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Elhossini RM, Abdel-Hamid MS, Ashaat E, Otaify GA, Dawoud H, Elshimy K, El Ruby M, Aglan M. Two new patients with focal dermal hypoplasia: A novel PORCN variant and insights on the diagnostic considerations. Congenit Anom (Kyoto) 2022; 62:68-77. [PMID: 34962003 DOI: 10.1111/cga.12457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/21/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022]
Abstract
Mutations in the PORCN gene cause an X-linked dominant condition; focal dermal hypoplasia (FDH), characterized by atrophic skin, pigmented skin lesions in addition to several ocular and skeletal malformations. FDH is rare with around 275 cases reported so far from diverse ethnic groups. Herein, we provide a report of two new patients with FDH from Egypt. In addition to the typical clinical manifestations of the disease, infrequently reported clinical findings in the form of broad metaphysis, bilateral short broad femurs, and dermal sinus over the sacrum were seen in Patient 1 and partial fusion of labia majora, ventral hernia, and bladder extrophy were present in Patient 2. Two heterozygous protein-truncating PORCN mutations were identified in our patients, a known nonsense c.370C>T p.(Arg124Ter) and a novel frameshift c.375delG p.(Ala126HisfsTer3). Segregation analyses confirmed that the two mutations were "de novo" and not inherited from any of the parents. Our study expands the clinical and mutational spectrum of focal dermal hypoplasia and emphasizes the importance of investigating the different body systems and organs for the early management of patients.
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Affiliation(s)
- Rasha Moheb Elhossini
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Mohamed S Abdel-Hamid
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Engy Ashaat
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Ghada A Otaify
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Heba Dawoud
- Genetics Unit, Department of Pediatrics, Tanta University, Tanta, Egypt
| | | | - Mona El Ruby
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Mona Aglan
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
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Dhankar N, Gupta I, Dayal S, Tyagi M. Focal dermal hypoplasia (Goltz Syndrome): A rare case. Indian Dermatol Online J 2022; 13:502-504. [PMID: 36262578 PMCID: PMC9574143 DOI: 10.4103/idoj.idoj_663_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/16/2021] [Accepted: 12/03/2021] [Indexed: 11/22/2022] Open
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Lyons D, Rushton C, Sidhu S. A Rare Case of Mainly Unilateral Focal Dermal Hypoplasia (Goltz Syndrome) in an Adult Male: A Case Report and Review of the Literature. J Med Cases 2020; 11:61-64. [PMID: 34434364 PMCID: PMC8383521 DOI: 10.14740/jmc3442] [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: 02/20/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022] Open
Abstract
Focal dermal hypoplasia (Goltz syndrome), is an exceedingly rare X-linked dominant genetic disorder. It is a multisystem disease, but it is hallmarked by characteristic skin changes. Focal dermal hypoplasia typically occurs in females (90%), and males are thought to only survive through having either a sporadic new mutation or somatic mosaicism. This report details a 48-year-old male diagnosed with predominately unilateral focal dermal hypoplasia that was reviewed decades post his initial diagnosis. He presented with multiple atrophic hyperpigmented macules and fat herniation along the lines of Blaschko, across primarily the right side of the body. Skin biopsy is the mainstay for the diagnosis and therefore dermatologists need to be aware of the classical cutaneous findings of familial dermal hypoplasia to ensure accurate diagnosis. Familial dermal hypoplasia is best managed through the collective minds of multidisciplinary teams.
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Affiliation(s)
- Duncan Lyons
- Gold Coast Hospital, Gold Coast, Queensland, Australia
| | | | - Sandeepal Sidhu
- Launceston General Hospital, Launceston, Tasmania, Australia
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Jose M, Chaudhary SS, Anand S, Garg A. Extensive Mucocutaneous Papillomas in a Case of Focal Dermal Hypoplasia. Indian Dermatol Online J 2018; 9:208-210. [PMID: 29854650 PMCID: PMC5956877 DOI: 10.4103/idoj.idoj_145_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Melna Jose
- Department of Dermatology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Shyam Sundar Chaudhary
- Department of Dermatology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Shiwesh Anand
- Department of Dermatology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Anu Garg
- Department of Dermatology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Belarbi F, Amal S, Akhdari N, Amouzoune S, Belbachir A, Rais H, Hocar O. Hypoplasie dermique focale (syndrome de Goltz) associée à une bicuspidie de l’aorte. Ann Dermatol Venereol 2017; 144:719-720. [DOI: 10.1016/j.annder.2017.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/21/2017] [Accepted: 06/12/2017] [Indexed: 11/26/2022]
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Ghosh SK, Dutta A, Sarkar S, Nag SS, Biswas SK, Mandal P. Focal Dermal Hypoplasia (Goltz Syndrome): A Cross-sectional Study from Eastern India. Indian J Dermatol 2017; 62:498-504. [PMID: 28979012 PMCID: PMC5618837 DOI: 10.4103/ijd.ijd_317_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Focal dermal hypoplasia (Goltz syndrome), is an extremely rare genetic disorder characterized by distinct skin manifestations and a wide range of abnormalities involving the ocular, dental, skeletal, urinary, gastrointestinal, cardiovascular, and central nervous systems. The objective of the present series is to emphasize the different typical as well as unusual features of this rare syndrome. METHOLOGY This cross-sectional observational study was performed over a period of 8 years in a tertiary care hospital of Eastern India. Consecutive patients with the clinical diagnosis of Goltz syndrome were studied. RESULTS A total of 8 patients with Goltz syndrome were evaluated. Out of them, one patient was a boy and the rest were girl. The age ranged from 3 days to 9 years. There was no family history. A characteristic Blaschkoid hypo- and hyper-pigmented skin lesions, congenital nodular fat herniation, and skin atrophy were present in all patients. Congenital cutaneous aplasia was present in 50% of the patients. Facial asymmetry and ear deformity (megalopinna and low-set ears) were seen in 37.5% and 12.5% of patients, respectively. Cutaneous telangiectasia was noticed in 37.5% of patients. Freckle- and lentigines-like pigmentation within the hypopigmented macules was found in 25% of patients. Raspberry-like papillomas around mouth were documented in 6 (75%) patients. Dysplastic nail changes with ridging were seen in 7 (87.5%) patients. Genital abnormality in the form of bilateral undescended testes and microphthalmia with aniridia were found in one patient each. Limb defects were present in all patients. Left-sided renal agenesis was found in one patient. The patient also had multiple cortical cysts of the right kidney. LIMITATIONS Genetic testing could not be performed in the present series. CONCLUSIONS Our case series showed a few unusual or extremely rare manifestations such as undescended testes, dermal sinus, kyphoscoliosis, aniridia, unilateral kidney agenesis, and renal cortical cysts among others.
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Affiliation(s)
- Sudip Kumar Ghosh
- Department of Dermatology, Venereology, and Leprosy R.G.Kar Medical College, Kolkata, West Bengal, India
| | - Abhijit Dutta
- Department of Pediatrics, North Bengal Medical College, West Bengal, India
| | - Sharmila Sarkar
- Department of Psychiatry, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Shanka Subhra Nag
- Department of Pediatrics, North Bengal Medical College, West Bengal, India
| | - Surajit Kumar Biswas
- Department of Dermatology, Venereology, and Leprosy R.G.Kar Medical College, Kolkata, West Bengal, India
| | - Prabhakar Mandal
- Department of Dermatology, Venereology, and Leprosy R.G.Kar Medical College, Kolkata, West Bengal, India
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Motil KJ, Fete M, Fete TJ. Growth, nutritional, and gastrointestinal aspects of focal dermal hypoplasia (Goltz-Gorlin syndrome). AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2016; 172C:29-33. [PMID: 27001925 DOI: 10.1002/ajmg.c.31468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Focal dermal hypoplasia (FDH) is a rare genetic disorder caused by mutations in the PORCN gene located on the X-chromosome. In the present study, we characterized the pattern of growth, body composition, and the nutritional and gastrointestinal aspects of children and adults (n = 19) affected with this disorder using clinical anthropometry and a survey questionnaire. The mean birth length (P < 0.06) and weight (P < 0.001) z-scores of the participants were lower than the reference population. The mean head circumference (P < 0.001), height (length) (P < 0.001), weight (P < 0.01), and BMI (P < 0.05) for age z-scores of the participants were lower than the reference population. The height-for-age and weight-for-age z-scores of the participants did not differ significantly between birth and current measurements. Three-fourths of the group reported having one or more nutritional or gastrointestinal problems including short stature (65%), underweight (77%), oral motor dysfunction (41%), gastroesophageal reflux (24%), gastroparesis (35%), and constipation (35%). These observations provide novel clinical information about growth, body composition, and nutritional and gastrointestinal aspects of children and adults with FDH and underscore the importance of careful observation and early clinical intervention in the care of individuals affected with this disorder.
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Abstract
Focal dermal hypoplasia (Goltz syndrome) is a rare genetic multisystem disorder primarily involving the skin, skeletal system, eyes, and face. We report the case of an eight-month-old female child who presented with multiple hypopigmented atrophic macules along the lines of blaschko, skeletal anomalies, umbilical hernia, developmental delay, hypoplastic nails, syndactyly, and lobster claw deformity characteristic of Goltz syndrome.
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Affiliation(s)
- Sahana M Srinivas
- Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bangalore, India
| | - Ravi Hiremagalore
- Department of Pediatric Dermatology, Indira Gandhi Institute of Child Health, Bangalore, India
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Amalnath SD, Gopalakrishnan M, Dutta TK. Split-hand/feet malformation in three tamilian families and review of the reports from India. INDIAN JOURNAL OF HUMAN GENETICS 2014; 20:92-5. [PMID: 24959024 PMCID: PMC4065489 DOI: 10.4103/0971-6866.132769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Split-hand/foot malformation (SHFM) is a rare condition which can be either syndromic or nonsyndromic. We report three unrelated pedigrees, one with autosomal dominant (AD) inheritance and the other two with autosomal recessive (AR) pattern. We also briefly review the published reports from India.
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Affiliation(s)
- S Deepak Amalnath
- Department of Medicine, Jawaharlal Institute of Medical Education and Research, Pondicherry, India
| | - Maya Gopalakrishnan
- Department of Medicine, Jawaharlal Institute of Medical Education and Research, Pondicherry, India
| | - Tarun Kumar Dutta
- Department of Medicine, Jawaharlal Institute of Medical Education and Research, Pondicherry, India
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Abstract
Goltz syndrome is a rare multisystem disorder with cutaneous, ocular, dental and skeletal abnormalities. Other mesoectodermal abnormalities are also present. Its hallmark is thinning of the dermis resulting subcutaneous fat herniation. The present case is a 5 year old girl having linear skin atrophy with fat herniation, skeletal abnormalities in the form of polysyndactyly, facial asymmetry, squint with coloboma iris, deformed pinna, abnormal dentition, umbilical hernia along with osteopathia striata of long bones which is consistent with Goltz syndrome. We are presenting this case due to its rarity.
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Affiliation(s)
- Sheela Bharani
- Department of Pediatrics, Medical College, Vadodara, Gujarat, India
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Wang L, Jin X, Zhao X, Liu D, Hu T, Li W, Jiang L, Dan H, Zeng X, Chen Q. Focal dermal hypoplasia: updates. Oral Dis 2013; 20:17-24. [PMID: 23463902 DOI: 10.1111/odi.12083] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 01/25/2013] [Accepted: 02/06/2013] [Indexed: 02/05/2023]
Abstract
Focal dermal hypoplasia (FDH), or Goltz-Gorlin syndrome, is a rare syndrome and may result in multisystem disorders. Several reviews of FDH have been published. However, the last comprehensive review of this disorder appeared more than 20 years ago. To date, a number of new clinical manifestations have been reported and considerable knowledge has accumulated regarding etiology and pathogenetic mechanisms. The purpose of this review is to gather these more recent data and to provide organized and reliable information. So we reviewed 159 cases of FDH that had been reported from 1990 to 2012, summarized the new discoveries, and suggested a potential standard for the diagnosis of FDH. We also reported on a Chinese girl with FDH, who was clinically and histologically in accord with FDH, as an example.
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Affiliation(s)
- L Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, China
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Altschuler EL, Yoon RS, Dentico R, Liporace FA. Spontaneous patella fracture presenting as osteomyelitis in focal dermal hypoplasia. Knee 2012; 19:500-3. [PMID: 22000280 DOI: 10.1016/j.knee.2011.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 08/24/2011] [Accepted: 09/12/2011] [Indexed: 02/02/2023]
Abstract
We report the first case of the assessment and treatment of a spontaneous patellar fracture in a patient with Goltz syndrome-a rare dermal hypoplasia. This case illustrates the non-straightforward presentation of a spontaneous patellar fracture in seemingly osteoporotic bone stock further complicated by the inability to rule out osteomyelitis. In this confusing presentation, a high index of suspicion for patella fracture should be maintained for patients with knee pain and osteoporosis on x-ray with a dysplastic syndrome.
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Affiliation(s)
- Eric L Altschuler
- Clinical Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation UMDNJ - New Jersey Medical School Newark, NJ 07103, USA.
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Abstract
Goltz syndrome is a rare genetic disease of X-linked dominant inheritance. It is more common in female patients and, in most cases, results in miscarriage of male fetuses. It has a broad scope of possible clinical manifestations. Its diagnosis consists of the sum of the many clinical, radiological and histopathological findings. The treatment options are genetic counseling, reconstructive surgery and multidisciplinary approach, aiming to improve quality of life and ensure a normal and productive life.
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Focal dermal hypoplasia: report of a Taiwanese case. DERMATOL SIN 2011. [DOI: 10.1016/j.dsi.2011.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Tenkir A, Teshome S. Goltz syndrome (focal dermal hypoplasia) with unilateral ocular, cutaneous and skeletal features: case report. BMC Ophthalmol 2010; 10:28. [PMID: 21092077 PMCID: PMC2996349 DOI: 10.1186/1471-2415-10-28] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 11/19/2010] [Indexed: 05/26/2023] Open
Abstract
Background Goltz syndrome or focal dermal hypoplasia (FDH) is an uncommon multisystem disorder. Herein, we report a typical case of FDH with unilateral ocular, cutaneous and skeletal features. Case Presentation a 4-year-old girl presented with microphthalmos and iris coloboma of the left eye, facial asymmetry, and a low-set protruding ear. Cutaneous changes included hypopigmented atrophic macules on the left side of the face, chest, abdomen and limbs. Characteristic lobster claw deformity of left hand and oligodactyly and syndactyly of left foot were present. Conclusions FDH usually affects both sides of the body. This case represents the unusual unilateral manifestation of the syndrome.
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Affiliation(s)
- Addis Tenkir
- Department of Ophthalmology, Jimma University, Ethiopia.
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Aoyama M, Sawada H, Shintani Y, Isomura I, Morita A. Case of unilateral focal dermal hypoplasia (Goltz syndrome). J Dermatol 2008; 35:33-5. [PMID: 18181774 DOI: 10.1111/j.1346-8138.2007.00408.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Focal dermal hypoplasia (FDH) is a rare multisystem condition in which developmental defects of the skin are associated with ocular, dental and skeletal abnormalities. Herein, we report an 8-year-old girl with FDH. Her body halves were asymmetric and she had linear cutaneous atrophy with yellow nodules on her extremities. Syndactylies of the third and fourth fingers of the right hand and second and third toes of the right foot were also observed. Histological examination revealed dermal hypoplasia and upward extension of the adipose tissue. Based on these observations, she was diagnosed with unilateral FDH.
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Affiliation(s)
- Masako Aoyama
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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