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Wang Y, Wang S, Zheng L, Wang X, Wang H, Zhong Z, Liu S, Zheng X, Gao M. Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome with Cutis Verticis Gyrata: Case Report and Review of Literature. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1415-1420. [PMID: 35910507 PMCID: PMC9329683 DOI: 10.2147/ccid.s372522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/14/2022] [Indexed: 12/01/2022]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a rare disease clinically characterized by a wide range of cutaneous and osteoarticular manifestations. Here, we report a case of SAPHO syndrome with cutis verticis gyrata (CVG) and investigated the genetic causes in the four members of this pedigree. After failure of conventional treatments, a recombinant human TNF-α receptor II:IgG Fc fusion protein (rhTNFR:Fc, YISAIPU®) achieved good control of the disease at the 2-year follow-up. We did not identify any pathogenic mutation in this pedigree. We also summarized the clinical and therapeutic characteristics of 83 patients with SAPHO syndrome through the China National Knowledge Infrastructure (CKNI) database from 2016 to 2021. Patients with acne were young and predominantly male. About 45.8% patients were treated with biological therapies or traditional Chinese medicine (TCM), 84.2% of which showed positive effects against cutaneous and osteoarticular manifestations. We report a case of SAPHO syndrome with CVG that was successfully treated with rhTNFR:Fc. Our results reveal the genetic heterogeneity involved. Biologics and TCM are likely alternative options for the treatment of SAPHO syndrome.
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Affiliation(s)
- Yifan Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Shan Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Liyun Zheng
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Xiuli Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Hui Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Zhenyu Zhong
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Siqi Liu
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Xiaodong Zheng
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Min Gao
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
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Samira B, Meriem D, Oumkeltoum E, Driss E, Yassine B, Saloua E. [Primitive essential Cutis verticis gyrata, a rare skin disease: case report and review of literature]. Pan Afr Med J 2014; 19:345. [PMID: 25922634 PMCID: PMC4406381 DOI: 10.11604/pamj.2014.19.345.5729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 11/20/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Boukind Samira
- Service de Chirurgie Plastique, Réparatrice, Esthétique et Brûlés, CHU Mohammed VI, Marrakech, Maroc
| | - Dlimi Meriem
- Service de Chirurgie Plastique, Réparatrice, Esthétique et Brûlés, CHU Mohammed VI, Marrakech, Maroc
| | - Elatiqi Oumkeltoum
- Service de Chirurgie Plastique, Réparatrice, Esthétique et Brûlés, CHU Mohammed VI, Marrakech, Maroc
| | - Elamrani Driss
- Service de Chirurgie Plastique, Réparatrice, Esthétique et Brûlés, CHU Mohammed VI, Marrakech, Maroc
| | - Benchamkha Yassine
- Service de Chirurgie Plastique, Réparatrice, Esthétique et Brûlés, CHU Mohammed VI, Marrakech, Maroc
| | - Ettalbi Saloua
- Service de Chirurgie Plastique, Réparatrice, Esthétique et Brûlés, CHU Mohammed VI, Marrakech, Maroc
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[Primary essential cutis verticis gyrata: Case report and literature review]. ANN CHIR PLAST ESTH 2009; 55:243-8. [PMID: 19939538 DOI: 10.1016/j.anplas.2009.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2009] [Accepted: 06/13/2009] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Cutis verticis gyrata (CVG) is a rare and slowly progressive deformity of the scalp with thick gyrated skin folds and ridges which are similar to gyri of the brain cortex. Those folds can lead to local skin infections, to a social and cosmetic complain. CVG can be classified into two forms: primary (essential and non-essential) and secondary. To date, fifteen operated cases of primary essential CVG have been reported in the medical literature. CASE REPORT We report the case of an 18 year-old male patient with a primary essential CVG. There were several large skin folds in the sagittal axis on the vertex region, and in the coronal axis on the occipital region. He did not present any cutaneous complication. His main complains was the unaesthetic aspect of his scalp with a psychological complex. The disease had occurred during puberty. We present the excision pattern and the results with a six months follow-up. CONCLUSION CVG can be treated surgically with resection of the thickened excess skin in coronal and sagittal axis. Scalp lift must be effective all over the different areas of the scalp. The scalp flaps must have a reliable vascularisation. Combined incisions of the galea help to treat the residual folds. The excision pattern must be reproductible, as this disease is progressive.
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Beier JP, Kneser U, Horch RE. Surgical treatment of facial cutis verticis gyrata with direct excision. J Cutan Med Surg 2007; 11:4-8. [PMID: 17274933 DOI: 10.2310/7750.2007.00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cutis verticis gyrata (CVG) is a rare deformity of the skin presenting with thick gyrated folds and ridges, involving predominantly parts of the head and the face. OBJECTIVE We report on aspects of the surgical treatment of facial CVG based on our experiences with four patients, who had developed a progressive and enormous thickening and an extraordinary strong gyration of the facial skin. METHODS A single or staged repeated straightforward surgical treatment with direct excision of abundant and thickened gyriform folds, in one case accomplished by an upper face-lift, was performed. RESULTS Direct excision within the lines of tension resulted in a major reduction of the facial skin distortion, a reduced scalp, and facial skin thickening and avoided maceration in all four patients. The quality of life was considerably improved in all patients. CONCLUSION Direct excision of gyriform skin is a successful surgical approach to the rare skin deformity of CVG.
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Affiliation(s)
- Justus P Beier
- Department od Plastic and Hand Surgery, University Hospital of Erlangen-Nuremberg, Friedrich-Alexander-University Erlangen, Nuremberg, Germany
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