progenitor cells isolated from mutant Krt75 mouse models reproduced the blebbing phenotype when grafted in vivo. In contrast, mutant cells manipulated with a lentiviral vector expressing mutant Krt75-specific shRNA persistently suppressed this phenotype. The phenotypic correction was associated with significant reduction of mutant Krt75 mRNA in the skin grafts. Thus, data obtained from this study demonstrated the feasibility of utilizing RNA interference to achieve durable correction of hair structural phenotypes through allele-specific silencing of the mutant keratin genes.
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Forrest CE, Casey G, Mordaunt DA, Thompson EM, Gordon L. Pachyonychia Congenita: A Spectrum of KRT6a Mutations in Australian Patients. Pediatr Dermatol 2016; 33:337-42. [PMID: 27041546 DOI: 10.1111/pde.12841] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare inherited disorder of keratinization characterised by hypertrophic nail dystrophy, painful palmoplantar blisters, cysts, follicular hyperkeratosis and oral leukokeratosis. It is associated with mutations in five differentiation-specific keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17. OBJECTIVES Living with Pachyonychia Congenita can be isolating. The aim of this paper is to document a single patient's experience within a national context. METHOD We report the case of a 2 year old female with an atypical presentation of PC due to a mutation in KRT6A with severely hypertrophic follicular keratoses, skin fragility, relative sparing of nail hypertrophy on one hand and failure to thrive in early infancy. In collaboration with the International Pachyonychia Congenita Research Registry (IPCRR), a database search was performed using Australian residency and KRT6A mutation as inclusion criteria. The IPCRR database was also searched for a matching KRT6A mutation. Six Australian patients were identified in addition to one patient with an identical mutation residing in the United States. The detailed standardized patient questionnaire data was manually collated and analysed. RESULTS Fingernail hypertrophy and oral leukokeratosis were the most common features. There was no recording of asymmetric distribution in any other Australian patient. Trouble nursing as an infant and follicular hyperkeratosis also occurred in the American patient, however they did not have asymmetric distribution and the oral leukokeratosis appeared later in life. CONCLUSION This case has unique features. Sharing information can assist patients navigating life with this condition.
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Affiliation(s)
| | - Genevieve Casey
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Dylan A Mordaunt
- South Australian Clinical Genetics Service, North Adelaide, South Australia, Australia.,Department of Paediatrics, University of Adelaide, North Adelaide, South Australia, Australia
| | - Elizabeth M Thompson
- South Australian Clinical Genetics Service, North Adelaide, South Australia, Australia.,Department of Paediatrics, University of Adelaide, North Adelaide, South Australia, Australia
| | - Lynne Gordon
- Flinders Medical Centre, Adelaide, South Australia, Australia
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Micol-Martínez O, López-González V, Garcia-Marcos P, Martínez-Menchón T, Guillén-Navarro E. Paquioniquia congénita: nuevo caso asociado al gen KRT17. An Pediatr (Barc) 2016; 84:174-6. [DOI: 10.1016/j.anpedi.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/13/2015] [Accepted: 08/21/2015] [Indexed: 10/22/2022] Open
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Liao C, Xie G, Zhu L, Chen X, Li X, Lu H, Xu B, Ramot Y, Paus R, Yue Z. p53 Is a Direct Transcriptional Repressor of Keratin 17: Lessons from a Rat Model of Radiation Dermatitis. J Invest Dermatol 2016; 136:680-689. [DOI: 10.1016/j.jid.2015.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 11/04/2015] [Accepted: 11/06/2015] [Indexed: 11/15/2022]
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Congenital pachyonychia: A new case associated with the KRT17 gene. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Wee JS, Smith FJD, Wilson NJ, O'Toole EA. Focal PPK secondary to a novel KRT6C mutation (Pachyonychia congenita-K6c). J Eur Acad Dermatol Venereol 2015; 30:1415-6. [PMID: 26301947 DOI: 10.1111/jdv.13259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- J S Wee
- Department of Dermatology, St George's Hospital, London, UK
| | - F J D Smith
- Centre for Dermatology and Genetic Medicine, College of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, UK
| | - N J Wilson
- Centre for Dermatology and Genetic Medicine, College of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, UK
| | - E A O'Toole
- Department of Dermatology, The Royal London Hospital, London, UK
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Almutawa F, Thusaringam T, Watters K, Gayden T, Jabado N, Sasseville D. Pachyonychia Congenita (K16) with Unusual Features and Good Response to Acitretin. Case Rep Dermatol 2015; 7:220-6. [PMID: 26464567 PMCID: PMC4592507 DOI: 10.1159/000438920] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pachyonychia congenita (PC) is a rare autosomal dominant disease whose main clinical features include hypertrophic onychodystrophy and palmoplantar keratoderma. The new classification is based on genetic variants with mutations in keratin KRT6A, KRT6B, KRT6C, KRT16, KRT17, and an unknown mutation. Here, we present a case of PC with unusual clinical and histological features and a favorable response to oral acitretin. CASE A 49-year-old male presented with diffuse and striate palmoplantar keratoderma, thickened nails, knuckle pads, and pseudoainhum. Histology showed compact hyperkeratosis, prominent irregular acanthosis, and extensive epidermolytic hyperkeratosis, suggestive of Vörner's palmoplantar keratoderma. However, keratin 9 and 1 were not mutated, and full exome sequencing showed heterozygous missense mutation in type I keratin K16. CONCLUSION To our knowledge, epidermolytic hyperkeratosis has not been previously described with PC. Our patient had an excellent response, maintained over the last 5 years, to a low dose of acitretin. We wish to emphasize the crucial role of whole exome sequencing in establishing the correct diagnosis.
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Affiliation(s)
- Fahad Almutawa
- Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Thusanth Thusaringam
- Division of Dermatology, McGill University Health Centre, Montreal, Que., Canada
| | - Kevin Watters
- Department of Pathology, McGill University Health Centre, Montreal, Que., Canada
| | - Tenzin Gayden
- Department of Pediatrics, McGill University Health Centre, Montreal, Que., Canada ; Department of Human Genetics, McGill University Health Centre, Montreal, Que., Canada
| | - Nada Jabado
- Department of Pediatrics, McGill University Health Centre, Montreal, Que., Canada ; Department of Human Genetics, McGill University Health Centre, Montreal, Que., Canada
| | - Denis Sasseville
- Division of Dermatology, McGill University Health Centre, Montreal, Que., Canada
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Hu YH, Lin YC, Hwu WL, Lee YM. Pincer nail deformity as the main manifestation of Clouston syndrome. Br J Dermatol 2015; 173:581-3. [PMID: 25677863 DOI: 10.1111/bjd.13703] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y-H Hu
- Department of Dermatology, Taipei MacKay Memorial Hospital, Taipei, Taiwan
| | - Y-C Lin
- Department of Dermatology, Taipei MacKay Memorial Hospital, Taipei, Taiwan
| | - W-L Hwu
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Y-M Lee
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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O'Toole EA, Kaspar RL, Sprecher E, Schwartz ME, Rittié L. Pachyonychia congenita cornered: report on the 11th Annual International Pachyonychia Congenita Consortium Meeting. Br J Dermatol 2014; 171:974-7. [PMID: 25124823 DOI: 10.1111/bjd.13341] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2014] [Indexed: 12/30/2022]
Abstract
This is a report of the research presented at the 11th Annual Meeting of the International Pachyonychia Congenita Consortium, held on 6 May 2014 in Albuquerque, NM, U.S.A. This year's meeting was divided into five corners concerning pachyonychia congenita (PC) research: (i) 'PC Pathogenesis Cornered', an overview of recent keratin research, for PC and other skin disorders; (ii) 'From All Corners of …', an outline of other genetic disorders that we can learn from; (iii) 'Fighting For Our Corner', an outline of National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases programmes and U.S. funding opportunities applicable to rare skin disorders; (iv) 'The PC Corner', focusing on recent clinical studies related to PC; and (v) 'Clinical Corners: Turning the Corner?', an update on ongoing PC clinical trials.
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Affiliation(s)
- E A O'Toole
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
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