1
|
Cuperus E, Bygum A, Boeckmann L, Bodemer C, Bolling MC, Caproni M, Diociaiuti A, Emmert S, Fischer J, Gostynski A, Guez S, van Gijn ME, Hannulla-Jouppi K, Has C, Hernández-Martín A, Martinez AE, Mazereeuw-Hautier J, Medvecz M, Neri I, Sigurdsson V, Suessmuth K, Traupe H, Oji V, Pasmans SGMA. Proposal for a 6-step-approach for differential diagnosis of neonatal erythroderma. J Eur Acad Dermatol Venereol 2022; 36:973-986. [PMID: 35238435 PMCID: PMC9310754 DOI: 10.1111/jdv.18043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/15/2021] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
The broad differential diagnosis of neonatal erythroderma often poses a diagnostic challenge. Mortality of neonatal erythroderma is high due to complications of the erythroderma itself and the occasionally severe and life-threatening underlying disease. Early correct recognition of the underlying cause leads to better treatment and prognosis. Currently, neonatal erythroderma is approached by a case by case basis. The purpose of this scoping review was to develop a diagnostic approach in neonatal erythroderma. After a systematic literature search in Embase (January 1990 - May 2020, 74 cases of neonatal erythroderma were identified, and 50+ diagnoses could be extracted. Main causes were the ichthyoses (40%) and primary immunodeficiencies (35%). Congenital erythroderma was present in 64% (47/74) of the cases, predominantly with congenital ichthyosis (11/11; 100%), Netherton syndrome (12/14, 86%), and Omenn syndrome (11/23, 48%). Time until diagnosis ranged from 102 days to 116 days for cases of non-congenital erythroderma and congenital erythroderma respectively. Among the 74 identified cases a total of 17 patients (23%) died within a mean of 158 days and were related to Omenn syndrome (35%), graft versus host disease (67%), and Netherton syndrome (18%). Disease history and physical examination are summarized in this paper. Age of onset and a collodion membrane can help to narrow the differential diagnoses. Investigations of blood, histology, hair analysis, genetic analysis and clinical imaging are summarized and discussed. A standard blood investigation is proposed and the need for skin biopsies with Lympho-Epithelial Kazal-Type related Inhibitor-staining is highlighted. Overall, this review shows that diagnostic procedures narrow the differential diagnosis in neonatal erythroderma. A 6-step flowchart for the diagnostic approach for neonatal erythroderma during the first month of life is proposed. The approach was made with the support of expert leaders from international multidisciplinary collaborations in the European Reference Network Skin-subthematic group Ichthyosis.
Collapse
Affiliation(s)
- E Cuperus
- Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Department of Dermatology, Center of Pediatric Dermatology, The Netherlands
| | - A Bygum
- University of Southern Denmark, Clinical Institute, Denmark & Odense University Hospital, Department of Clinical Genetics, Denmark
| | - L Boeckmann
- University Medical Center Rostock. Clinic and Policlinic for Dermatology and Venereology. Rostock, Germany
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses (MAGEC), Necker-Enfants Malades Hospital (AP-HP5), Paris-Centre University, Imagine Institute, INSERM, Paris, France
| | - M C Bolling
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Groningen, the Netherlands
| | - M Caproni
- Department of Health Sciences, Section of Dermatology, USL Toscana Centro, Rare Diseases Unit, University of Florence, Florence, Italy
| | - A Diociaiuti
- Dermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - S Emmert
- University Medical Center Rostock. Clinic and Policlinic for Dermatology and Venereology. Rostock, Germany
| | - J Fischer
- Institute of Human Genetics, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - A Gostynski
- Department of Dermatology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - S Guez
- Pediatrics Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - M E van Gijn
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands
| | - K Hannulla-Jouppi
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, HUS, Helsinki, Finland
| | - C Has
- Department of Dermatology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - A E Martinez
- Pediatric Dermatology, NHS Foundation Trust, Great Ormond Street, London, UK
| | - J Mazereeuw-Hautier
- Dermatology Department, Reference Center for Rare Skin Diseases, Toulouse, France
| | - M Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - I Neri
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater, Studiorum University of Bologna, Bologna, Italy
| | - V Sigurdsson
- University Medical Center Utrecht and Utrecht University, Department of Dermatology, Utrecht, The Netherlands
| | - K Suessmuth
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - S G M A Pasmans
- Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Department of Dermatology, Center of Pediatric Dermatology, The Netherlands
| |
Collapse
|
2
|
Cantarín-Extremera V, Bernardino-Cuesta B, Martín-Villaescusa C, Melero-Llorente J, Hernández-Martín A, Aparicio-López C, de Lucas-Collantes C, Tamariz Martel-Moreno A, Duat-Rodríguez A, Ruiz-Falcó-Rojas ML. [Tuberous sclerosis complex: analysis of areas of involvement, treatment progress and translation to routine clinical practice in a cohort of paediatric patients]. Rev Neurol 2021; 73:141-150. [PMID: 34328203 DOI: 10.33588/rn.7305.2020665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tuberous sclerosis complex (TSC) displays great phenotypic variability. Increasingly early diagnosis, including prenatal identification, entails the need for the paediatrician and neuropaediatrician to establish early suspicion and identification of factors that may influence prognosis and treatment. AIM To determine the clinical criteria for early diagnosis, initial complementary tests, actions and treatments to prevent different comorbidities, so as to improve the prognosis of these patients. PATIENTS AND METHODS Descriptive, retrospective study of = 18-year-olds with a definitive diagnosis of TSC in a tertiary hospital from 1998 to 2019. We collected variables referring to epidemiological data, multisystem involvement, complementary tests and genetics. RESULTS Ninety-four patients were analysed. The main diagnostic reasons were epilepsy and rhabdomyomas. The frequency of occurrence of clinical criteria was determined, and neuropathological findings were the main findings, followed by cutaneous stigmata, rhabdomyomas and renal lesions. Statistical relationships were found between clinical, radiological and genetic aspects, the influence of preventive activities on the occurrence of epilepsy and the relevance of everolimus use were tested. CONCLUSIONS Rhabdomyomas and skin stigmata in patients and parents are major diagnostic signs in infants. Tubers and subependymal nodules are statistically associated with the development of epilepsy. Early epileptic spasms, refractory to treatment in the first months, increase the risk of cognitive deficits and autism spectrum disorder. Epileptic abnormalities need to be closely monitored in the first year of life. Everolimus is an alternative treatment for several comorbidities, but its early use (< 3 years) requires further study.
Collapse
Affiliation(s)
- V Cantarín-Extremera
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER). ISCIII, Madrid, España
| | | | | | | | | | - C Aparicio-López
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España
| | | | | | - A Duat-Rodríguez
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER). ISCIII, Madrid, España
| | - M L Ruiz-Falcó-Rojas
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER). ISCIII, Madrid, España
| |
Collapse
|
3
|
Abstract
Rosacea is a chronic inflammatory condition that affects the skin and the eyes. The pathogenesis of rosacea is complex and includes the interaction between genetic and environmental factors, dysregulation of the innate immune system, neurovascular modifications and the interaction with skin commensals. Clinical manifestations in children include the telangiectatic form, papulopustular rosacea, ocular rosacea, periorificial dermatitis, granulomatous rosacea and idiopathic facial aseptic granuloma. Management is aimed at identifying and avoiding triggers. Topical therapy is used for mild cases with topical antibiotics and anti-inflammatory agents. Oral agents are indicated, in combination with topical therapy, for moderate to severe cases. Prolonged therapy may be required.
Collapse
Affiliation(s)
- L Noguera-Morel
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| |
Collapse
|
4
|
Andina D, Belloni-Fortina A, Bodemer C, Bonifazi E, Chiriac A, Colmenero I, Diociaiuti A, El-Hachem M, Fertitta L, van Gysel D, Hernández-Martín A, Hubiche T, Luca C, Martos-Cabrera L, Maruani A, Mazzotta F, Akkaya AD, Casals M, Ferrando J, Grimalt R, Grozdev I, Kinsler V, Morren MA, Munisami M, Nanda A, Novoa MP, Ott H, Pasmans S, Salavastru C, Zawar V, Torrelo A. Skin manifestations of COVID-19 in children: Part 3. Clin Exp Dermatol 2020; 46:462-472. [PMID: 33207021 PMCID: PMC7753282 DOI: 10.1111/ced.14483] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022]
Abstract
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial
recognized symptoms were respiratory, sometimes culminating in severe respiratory distress
requiring ventilation, and causing death in a percentage of those infected. As time has
passed, other symptoms have been recognized. The initial reports of cutaneous
manifestations were from Italian dermatologists, probably because Italy was the first
European country to be heavily affected by the pandemic. The overall clinical
presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in
adults as do the cutaneous manifestations of childhood. In this review, we summarize the
current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough
and critical review of articles published in the literature and from the personal
experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss
one of the first and most widespread cutaneous manifestations of COVID‐19, chilblain‐like
lesions, and in Part 2 we expanded to other manifestations, including erythema multiforme,
urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome. In this part of
the review, we discuss the histological findings of COVID‐19 manifestations, and the
testing and management of infected children for both COVID‐19 and any other pre‐existing
conditions. Click here for the corresponding questions to this CME article.
Collapse
Affiliation(s)
- D Andina
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Belloni-Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - C Bodemer
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - E Bonifazi
- Dermatologia Pediatrica Association, Bari, Italy
| | - A Chiriac
- Nicolina Medical Center, Iasi, Romania
| | - I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Fertitta
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - D van Gysel
- Department of Pediatrics, O. L. Vrouw Hospital, Aalst, Belgium
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - T Hubiche
- Department of Dermatology, Université Côte d'Azur, Nice, France
| | - C Luca
- Nicolina Medical Center, Iasi, Romania
| | - L Martos-Cabrera
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, SPHERE-INSERM1246, CHRU Tours, Tours, France
| | - F Mazzotta
- Dermatologia Pediatrica Association, Bari, Italy
| | - A D Akkaya
- Department of Dermatology, Ulus Liv Hospital, Istanbul, Turkey
| | - M Casals
- Department of Dermatology, Hospital Universitari de Sabadell, Barcelona, Spain
| | - J Ferrando
- Department of Dermatology, Hospital Clìnic, Barcelona, Spain
| | - R Grimalt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - I Grozdev
- Department of Dermatology, Children's University Hospital Queen Fabiola, Brussels, Belgium
| | - V Kinsler
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - M A Morren
- Pediatric Dermatology Unit, Department of Pediatrics and Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Munisami
- Department of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute Of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - M P Novoa
- Department of Dermatology, Hospital San Jose, Bogota, Colombia
| | - H Ott
- Division of Pediatric Dermatology, Children's Hospital Auf der Bult, Hannover, Germany
| | - S Pasmans
- Erasmus MC University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - V Zawar
- Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | |
Collapse
|
5
|
Andina D, Belloni-Fortina A, Bodemer C, Bonifazi E, Chiriac A, Colmenero I, Diociaiuti A, El-Hachem M, Fertitta L, van Gysel D, Hernández-Martín A, Hubiche T, Luca C, Martos-Cabrera L, Maruani A, Mazzotta F, Akkaya AD, Casals M, Ferrando J, Grimalt R, Grozdev I, Kinsler V, Morren MA, Munisami M, Nanda A, Novoa MP, Ott H, Pasmans S, Salavastru C, Zawar V, Torrelo A. Skin manifestations of COVID-19 in children: Part 1. Clin Exp Dermatol 2020; 46:444-450. [PMID: 33180982 PMCID: PMC9275402 DOI: 10.1111/ced.14481] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023]
Abstract
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial
recognized symptoms were respiratory, sometimes culminating in severe respiratory distress
requiring ventilation, and causing death in a percentage of those infected. As time has
passed, other symptoms have been recognized. The initial reports of cutaneous
manifestations were from Italian dermatologists, probably because Italy was the first
European country to be heavily affected by the pandemic. The overall clinical
presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in
adults as do the cutaneous manifestations of childhood. In this review, we summarize the
current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough
and critical review of articles published in the literature and from the personal
experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss
one of the first and most widespread cutaneous manifestation of COVID‐19, chilblain‐like
lesions. In Part 2, we review other manifestations, including erythema multiforme,
urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome, while in Part 3,
we discuss the histological findings of COVID‐19 manifestations, and the testing and
management of infected children, for both COVID‐19 and any other pre‐existing
conditions. Click here for the corresponding questions to this CME article.
Collapse
Affiliation(s)
- D Andina
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Belloni-Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - C Bodemer
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - E Bonifazi
- Dermatologia Pediatrica Association, Bari, Italy
| | - A Chiriac
- Nicolina Medical Center, Iasi, Romania
| | - I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Fertitta
- St Parascheva Infectious Diseases Hospital, Iasi, Romania
| | - D van Gysel
- Department of Pediatrics, O. L. Vrouw Hospital, Aalst, Belgium
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - T Hubiche
- Department of Dermatology, Université Côte d'Azur, Nice, France
| | - C Luca
- Nicolina Medical Center, Iasi, Romania
| | - L Martos-Cabrera
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, SPHERE-INSERM1246, CHRU Tours, Tours, France
| | - F Mazzotta
- Dermatologia Pediatrica Association, Bari, Italy
| | - A D Akkaya
- Department of Dermatology, Ulus Liv Hospital, Istanbul, Turkey
| | - M Casals
- Department of Dermatology, Hospital Universitari de Sabadell, Barcelona, Spain
| | - J Ferrando
- Department of Dermatology, Hospital Clìnic, Barcelona, Spain
| | - R Grimalt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - I Grozdev
- Department of Dermatology, Children's University Hospital Queen Fabiola, Brussels, Belgium
| | - V Kinsler
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - M A Morren
- Pediatric Dermatology Unit, Department of Pediatrics and Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Munisami
- Department of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - M P Novoa
- Department of Dermatology, Hospital San Jose, Bogota, Colombia
| | - H Ott
- Division of Pediatric Dermatology, Children's Hospital Auf der Bult, Hannover, Germany
| | - S Pasmans
- Erasmus MC University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - V Zawar
- Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | |
Collapse
|
6
|
Colmenero I, Santonja C, Alonso-Riaño M, Noguera-Morel L, Hernández-Martín A, Andina D, Wiesner T, Rodríguez-Peralto JL, Requena L, Torrelo A. SARS-CoV-2 endothelial infection causes COVID-19 chilblains: histopathological, immunohistochemical and ultrastructural study of seven paediatric cases. Br J Dermatol 2020; 183:729-737. [PMID: 32562567 PMCID: PMC7323219 DOI: 10.1111/bjd.19327] [Citation(s) in RCA: 309] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2020] [Indexed: 12/16/2022]
Abstract
Background Chilblains (‘COVID toes’) are being seen with increasing frequency in children and young adults during the COVID‐19 pandemic. Detailed histopathological descriptions of COVID‐19 chilblains have not been reported, and causality of SARS‐CoV‐2 has not yet been established. Objectives To describe the histopathological features of COVID‐19 chilblains and to explore the presence of SARS‐CoV‐2 in the tissue. Methods We examined skin biopsies from seven paediatric patients presenting with chilblains during the COVID‐19 pandemic. Immunohistochemistry for SARS‐CoV‐2 was performed in all cases and electron microscopy in one. Results Histopathology showed variable degrees of lymphocytic vasculitis ranging from endothelial swelling and endotheliitis to fibrinoid necrosis and thrombosis. Purpura, superficial and deep perivascular lymphocytic inflammation with perieccrine accentuation, oedema, and mild vacuolar interface damage were also seen. SARS‐CoV‐2 immunohistochemistry was positive in endothelial cells and epithelial cells of eccrine glands. Coronavirus particles were found in the cytoplasm of endothelial cells on electron microscopy. Conclusions Although the clinical and histopathological features were similar to other forms of chilblains, the presence of viral particles in the endothelium and the histological evidence of vascular damage support a causal relation of the lesions with SARS‐CoV‐2. Endothelial damage induced by the virus could be the key mechanism in the pathogenesis of COVID‐19 chilblains and perhaps also in a group of patients severely affected by COVID‐19 presenting with features of microangiopathic damage. What is already known about this topic? Despite the high number of cases of chilblains seen during the COVID‐19 pandemic, a definite causative role for SARS‐CoV‐2 has not yet been proven. Different pathogenetic hypotheses have been proposed, including coagulation anomalies, interferon release and external factors.
What does this study add? The demonstration of SARS‐CoV‐2 in endothelial cells of skin biopsies by immunohistochemistry and electron microscopy confirms that these lesions are part of the spectrum of COVID‐19. Virus‐induced vascular damage and secondary ischaemia could explain the pathophysiology of COVID‐19 chilblains. Our findings support the hypothesis that widespread endothelial infection by SARS‐CoV‐2 could have a pathogenetic role in the severe forms of COVID‐19.
Linked Comment: Wetter. Br J Dermatol 2020; 183:611.
Collapse
Affiliation(s)
- I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - C Santonja
- Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M Alonso-Riaño
- Department of Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - L Noguera-Morel
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - D Andina
- Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - T Wiesner
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - L Requena
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| |
Collapse
|
7
|
Navarro L, Andina D, Noguera-Morel L, Hernández-Martín A, Colmenero I, Torrelo A. Dermoscopy features of COVID-19-related chilblains in children and adolescents. J Eur Acad Dermatol Venereol 2020; 34:e762-e764. [PMID: 32618033 PMCID: PMC7362154 DOI: 10.1111/jdv.16800] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- L Navarro
- Department of Dermatology, Hospital Beata María Ana, Madrid, Spain
| | - D Andina
- Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - L Noguera-Morel
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| |
Collapse
|
8
|
Nieto-Benito LM, Baniandrés-Rodríguez O, Moreno-Torres A, Hernández-Martín A, Torrelo-Fernández A, Campos-Domínguez M. Clinical response to ustekinumab in CARD14-associated papulosquamous eruption (CAPE) with a new missense mutation in CARD14: a case report and systematic review. J Eur Acad Dermatol Venereol 2020; 34:e728-e730. [PMID: 32349169 DOI: 10.1111/jdv.16548] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- L M Nieto-Benito
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - O Baniandrés-Rodríguez
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Moreno-Torres
- Department of Pathology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - A Hernández-Martín
- Department of Dermatology, Hospital Universitario del Niño Jesús, Madrid, Spain
| | - A Torrelo-Fernández
- Department of Dermatology, Hospital Universitario del Niño Jesús, Madrid, Spain
| | - M Campos-Domínguez
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Laboratory of Immune-regulation, 'Gregorio Marañón' Health Research Institute (IISGM), Madrid, Spain.,Medical School, Universidad Complutense de Madrid, Spain
| |
Collapse
|
9
|
Herrero-Moyano M, Noguera-Morel L, Torrelo A, Hernández-Martín A. Síndrome de Ehlers-Danlos clásico: hallazgos clínicos y ecográficos. Actas Dermo-Sifiliográficas 2020; 111:83-85. [DOI: 10.1016/j.ad.2018.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/26/2018] [Indexed: 10/28/2022] Open
|
10
|
Sainz-Gaspar L, Sánchez-Bernal J, Noguera-Morel L, Hernández-Martín A, Colmenero I, Torrelo A. Nevo de Spitz y otros tumores spitzoides en la infancia. Parte 1: aspectos clínicos, histológicos e inmunohistoquímicos. Actas Dermo-Sifiliográficas 2020; 111:7-19. [DOI: 10.1016/j.ad.2019.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/03/2019] [Indexed: 11/25/2022] Open
|
11
|
Sainz-Gaspar L, Sánchez-Bernal J, Noguera-Morel L, Hernández-Martín A, Colmenero I, Torrelo A. Spitz Nevus and Other Spitzoid Tumors in Children —Part 1: Clinical, Histopathologic, and Immunohistochemical Features. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
12
|
Herrero-Moyano M, Noguera-Morel L, Torrelo A, Hernández-Martín A. Classic Ehlers-Danlos Syndrome: Clinical and Ultrasound Findings. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
13
|
Sainz-Gaspar L, Sánchez-Bernal J, Noguera-Morel L, Hernández-Martín A, Colmenero I, Torrelo A. Spitz Nevus and Other Spitzoid Tumors in Children. Part 2: Cytogenetic and Molecular Features. Prognosis and Treatment. Actas Dermosifiliogr (Engl Ed) 2019; 111:20-25. [PMID: 31739993 DOI: 10.1016/j.ad.2019.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/03/2019] [Indexed: 12/25/2022] Open
Abstract
Melanocytic neoplasms with spitzoid morphology (Spitz nevi, atypical Spitz tumors, and spitzoid melanomas) may be benign or malignant. Because the malignant potential of atypical Spitz tumors is uncertain, the proper therapeutic approach has been much debated over the years. Promising new techniques for molecular analysis have enabled better predictions of the biological behavior of these tumors. We review their cytogenetic features and prognosis and also provide an update of the most recent recommendations for management.
Collapse
Affiliation(s)
- L Sainz-Gaspar
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - J Sánchez-Bernal
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - L Noguera-Morel
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - A Hernández-Martín
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - I Colmenero
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - A Torrelo
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España.
| |
Collapse
|
14
|
Noguera-Morel L, Knöpfel N, Torrelo A, Hernández-Martín A. A Retrospective Study of Systemic Treatment of Severe Atopic Dermatitis With Azathioprine: Effectiveness and Tolerance in 11 Pediatric Patients. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2018.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
15
|
Mazereeuw-Hautier J, Hernández-Martín A, O'Toole EA, Bygum A, Amaro C, Aldwin M, Audouze A, Bodemer C, Bourrat E, Diociaiuti A, Dolenc-Voljč M, Dreyfus I, El Hachem M, Fischer J, Ganemo A, Gouveia C, Gruber R, Hadj-Rabia S, Hohl D, Jonca N, Ezzedine K, Maier D, Malhotra R, Rodriguez M, Ott H, Paige DG, Pietrzak A, Poot F, Schmuth M, Sitek JC, Steijlen P, Wehr G, Moreen M, Vahlquist A, Traupe H, Oji V. Management of congenital ichthyoses: European guidelines of care, part two. Br J Dermatol 2018; 180:484-495. [PMID: 29897631 DOI: 10.1111/bjd.16882] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 01/03/2023]
Abstract
These guidelines for the management of congenital ichthyoses have been developed by a multidisciplinary group of European experts following a systematic review of the current literature, an expert conference held in Toulouse in 2016, and a consensus on the discussions. These guidelines summarize evidence and expert-based recommendations and intend to help clinicians with the management of these rare and often complex diseases. These guidelines comprise two sections. This is part two, covering the management of complications and the particularities of some forms of congenital ichthyosis.
Collapse
Affiliation(s)
- J Mazereeuw-Hautier
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Toulouse, France
| | | | - E A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts, and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - A Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - C Amaro
- Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - M Aldwin
- Ichthyosis Support Group, PO Box 1242, Yateley, GU47 7FL, U.K
| | - A Audouze
- Association Ichtyose France, Bellerive sur Allier, France
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Saint-Louis, Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - E Bourrat
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Saint-Louis, Paris, France
| | - A Diociaiuti
- Dermatology Division, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - M Dolenc-Voljč
- Department of Dermatovenereology, University Medical Centre Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - I Dreyfus
- Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, Toulouse, France
| | - M El Hachem
- Dermatology Division, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - J Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Ganemo
- Department of Dermatology, Institute of Clinical Research in Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - C Gouveia
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - R Gruber
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Saint-Louis, Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - D Hohl
- Department of Dermatology, Hôpital de Beaumont, Lausanne, Switzerland
| | - N Jonca
- Epithelial Differentiation and Rheumatoid Autoimmunity Unit (UDEAR), UMR 1056 Inserm - Toulouse 3 University, Purpan Hospital, Toulouse, France
| | - K Ezzedine
- Depatment of Dermatology, Hôpital Henri Mondor, EA EpiDerm, UPEC-Université Paris-Est Créteil, 94010, Créteil, France
| | - D Maier
- Dermatology Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, West Sussex, U.K
| | - M Rodriguez
- Department of Ear, Nose and Throat, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - H Ott
- Division of Pediatric Dermatology and Allergology, Auf Der Bult Children's Hospital, Hanover, Germany
| | - D G Paige
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, U.K
| | - A Pietrzak
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - F Poot
- ULB-Erasme Hospital, Department of Dermatology, Brussels, Belgium
| | - M Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - J C Sitek
- Department of Dermatology and Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - P Steijlen
- Department of Dermatology, Maastricht University Medical Centre, GROW Research School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - G Wehr
- Selbsthilfe Ichthyose, Kürten, Germany
| | - M Moreen
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology KU Leuven, Leuven, Belgium
| | - A Vahlquist
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Von-Esmarch-Straße 58, D-48149, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Von-Esmarch-Straße 58, D-48149, Münster, Germany.,Hautarztpraxis am Buddenturm, Rudolf-von-Langen-Straße 55, D-48147, Münster, Germany
| |
Collapse
|
16
|
Noguera-Morel L, Knöpfel N, Torrelo A, Hernández-Martín A. A Retrospective Study of Systemic Treatment of Severe Atopic Dermatitis With Azathioprine: Effectiveness and Tolerance in 11 Pediatric Patients. Actas Dermosifiliogr (Engl Ed) 2018; 110:227-231. [PMID: 30376955 DOI: 10.1016/j.ad.2018.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/20/2018] [Accepted: 06/03/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically affects children. Severe forms may have a profound effect on patients' quality of life. Some forms are resistant to conventional treatment and require the use of systemic immunosuppressants such as azathioprine (AZA) to adequately manage the disease. OBJECTIVE To evaluate the effectiveness and tolerance of AZA in children with severe AD. PATIENTS AND METHODS We performed a retrospective study of children with severe AD treated with AZA between January 2007 and May 2017. RESULTS We reviewed the cases of 11 patients (6 boys and 5 girls) with a mean age of 13 years (range, 8-18 years). The mean (SD) age at start of treatment was 10.9 (2.2) years (95% CI 8.6-13.1). The mean initial dosage of AZA was 1.8 (0.2) mg/kg/d. We evaluated treatment response after 4 weeks, 12 to 16 weeks, and 6 months. Mean treatment duration was 10.8 (5.7) months. Treatment had to be suspended in 2 patients because of adverse effects. Seven of the 9 remaining patients presented complete or almost complete clearance of the AD after 6 months of treatment. CONCLUSION In our experience, AZA is well tolerated and may be considered as a treatment option in children with severe AD resistant to conventional treatment.
Collapse
Affiliation(s)
- L Noguera-Morel
- Departamento de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - N Knöpfel
- Departamento de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - A Torrelo
- Departamento de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - A Hernández-Martín
- Departamento de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España.
| |
Collapse
|
17
|
Rodrigo-Nicolás B, Bueno-Martínez E, Martín-Santiago A, Cañueto J, Vicente A, Torrelo A, Noguera-Morel L, Duat-Rodríguez A, Jorge-Finnigan C, Palacios-Álvarez I, García-Hernández J, Sebaratnam D, González-Sarmiento R, Hernández-Martín A. Recessive XLI: high prevalence of neurological disorders. Br J Dermatol 2018. [DOI: 10.1111/bjd.17182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
18
|
Rodrigo-Nicolás B, Bueno-Martínez E, Martín-Santiago A, Cañueto J, Vicente A, Torrelo A, Noguera-Morel L, Duat-Rodríguez A, Jorge-Finnigan C, Palacios-Álvarez I, García-Hernández J, Sebaratnam D, González-Sarmiento R, Hernández-Martín A. 隐性 XLI: 神经系统疾病的高患病率. Br J Dermatol 2018. [DOI: 10.1111/bjd.17183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Rodrigo-Nicolás B, Bueno-Martínez E, Martín-Santiago A, Cañueto J, Vicente A, Torrelo A, Noguera-Morel L, Duat-Rodríguez A, Jorge-Finnigan C, Palacios-Álvarez I, García-Hernández J, Sebaratnam D, González-Sarmiento R, Hernández-Martín A. Evidence of the high prevalence of neurological disorders in nonsyndromic X-linked recessive ichthyosis: a retrospective case series. Br J Dermatol 2018; 179:933-939. [DOI: 10.1111/bjd.16826] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 12/11/2022]
Affiliation(s)
| | - E. Bueno-Martínez
- Molecular Medicine Unit-Department of Medicine; IBSAL and IBMCC and University Hospital of Salamanca; CSIC, University of Salamanca; Spain
| | - A. Martín-Santiago
- Department of Dermatology; Hospital Son Espases; Palma de Mallorca Spain
| | - J. Cañueto
- Department of Dermatology; Hospital Universitario de Salamanca; Salamanca Spain
| | - A. Vicente
- Department of Dermatology; Hospital Sant Joan de Deu; Barcelona Spain
| | - A. Torrelo
- Department of Dermatology; Hospital Infantil Niño Jesús; Madrid Spain
| | - L. Noguera-Morel
- Department of Dermatology; Hospital Infantil Niño Jesús; Madrid Spain
| | | | - C. Jorge-Finnigan
- Department of Dermatology; Hospital Infantil Niño Jesús; Madrid Spain
| | | | - J.L. García-Hernández
- Molecular Medicine Unit-Department of Medicine; IBSAL and IBMCC and University Hospital of Salamanca; CSIC, University of Salamanca; Spain
| | - D.F. Sebaratnam
- Department of Dermatology; Hospital Infantil Niño Jesús; Madrid Spain
| | - R. González-Sarmiento
- Molecular Medicine Unit-Department of Medicine; IBSAL and IBMCC and University Hospital of Salamanca; CSIC, University of Salamanca; Spain
| | | |
Collapse
|
20
|
Latour I, Hernández-Martín A, Ged C, Knöpfel N, Taïeb A, Torrelo A. Reversed actinic damage in two children with xeroderma pigmentosum treated with topical imiquimod. J Eur Acad Dermatol Venereol 2018; 32:e282-e284. [PMID: 29377344 DOI: 10.1111/jdv.14818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- I Latour
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| | - A Hernández-Martín
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| | - C Ged
- INSERUM U 1053, University of Bordeaux, 146 rue Léo Saignat FR-33000, Bordeaux, France
| | - N Knöpfel
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| | - A Taïeb
- INSERUM U 1053, University of Bordeaux, 146 rue Léo Saignat FR-33000, Bordeaux, France
| | - A Torrelo
- Hospital Infantil Universitario Niño Jesús, Menéndez Pelayo 65, 28009, Madrid, Spain
| |
Collapse
|
21
|
Knöpfel N, Noguera-Morel L, Azorin D, Sanz F, Torrelo A, Hernández-Martín A. CutaneousLeishmania tropicain children: report of three imported cases successfully treated with liposomal amphotericin B. J Eur Acad Dermatol Venereol 2017; 32:e8-e10. [DOI: 10.1111/jdv.14434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- N. Knöpfel
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Av. de Menéndez Pelayo, 65 28009 Madrid Spain
| | - L. Noguera-Morel
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Av. de Menéndez Pelayo, 65 28009 Madrid Spain
| | - D. Azorin
- Department of Pathology; Hospital Infantil Universitario Niño Jesús; 65, 28009 Madrid Spain
| | - F. Sanz
- Department of Pediatrics; Hospital Infantil Universitario Niño Jesús; 65, 28009 Madrid Spain
| | - A. Torrelo
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Av. de Menéndez Pelayo, 65 28009 Madrid Spain
| | - A. Hernández-Martín
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Av. de Menéndez Pelayo, 65 28009 Madrid Spain
| |
Collapse
|
22
|
Hernández-Martín A, Noguera-Morel L, Bernardino-Cuesta B, Torrelo A, Pérez-Martin M, Aparicio-López C, de Lucas-Collantes C. Cyclosporine A for severe atopic dermatitis in children. efficacy and safety in a retrospective study of 63 patients. J Eur Acad Dermatol Venereol 2017; 31:837-842. [DOI: 10.1111/jdv.14066] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/08/2016] [Indexed: 11/27/2022]
Affiliation(s)
- A. Hernández-Martín
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - L. Noguera-Morel
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - B. Bernardino-Cuesta
- Department of Pediatrics; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - A. Torrelo
- Department of Dermatology; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - M.A. Pérez-Martin
- Department of Pediatrics; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | - C. Aparicio-López
- Department of Nephrology; Hospital Infantil Universitario Niño Jesús; Madrid Spain
| | | |
Collapse
|
23
|
Torrelo A, Noguera-Morel L, Hernández-Martín A, Clemente D, Barja J, Buzón L, Azorín D, de Jesús A, López-Robledillo J, Colmenero I, Kutzner H, Goldbach-Mansky R, Requena L. Recurrent lipoatrophic panniculitis of children. J Eur Acad Dermatol Venereol 2016; 31:536-543. [DOI: 10.1111/jdv.13858] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/08/2016] [Indexed: 12/28/2022]
Affiliation(s)
- A. Torrelo
- Department of Dermatology; Hospital del Niño Jesús; Madrid Spain
| | - L. Noguera-Morel
- Department of Dermatology; Hospital del Niño Jesús; Madrid Spain
| | | | - D. Clemente
- Department of Rheumatology; Hospital del Niño Jesús; Madrid Spain
| | - J.M. Barja
- Department of Dermatology; Hospital El Bierzo; León Spain
| | - L. Buzón
- Department of Microbiology; Hospital Gregorio Marañón; Madrid Spain
| | - D. Azorín
- Department of Pathology; Hospital del Niño Jesús; Madrid Spain
| | - A.A. de Jesús
- Translational Autoinflammatory Disease Section; NIAMS; NIH; Bethesda USA
| | | | - I. Colmenero
- Paediatric Histopathology Department; Birmingham Children's Hospital; Birmingham UK
| | - H. Kutzner
- Dermatohistopathologisches Gemeinschaftslabor; Friedrichshafen Germany
| | - R. Goldbach-Mansky
- Translational Autoinflammatory Disease Section; NIAMS; NIH; Bethesda USA
| | - L. Requena
- Department of Dermatology; Fundación Jiménez Díaz; Madrid Spain
| |
Collapse
|
24
|
Hernández-Martín A, Duat-Rodríguez A. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease. Actas Dermo-Sifiliográficas (English Edition) 2016. [DOI: 10.1016/j.adengl.2016.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
25
|
Noguera-Morel L, Andrés-Ramos I, Hernández-Martín A, Torrelo A. Michelin Baby Associated With Facial Abnormalities. Actas Dermosifiliogr 2016; 107:530-1. [PMID: 26976497 DOI: 10.1016/j.ad.2016.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/04/2016] [Accepted: 01/17/2016] [Indexed: 11/17/2022] Open
Affiliation(s)
- L Noguera-Morel
- Servicio de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España.
| | - I Andrés-Ramos
- Servicio de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - A Hernández-Martín
- Servicio de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - A Torrelo
- Servicio de Dermatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| |
Collapse
|
26
|
Hernández-Martín A, Duat-Rodríguez A. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease. Actas Dermosifiliogr 2016; 107:454-64. [PMID: 26979265 DOI: 10.1016/j.ad.2016.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 01/07/2016] [Accepted: 01/17/2016] [Indexed: 01/10/2023] Open
Abstract
Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome and probably the one best known to dermatologists, who are generally the first physicians to suspect its diagnosis. Although the genetic locus of NF1 was identified on chromosome 17 in 1987, diagnosis of the disease is still mainly based on clinical observations and the diagnostic criteria of the National Institute of Health, dating from 1988. Cutaneous manifestations are particularly important because café-au-lait spots, freckling on flexural areas, and cutaneous neurofibromas comprise 3 of the 7 clinical diagnostic criteria. However, café-au-lait spots and freckling can also be present in other diseases. These manifestations are therefore not pathognomonic and are insufficient for definitive diagnosis in the early years of life. NF1 is a multisystemic disease associated with a predisposition to cancer. A multidisciplinary follow-up is necessary and dermatologists play an important role.
Collapse
Affiliation(s)
- A Hernández-Martín
- Servicio de Dermatología, Hospital Infantil del Niño Jesús, Madrid, España.
| | - A Duat-Rodríguez
- Servicio de Neurología, Hospital Infantil del Niño Jesús, Madrid, España
| |
Collapse
|
27
|
Hernández-Martín A, Duat-Rodríguez A. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots and Freckling. Part II. Other Skin Manifestations Characteristic of NF1. NF1 and Cancer. Actas Dermosifiliogr 2016; 107:465-73. [PMID: 26956402 DOI: 10.1016/j.ad.2016.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/07/2016] [Accepted: 01/17/2016] [Indexed: 12/16/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome and probably the one best known to dermatologists. Although the genetic locus of NF1 was identified on chromosome 17 in 1987, diagnosis of the disease is still based primarily on clinical observations. The 7 diagnostic criteria of the National Institutes of Health, which were established in 1988, include 3 skin manifestations (café-au-lait spots, freckling on flexural areas, and cutaneous neurofibromas). The age at which these diagnostic lesions appear is variable: onset can be late in some patients while others never develop certain symptoms. Definitive diagnosis may therefore be delayed by years. Although the appearance of the characteristic café-au-lait spots and freckling in the early years of childhood are very suggestive of the disease, these signs are not pathognomonic and, in isolation, do not constitute sufficient evidence to establish a definitive diagnosis. Thus, other diagnoses should be considered in patients whose only symptoms are café-au-lait spots and freckling. By contrast, the presence of multiple cutaneous neurofibromas or at least 1 plexiform neurofibroma is a very specific indication of NF1. Identification of the different types of neurofibroma allows us to confirm the diagnosis and initiate appropriate management.
Collapse
Affiliation(s)
- A Hernández-Martín
- Servicio de Dermatología Hospital Infantil del Niño Jesús. Madrid, España.
| | - A Duat-Rodríguez
- Servicio de Neurología, Hospital Infantil del Niño Jesús, Madrid, España
| |
Collapse
|
28
|
Torrelo A, Noguera-Morel L, Hernández-Martín A, Clemente D, Kutzner H, Barja JM, de Jesus AA, López-Robledillo JC, Goldbach-Mansky R, Requena L. Recurrent Inflammatory Panniculitis with Partial Lipoatrophy and Elevated temperature: a possible new autoinflammatory disorder. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599121 DOI: 10.1186/1546-0096-13-s1-p171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
29
|
Noguera-Morel L, Hernández-Ostiz S, Casas-Fernández L, Hernández-Martín A, Rodríguez-Blanco I, Requena L, Hotz A, Fischer J, Torrelo A. CHILD syndrome with minimal limb abnormalities. J Eur Acad Dermatol Venereol 2015; 30:e201-e202. [PMID: 26611379 DOI: 10.1111/jdv.13526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L Noguera-Morel
- Department of Dermatology, Hospital Niño Jesús, Madrid, Spain
| | | | - L Casas-Fernández
- Department of Dermatology, Hospital Barbanza, EOXI, Santiago de Compostela, Spain
| | | | - I Rodríguez-Blanco
- Department of Dermatology, Hospital Barbanza, EOXI, Santiago de Compostela, Spain
| | - L Requena
- Department of Dermatology, Fundación Jiménez Díaz, Madrid, Spain
| | - A Hotz
- Institute for Human Genetics, University Medical Center Freiburg, Freiburg, Germany
| | - J Fischer
- Institute for Human Genetics, University Medical Center Freiburg, Freiburg, Germany
| | - A Torrelo
- Department of Dermatology, Hospital Niño Jesús, Madrid, Spain
| |
Collapse
|
30
|
|
31
|
Hernández-Martín A, Dávila-Seijo P, de Lucas R, Baselga E, Redondo P, Martín-Santiago A, Azaña-Defez J, González-Viejo I, Jiménez-Ferreres L, González-Enseñat M, Arroyo-Manzanal M, Soria J, Garcia-Doval I. Prioritization of therapy uncertainties in congenital ichthyosis: results from a Priority Setting Partnership. Br J Dermatol 2015; 173:1280-3. [DOI: 10.1111/bjd.13914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - P. Dávila-Seijo
- Dermatology and Venereology Department; Umeå University Hospital; Umeå Sweden
| | - R. de Lucas
- Department of Dermatology; Hospital Universitario La Paz; Madrid Spain
| | - E. Baselga
- Department of Dermatology; Hospital Santa Creu y Sant Pau; Barcelona Spain
| | - P. Redondo
- Department of Dermatology; Clínica Universidad de Navarra; Pamplona Spain
| | - A. Martín-Santiago
- Department of Dermatology; Hospital Son Espases; Palma de Mallorca Spain
| | - J.M. Azaña-Defez
- Department of Dermatology; Complejo Hospitalario Universitario; Albacete Spain
| | - I. González-Viejo
- Department of Ophthalmology; Hospital Universitario Miguel Servet; Zaragoza Spain
| | | | | | - M.I. Arroyo-Manzanal
- Centro de Referencia Estatal de Atención a personas con Enfermedades Raras y sus familias; Burgos Spain
- ASIC (Spanish Association of Ichthyosis Patients); Madrid Spain
| | - J.M. Soria
- ASIC (Spanish Association of Ichthyosis Patients); Madrid Spain
| | - I. Garcia-Doval
- Research Unit; Fundación Academia Española de Dermatología y Venereología; Madrid Spain
| |
Collapse
|
32
|
Hernández-Martín A, Dávila'Seijo P, Soria de Francisco J, Arroyo-Manzanal M, García-Doval I. Fragomented Health Care Delivery in Ichthyosis. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2015.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
33
|
Ramos-Geldres T, Dávila-Seijo P, Duat-Rodríguez A, Noguera-Morel L, Ezquieta-Zubicaray B, Rosón-López E, Hernández-Martín A, Torrelo-Fernández A. LEOPARD Syndrome Without Hearing Loss or Pulmonary Stenosis: A Report of 2 Cases. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2015.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
34
|
Hernández-Martín A, Dávila'Seijo P, Soria de Francisco JM, Arroyo-Manzanal MI, García-Doval I. Fragmented Health Care Delivery in Ichthyosis. Actas Dermosifiliogr 2015; 106:514-5. [PMID: 25583288 DOI: 10.1016/j.ad.2014.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- A Hernández-Martín
- Servicio de Dermatología, Hospital Infantil del Niño Jesús, Madrid, España.
| | - P Dávila'Seijo
- Departamento de Dermatología y Venereología. Umeå University Hospital. Umeå, Suecia, España
| | | | - M I Arroyo-Manzanal
- Centro de Referencia Estatal de Atención a personas con Enfermedades Raras y sus familias, Burgos, España
| | - I García-Doval
- Servicio de Dermatología, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España
| |
Collapse
|
35
|
Torrelo A, Vicente A, Navarro L, Planaguma M, Bueno E, González-Sarmiento R, Hernández-Martín A, Noguera-Morel L, Requena L, Colmenero I, Parareda A, González-Enseñat MA, Happle R. Early-onset acral basal cell carcinomas in Gorlin syndrome. Br J Dermatol 2014; 171:1227-9. [PMID: 24837096 DOI: 10.1111/bjd.13118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/28/2022]
Abstract
Two patients are reported in whom early-onset, distal papules with a histopathological diagnosis of basal cell carcinoma were the first manifestation of Gorlin syndrome (GS). These lesions showed no progression and remained stable through follow-up. Two different PTCH1 gene mutations were detected in the two patients, and thus a phenotype-genotype correlation of this manifestation of GS was not possible.
Collapse
Affiliation(s)
- A Torrelo
- Department of Dermatology, Hospital Niño Jesus, Menendez Pelayo 65, Madrid, 28034, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Torrelo A, Hernández-Martín A, Bueno E, Colmenero I, Rivera I, Requena L, Happle R, González-Sarmiento R. Molecular evidence of type 2 mosaicism in Gorlin syndrome. Br J Dermatol 2014; 169:1342-5. [PMID: 23746055 DOI: 10.1111/bjd.12458] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2013] [Indexed: 11/27/2022]
Abstract
We present a 12-year-old girl with a family history of Gorlin syndrome who had unilateral, segmentally arranged basaloid skin tumours present since birth, ipsilateral, palmoplantar pits of rather large size distributed along Blaschko lines, and an ipsilateral odontogenic keratocyst. The patient and her father were heterozygous for a germline mutation in the form of a single-base substitution in exon 18 of the PTCH1 gene. In the patient's lesional skin, a microdeletion in exon 3 of PTCH1 was detected, giving rise to a truncated protein. This additional mutation was ruled out in the contralateral skin and in blood lymphocytes, thus confirming its mosaic state. In this way we provide for the first time molecular proof of a type 2 segmental involvement of this autosomal dominant trait.
Collapse
Affiliation(s)
- A Torrelo
- Department of Dermatology , Hospital del Niño Jesús, Menendez Pelayo 65, Madrid, 28034, Spain
| | | | | | | | | | | | | | | |
Collapse
|
37
|
de la Fuente S, Hernández-Martín A, Happle R, Torrelo A. Mosaicismo tipo 2 en glomangiomatosis familiar. Actas Dermo-Sifiliográficas 2014; 105:524-5. [DOI: 10.1016/j.ad.2013.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/20/2013] [Accepted: 08/04/2013] [Indexed: 11/25/2022] Open
|
38
|
García-Salido A, Serrano A, Iglesias-Bouzas M, Blanco-Iglesias E, Hernández-Martín A, Casado-Flores J. Niño sano con síndrome de respuesta inflamatoria sistémica y shock séptico por parvovirus B19. An Pediatr (Barc) 2014; 80:269-70. [DOI: 10.1016/j.anpedi.2013.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/18/2013] [Accepted: 09/26/2013] [Indexed: 10/26/2022] Open
|
39
|
Concha-Garzón MJ, Hernández-Martín A, Faura-Berruga C, Dávila-Seijo P, Torrelo A. Spontaneous partial repigmentation of halo nevi around congenital melanocytic nevus and vitiligo in a 13-year-old boy. Indian J Dermatol Venereol Leprol 2014; 80:69-70. [PMID: 24448132 DOI: 10.4103/0378-6323.125539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
40
|
Hernández-Martín A, Torrelo A, Ciria S, Colmenero I, Aguilar A, Grimalt R, González-Sarmiento R. Ectodermal dysplasia-skin fragility syndrome: a novel mutation in thePKP1gene. Clin Exp Dermatol 2013; 38:787-90. [DOI: 10.1111/ced.12109] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2012] [Indexed: 11/27/2022]
Affiliation(s)
| | - A. Torrelo
- Department of Dermatology; Hospital Niño Jesús; Madrid Spain
| | - S. Ciria
- Department of Molecular Medicine Unit; Department of Medicine and IBMCC; University of Salamanca and CSIC; Salamanca Spain
| | - I. Colmenero
- Department of Pathology; Hospital Niño Jesús; Madrid Spain
| | - A. Aguilar
- Department of Dermatology; Hospital de Leganés; Madrid Spain
| | - R. Grimalt
- Department of Dermatology; Hospital Clínic; Barcelona Spain
| | - R. González-Sarmiento
- Department of Molecular Medicine Unit; Department of Medicine and IBMCC; University of Salamanca and CSIC; Salamanca Spain
| |
Collapse
|
41
|
Hernández-Martín A, Torrelo-Fernández A, de Lucas-Laguna R, Casco F, González-Sarmiento R, Vega A, Pedreira-Massa JL, de Unamuno-Pérez P, Larcher F, Arroyo I, Traupe H. First symposium of ichthyosis experts. Actas Dermosifiliogr 2013; 104:877-82. [PMID: 23375695 DOI: 10.1016/j.ad.2012.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 11/25/2012] [Indexed: 12/01/2022] Open
Abstract
On June 22, 2012 the First Symposium of Ichthyosis Experts in Spain was held at the Hospital Niño de Jesús in Madrid. It was a one-day symposium for dermatologists, pediatricians, and physicians-in-training interested in this disease, as well as for other health care professionals involved in the care of patients with ichthyosis. The aim of the meeting was to try to structure the care of ichthyosis patients in Spain. As happens in other rare diseases, because of the low prevalence of ichthyosis and the absence of designated referral centers, the number of patients treated in each center is very low and few dermatologists have any real clinical experience with this condition or know how to order diagnostic genetic tests. This article summarizes the presentations given at the symposium and is intended as a reference for anyone interested in the subject.
Collapse
|
42
|
Affiliation(s)
- M T López-Villaescusa
- Servicio de Dermatología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | | | | | | |
Collapse
|
43
|
García-Martín P, Hernández-Martín A, Torrelo A. Ectodermal dysplasias: a clinical and molecular review. Actas Dermosifiliogr 2012; 104:451-70. [PMID: 23103118 DOI: 10.1016/j.ad.2012.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 07/19/2012] [Accepted: 07/20/2012] [Indexed: 01/31/2023] Open
Abstract
The ectodermal dysplasias are a large group of hereditary disorders characterized by alterations of structures of ectodermal origin. Although some syndromes can have specific features, many of them share common clinical characteristics. Two main groups of ectodermal dysplasias can be distinguished. One group is characterized by aplasia or hypoplasia of ectodermal tissues, which fail to develop and differentiate because of a lack of reciprocal signaling between ectoderm and mesoderm, the other has palmoplantar keratoderma as its most striking feature, with additional manifestations when other highly specialized epithelia are also involved. In recent decades, the genes responsible for at least 30 different types of ectodermal dysplasia have been identified, throwing light on the pathogenic mechanisms involved and their correlation with clinical findings.
Collapse
Affiliation(s)
- P García-Martín
- Servicio de Dermatología, Hospital Infantil del Niño Jesús, Madrid, Spain
| | | | | |
Collapse
|
44
|
Alonso-González J, Hernández-Martín A, García-Peñas JJ, Colmenero I, Torrelo A. Reticulated pigmentary changes in a patient with a variant form of Lesch-Nyhan disease. Clin Exp Dermatol 2012; 37:569-70. [PMID: 22420599 DOI: 10.1111/j.1365-2230.2011.04271.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
45
|
Cañueto J, Girós M, Ciria S, Pi-Castán G, Artigas M, García-Dorado J, García-Patos V, Virós A, Vendrell T, Torrelo A, Hernández-Martín A, Martín-Hernández E, Garcia-Silva MT, Fernández-Burriel M, Rosell J, Tejedor M, Martínez F, Valero J, García JL, Sánchez-Tapia EM, Unamuno P, González-Sarmiento R. Clinical, molecular and biochemical characterization of nine Spanish families with Conradi-Hünermann-Happle syndrome: new insights into X-linked dominant chondrodysplasia punctata with a comprehensive review of the literature. Br J Dermatol 2012; 166:830-8. [PMID: 22121851 DOI: 10.1111/j.1365-2133.2011.10756.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Conradi-Hünermann-Happle syndrome (CDPX2, OMIM 302960) is an inherited X-linked dominant variant of chondrodysplasia punctata which primarily affects the skin, bones and eyes. CDPX2 results from mutations in EBP (emopamil binding protein), and presents with increased levels of sterol precursors 8(9)-cholesterol and 8-dehydrocholesterol. OBJECTIVES To expand the understanding of CDPX2, clinically, biochemically and genetically. METHODS We present one of the largest series reported to date, including 13 female patients belonging to nine Spanish families. Patients were studied biochemically using gas chromatography-mass spectrometry, genetically using polymerase chain reaction and in their methylation status using the HUMARA assay. RESULTS In our cases, there was a clear relationship between abnormal sterol profile and the EBP gene mutation. We describe three novel mutations in the EBP gene. EBP mutations were inherited in three out of nine families and were sporadic in the remaining cases. CONCLUSIONS No clear genotype-phenotype correlation was found. Patients' biochemical profiles did not reveal a relationship between sterol profiles and severity of disease. A skewed X-chromosome inactivation may explain the clinical phenotype in CDPX2 in some familial cases.
Collapse
Affiliation(s)
- J Cañueto
- Department of Dermatology, University Hospital of Salamanca, Salamanca, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Hernández-Martín A, Torrelo A. When a Child's Life Depends on Us Recognizing Cutaneous Signs of Child Abuse. Actas Dermo-Sifiliográficas (English Edition) 2012. [DOI: 10.1016/j.adengl.2012.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
47
|
García M, Santiago JL, Terrón A, Hernández-Martín A, Vicente A, Fortuny C, De Lucas R, López JC, Cuadrado-Corrales N, Holguín A, Illera N, Duarte B, Sánchez-Jimeno C, Llames S, García E, Ayuso C, Martínez-Santamaría L, Castiglia D, De Luca N, Torrelo A, Mechan D, Baty D, Zambruno G, Escámez MJ, Del Río M. Two novel recessive mutations in KRT14 identified in a cohort of 21 Spanish families with epidermolysis bullosa simplex. Br J Dermatol 2012; 165:683-92. [PMID: 21623745 DOI: 10.1111/j.1365-2133.2011.10428.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Basal epidermolysis bullosa simplex (EBS) is a group of blistering genodermatoses mostly caused by mutations in the keratin genes, KRT5 and KRT14. Recessive mutations represent about 5% of all EBS mutations, being common and specific in populations with high consanguinity, where affected patients show severe phenotypes. OBJECTIVES To accomplish the first mutational analysis in patients of Spanish origin with EBS and to delineate a comprehensive genotype-phenotype correlation. METHODS Twenty-one EBS families were analysed. Immunofluorescence mapping at the dermoepidermal junction level was performed on skin biopsies from patients. Mutation screening of the entire coding sequences of KRT5 and KRT14 in genomic DNA was assessed by polymerase chain reaction and direct sequencing. RESULTS KRT5 or KRT14 causative mutations were identified in 18 of the 21 EBS families. A total of 14 different mutations were disclosed, of which 12 were dominant missense mutations and two truncating recessive mutations. Five of the 14 mutations were novel including three dominant in KRT5 (p.V186E, p.T321P and p.A428T) and two recessive in KRT14 (p.K116X and p.K250RfsX8). The two patients with EBS carrying homozygous recessive mutations were affected by severe phenotypes and belonged to consanguineous families. All five families with the EBS Dowling-Meara subtype carried recurrent mutations affecting the highly conserved ends of the α-helical rod domain of K5 and K14. The seven mutations associated with the localized EBS subtype were widely distributed along the KRT5 and KRT14 genes. Two families with mottled pigmentation carried the P25L mutation in KRT5, commonly associated with this subtype. CONCLUSIONS This study further confirms the genotype-phenotype correlation established for EBS in other ethnic groups, and is the first in a Mediterranean country (excluding Israel). This study adds two novel recessive mutations to the worldwide record to date, which includes a total of 14 mutations. As in previous reports, the recessive mutations resulted in a lack of keratin K14, giving rise to a generalized and severe presentation.
Collapse
Affiliation(s)
- M García
- Regenerative Medicine Unit, Epithelial Biomedicine Division, Basic Research Department, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Av. Complutense 22, 28040 Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Hernández-Martín A, Torrelo A. [When a child's life depends on us recognizing cutaneous signs of child abuse]. Actas Dermosifiliogr 2011; 103:90-1. [PMID: 22172124 DOI: 10.1016/j.ad.2011.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 09/22/2011] [Accepted: 09/25/2011] [Indexed: 11/27/2022] Open
Affiliation(s)
- A Hernández-Martín
- Servicio de Dermatología, Hospital Infantil del Niño Jesús, Madrid, España.
| | | |
Collapse
|
49
|
Hernández-Martín A, Torrelo A. Rasopathies: Developmental Disorders That Predispose to Cancer and Skin Manifestations. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/j.adengl.2011.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
50
|
Hernández-Martín A, Torrelo A. Rasopatías: trastornos del desarrollo con predisposición al cáncer y manifestaciones cutáneas. Actas Dermo-Sifiliográficas 2011; 102:402-16. [DOI: 10.1016/j.ad.2011.02.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 02/23/2011] [Accepted: 02/28/2011] [Indexed: 12/30/2022] Open
|