1
|
Daas F, Gupta P, Kiblawi F. Multiple vascular anomalies and refractory pericardial effusion in a young patient with Cantu syndrome: a case report and review of the literature. BMC Pediatr 2023; 23:644. [PMID: 38114927 PMCID: PMC10731865 DOI: 10.1186/s12887-023-04446-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Cantu syndrome is a rare and complex multisystem disorder characterized by hypertrichosis, facial dysmorphism, osteochondroplasia and cardiac abnormalities. With only 150 cases reported worldwide, Cantu syndrome is now gaining wider recognition due to molecular testing and a growing body of literature that further characterizes the syndrome and some of its most important features. Cardiovascular pathology previously described in the literature include cardiomegaly, pericardial effusion, vascular dilation and tortuosity, and other congenital heart defects. However, cardiovascular involvement is highly variable amongst individuals with Cantu syndrome. In some instances, it can be extensive and severe requiring surgical management and long term follow up. CASE PRESENTATION Herein we report a case of a fourteen-year-old female who presented with worsening pericardial effusion of unknown etiology, and echocardiographic findings of concentric left ventricular hypertrophy, a mildly dilated aortic root and ascending aorta. Her medical history was notable for hemoptysis and an episode of pulmonary hemorrhage secondary to multiple aortopulmonary collaterals that were subsequently embolized in early childhood. She was initially managed with Ibuprofen and Colchicine but continued to worsen, and ultimately required a pericardial window for the management of refractory pericardial effusion. Imaging studies obtained on subsequent visits revealed multiple dilated and tortuous blood vessels in the head, neck, chest, and pelvis. A cardiomyopathy molecular studies panel was sent, and a pathogenic variant was identified in the ABCC9 gene, confirming the molecular diagnosis of autosomal dominant Cantu syndrome. CONCLUSIONS Vascular anomalies and significant cardiac involvement are often present in Cantu syndrome, however there are currently no established screening recommendations or surveillance protocols in place. The triad of hypertrichosis, facial dysmorphism, and unexplained cardiovascular involvement in any patient should raise suspicion for Cantu syndrome and warrant further investigation. Initial cardiac evaluation and follow up should be indicated in any patient with a clinical and/or molecular diagnosis of Cantu syndrome. Furthermore, whole body imaging should be utilized to evaluate the extent of vascular involvement and dictate long term monitoring and care.
Collapse
Affiliation(s)
- Falastine Daas
- Department of Pediatrics, St. Joseph's University Medical Center, 703 Main Street, Paterson, NJ, 07503, USA.
| | - Punita Gupta
- Department of Pediatrics Division of Genetics, St. Joseph's University Medical Center, 703 Main Street, Paterson, NJ, 07503, USA
| | - Fuad Kiblawi
- Department of Pediatrics Division of Cardiology, St. Joseph's University Medical Center, 703 Main Street, Paterson, NJ, 07503, USA
| |
Collapse
|
2
|
de Queiroz M, Escobar GF, Peruzzo J. Milium cysts on hands; hypertrichosis on face. J Fam Pract 2022; 71:E7-E9. [PMID: 35994763 DOI: 10.12788/jfp.0454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The patient's dermatologic symptoms and his history of a particular chronic condition pointed toward the diagnosis.
Collapse
Affiliation(s)
- Marina de Queiroz
- Department of Dermatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Fortes Escobar
- Department of Dermatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliano Peruzzo
- Department of Dermatology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| |
Collapse
|
3
|
Vedak P. Hair and Nail Conditions: Hypertrichosis and Hirsutism. FP Essent 2022; 517:22-26. [PMID: 35679469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Hypertrichosis and hirsutism can be signs of underlying conditions, some of which may be life-threatening. They also can result in significant psychosocial distress for patients. Hypertrichosis refers to excessive hair growth beyond normal variation for a patient's age, sex, or race or for a particular body area. Hirsutism refers to an abnormal excess of hair growth solely in androgen-dependent areas of the body in females. The standard for hirsutism assessment is the modified Ferriman-Gallwey (mFG) score. Hirsutism can be idiopathic or associated with endocrine conditions, most commonly polycystic ovary syndrome (PCOS). Evaluation for underlying causes may be indicated depending on the clinical presentation. For premenopausal patients with an abnormal hirsutism score (ie, mFG score of 8 or greater), a serum total testosterone level should be obtained. If the level is normal in patients with moderate to severe hirsutism and/or evidence of a hyperandrogenic endocrine condition, an early morning serum total testosterone level and a free testosterone level should be obtained. An elevated total testosterone level indicates a hyperandrogenic state, and further testing is needed to determine if this is due to PCOS or another endocrine condition. Hair removal options for patients with hirsutism include temporary methods, electrolysis, and laser treatments. Pharmacotherapies include topical creams, combination oral contraceptives, and antiandrogens. Referral to an endocrinologist may be indicated if an underlying endocrine condition is suspected.
Collapse
Affiliation(s)
- Priyanka Vedak
- Department of Dermatology - University of North Carolina School of Medicine, 410 Market St Suite 400, Chapel Hill, NC 27516
| |
Collapse
|
4
|
Roessler HI, van der Heuvel LM, Shields K, Guilliams KP, Knoers NVAM, van Haaften G, Grange DK, van Haelst MM. Behavioral and cognitive functioning in individuals with Cantú syndrome. Am J Med Genet A 2021; 185:2434-2444. [PMID: 34056838 DOI: 10.1002/ajmg.a.62348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/20/2021] [Accepted: 05/07/2021] [Indexed: 11/07/2022]
Abstract
Cantú syndrome (CS) is caused by pathogenic variants in ABCC9 and KCNJ8 encoding the regulatory and pore-forming subunits of ATP-sensitive potassium (KATP ) channels. CS is characterized by congenital hypertrichosis, distinctive facial features, peripheral edema, and cardiac and neurodevelopmental abnormalities. Behavioral and cognitive issues have been self-reported by some CS individuals, but results of formal standardized investigations have not been published. To assess the cognitive profile, social functioning, and psychiatric symptoms in a large group of CS subjects systematically in a cross-sectional manner, we invited 35 individuals (1-69 years) with confirmed ABCC9 variants and their relatives to complete various commonly applied standardized age-related questionnaires, including the Kaufman brief intelligence test 2, the social responsiveness scale-2, and the Achenbach system of empirically based assessment. The majority of CS individuals demonstrated average verbal and nonverbal intelligence compared to the general population. Fifteen percent of cases showed social functioning strongly associated with a clinical diagnosis of autism spectrum disorder. Both externalizing and internalizing problems were also present in this cohort. In particular, anxiety, anxiety or attention deficit hyperactivity disorder, and autism spectrum behaviors were predominantly observed in the younger subjects in the cohort (≥25%), but this percentage decreased markedly in adults.
Collapse
Affiliation(s)
- Helen I Roessler
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lieke M van der Heuvel
- Department of Clinical Genetics, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Kathleen Shields
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kristin P Guilliams
- Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Pediatric Critical Care, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nine V A M Knoers
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Gijs van Haaften
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Dorothy K Grange
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Center for the Investigation of Membrane Excitability Diseases (CIMED), St. Louis, Missouri, USA
| | - Mieke M van Haelst
- Department of Clinical Genetics, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Clinical Genetics, VU Medical Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| |
Collapse
|
5
|
Sialiti S, Mansouri S, Khallaayoune M, Senouci K. Pigmented hypertrichotic dermatosis: manifestations of a rare syndrome. BMJ Case Rep 2021; 14:e241838. [PMID: 33795287 PMCID: PMC8021746 DOI: 10.1136/bcr-2021-241838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Sanae Sialiti
- Department of Dermatology-Venereology, CHU Ibn Sina, Rabat, Morocco, Rabat, Morocco
| | - Siham Mansouri
- Department of Dermatology-Venereology, CHU Ibn Sina, Rabat, Morocco, Rabat, Morocco
| | - Mehdi Khallaayoune
- Department of Dermatology-Venereology, CHU Ibn Sina, Rabat, Morocco, Rabat, Morocco
| | - Karima Senouci
- Department of Dermatology-Venereology, CHU Ibn Sina, Rabat, Morocco, Rabat, Morocco
| |
Collapse
|
6
|
Sellami K, Turki H. Localized Hypertrichosis of the Thigh. Skinmed 2020; 18:242. [PMID: 33032690] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Khadija Sellami
- Department of Dermatology, Hedi Chaker University Hospital, Sfax, Tunisia;
| | - Hamida Turki
- Department of Dermatology, Hedi Chaker University Hospital, Sfax, Tunisia
| |
Collapse
|
7
|
Abstract
RATIONALE Wiedemann-Steiner syndrome (WDSTS, online mendelian inheritance in man 605130) is a rare autosomal dominant disorder characterized by hypertrichosis cubiti. Here, we report a Chinese boy who do not show the characteristic of hypertrichosis cubiti, and was misdiagnosed as blepharophimosis-ptosis-epicanthus inversus syndrome at first. We found a de novo frameshift mutation (p.Glu390Lysfs*10) in the KMT2A gene, which was not reported before. Our study increases the cohort of Chinese WDSTS patients, and expand the WDSTS phenotypic and variation spectrum. PATIENT CONCERNS The patient demonstrated typical craniofacial features of blepharophimosis-ptosis-epicanthus inversus syndrome, including small palpebral fissures, ptosis, telecanthus, and epicanthus inversus, besides he had congenital heart disease (ventricular septal defects), strabismus, hypotonia, amblyopia, delayed speech and language development, delayed psychomotor development, and amblyopia (HP:0000646) which was not reported before. DIAGNOSIS FOXL2 gene was cloned and sequenced, however, there was no mutation detected in this patient. The result of Chromosomal microarray analysis was normal. The patient was diagnosed as WDSTS by whole exome sequencing. INTERVENTIONS The patient received cardiac surgery, frontalis suspension and regular speech and occupational therapy. He also treated with growth hormone (GH). OUTCOMES The patient's symptoms are improved after cardiac surgery and frontalis suspension, he can express himself well now and had a 10 cm gain in height. LESSONS As the relationship between genotype and phenotype becomes more and more clear, WES is incredibly powerful tool to diagnose the disease of WDSTS.
Collapse
Affiliation(s)
- Liu Jinxiu
- Yinfeng Medical Laboratory, Jinan Shandong
| | | | - Xue Ming
- Genetics Diagnostic Lab, Tai’an Maternity and Child Care Hospital, Tai’an, China
| | - Liu CS. Jonathan
- SoftGenetics LLC, 100 Oakwood Ave, State College, Pennsylvania 16803, USA
| | - Liu Xiangju
- Genetics Diagnostic Lab, Tai’an Maternity and Child Care Hospital, Tai’an, China
| | | |
Collapse
|
8
|
Purvis CG, Bandino JP, Elston DM. Acquired hypertrichosis of the periorbital area and malar cheek. Cutis 2019; 103:E20-E21. [PMID: 31116825] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Caitlin G Purvis
- Department of Dermatology, Medical University of South Carolina, Charleston, USA
| | - Justin P Bandino
- Department of Dermatology, Medical University of South Carolina, Charleston, USA
| | - Dirk M Elston
- Department of Dermatology, Medical University of South Carolina, Charleston, USA
| |
Collapse
|
9
|
Abstract
PURPOSE To compare the eyelash lengthening effect of latanoprost in adults and children with glaucoma. METHODS Twenty eyes of 13 men and 7 women (mean age: 54.9, range 42-69 years) with primary open-angle glaucoma and 20 eyes of 9 boys and 11 girls (mean age: 10.7, range 6-16 years) with glaucoma were included in this prospective study. In 19 children, juvenile glaucoma and in one, pseudophakic glaucoma had been detected. A single eyelash was pulled from the center of the upper eyelid before latanoprost therapy and at the sixth month of therapy, and measured. RESULTS In adult cases, the mean eyelash length was 5.79+/-0.18 mm (5.5-6.1 mm) at baseline and 6.45+/-0.21 mm (6.2-6.8 mm) at the sixth month. In children, the mean length was 5.66+/-0.22 mm (5.3-6.0 mm) at baseline and 6.39+/-0.37 mm (5.9-6.9 mm) at the sixth month. The mean difference in eyelash lengths at baseline and the sixth month was 0.67+/-0.09 mm (0.5-0.7 mm) in adults and 0.75+/-0.25 mm (0.4-1.2 mm) in children. CONCLUSIONS The differences in mean eyelash lengths at baseline and at the sixth month of latanoprost therapy were statistically significant in both adults and children (p=0.000). The mean of the difference of the eyelash length in children was higher than in adults but the result was not statistically significant (p=0.678).
Collapse
Affiliation(s)
- U Elgin
- Department of Glaucoma, Mi nistry of Health, Ankara Ulucanlar Eye Research Hospi tal, Ankara, Turkey.
| | | | | | | |
Collapse
|
10
|
Miyashiro D, Sanches JA. Paraneoplastic skin disorders: a review. GIORN ITAL DERMAT V 2016; 151:55-76. [PMID: 26439592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Paraneoplastic disorders are manifestations of internal malignancies without the direct action of the tumor. Its pathogenesis involves production of substances that interfere with cellular activity of distant tissues. Paraneoplasias may be the first sign of cancer, and clinicians should be familiarized with its manifestations in order to perform an early diagnosis of the underlying neoplasm. The aim of this review was to describe most common paraneoplastic skin diseases.
Collapse
Affiliation(s)
- Denis Miyashiro
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil -
| | | |
Collapse
|
11
|
|
12
|
|
13
|
Park JY, Koo SH, Jung YJ, Lim YJ, Chung ML. A patient with Cantú syndrome associated with fatal bronchopulmonary dysplasia and pulmonary hypertension. Am J Med Genet A 2014; 164A:2118-20. [PMID: 24715715 DOI: 10.1002/ajmg.a.36563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/07/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Jae Young Park
- Department of Pediatrics, Haeundae Paik Hospital, College of Medicine, Inje University, Pusan, Korea
| | | | | | | | | |
Collapse
|
14
|
Fernandez-Crehuet P, Ruiz-Villaverde R, Serrano JLFC. Hairy elbows - A case study. Aust Fam Physician 2013; 42:801-802. [PMID: 24217102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A boy aged 6 years was referred to our clinic for evaluation of the presence of fair, thin hair on both of his elbows. This condition had first been observed when he was 2 years of age and the hair had subsequently increased in length and thickness (Figure 1). He had a history of asthma and was being treated by a paediatrician. His family medical record was otherwise unremarkable. This unusual hairiness was symmetrically distributed on the extensor surfaces of both proximal forearms and distal arms. The underlying skin showed no abnormalities. No hypertrichosis was found elsewhere and examination of teeth, skeleton and fingernails was also normal. No other morphological changes were noted. In addition, his height was appropriate for his age. No developmental, mental or physical impairment was observed. The blood cell count and general biochemistry, as well as thyroid and sexual hormonal profiles were all normal. Radiological examination, which was performed on the parents' request, was normal. The boy was diagnosed with hypertrichosis cubiti (HC), and shaving of the areas was recommended.
Collapse
Affiliation(s)
- Pablo Fernandez-Crehuet
- PhD, MD, is a consultant, Department of Dermatology, Hospital Alto Guadalquivir, Andújar, Jaén, Spain
| | | | | |
Collapse
|
15
|
Brownstein CA, Towne MC, Luquette LJ, Harris DJ, Marinakis NS, Meinecke P, Kutsche K, Campeau PM, Yu TW, Margulies DM, Agrawal PB, Beggs AH. Mutation of KCNJ8 in a patient with Cantú syndrome with unique vascular abnormalities - support for the role of K(ATP) channels in this condition. Eur J Med Genet 2013; 56:678-82. [PMID: 24176758 DOI: 10.1016/j.ejmg.2013.09.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 09/19/2013] [Indexed: 11/19/2022]
Abstract
KCNJ8 (NM_004982) encodes the pore forming subunit of one of the ATP-sensitive inwardly rectifying potassium (KATP) channels. KCNJ8 sequence variations are traditionally associated with J-wave syndromes, involving ventricular fibrillation and sudden cardiac death. Recently, the KATP gene ABCC9 (SUR2, NM_020297) has been associated with the multi-organ disorder Cantú syndrome or hypertrichotic osteochondrodysplasia (MIM 239850) (hypertrichosis, macrosomia, osteochondrodysplasia, and cardiomegaly). Here, we report on a patient with a de novo nonsynonymous KCNJ8 SNV (p.V65M) and Cantú syndrome, who tested negative for mutations in ABCC9. The genotype and multi-organ abnormalities of this patient are reviewed. A careful screening of the KATP genes should be performed in all individuals diagnosed with Cantú syndrome and no mutation in ABCC9.
Collapse
Affiliation(s)
- Catherine A Brownstein
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Chandrakumar A, Martyn-Simmons CL. Anterior cervical hypertrichosis with associated developmental delay and learning difficulties in two sisters. J Dermatol 2012; 39:1061-2. [PMID: 22900798 DOI: 10.1111/j.1346-8138.2012.01618.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
17
|
Alam ST, Rahman MM, Akhter S, Hossain MA, Islam KA. Congenital hypertrichosis (Were Wolf Syndrome): a case report. Mymensingh Med J 2012; 21:567-569. [PMID: 22828564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hypertrichosis is abnormal increase in body hair, when it becomes extensive known as Were Wolf Syndrome. Any part of body can be affected and body hairs are longer and darker. Hairs may be of any type like lanugo, vellous or terminal. It may be present since birth or may occur later in life. A 8 years old boy was admitted in our hospital with excess body hair, he was diagnosed as a case of Were Wolf syndrome after excluding possible acquired causes of hypertrichosis. He had history of delayed developmental milestone and has been suffering from epilepsy. He was treated with developmental stimulation and anti epileptic drug. Then he was discharged after proper counseling.
Collapse
Affiliation(s)
- S T Alam
- Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | | | | | | |
Collapse
|
18
|
Hagemann K, Zanolari Calderari M, Perren A, Cree I, Mullis PE, Flück CE. Atypical presentation of a hormonally active adrenocortical tumor in an adolescent leading to delayed diagnosis. Hormones (Athens) 2011; 10:317-25. [PMID: 22281889 DOI: 10.14310/horm.2002.1324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
UNLABELLED Adrenocortical tumors are rare in children and present with variable signs depending on the type of hormone excess. We herein describe the unusual presentation of a child with adrenocortical tumor and introduce the concept of in vitro chemosensitivity testing. CASE REPORT A 10.5-year-old girl presented with hypertrichosis/hirsutism and weight loss. The weight loss and behavioral problems, associated with halted puberty and growth, led to the initial diagnosis of anorexia nervosa. However, subsequent weight gain but persisting arrest in growth and puberty and the appearance of central fat distribution prompted further evaluation. RESULTS AND FOLLOW-UP: 24h-urine free cortisol was elevated. Morning plasma ACTH was undetectable, while cortisol was elevated and circadian rhythmicity was absent. Thus a hormonally active adrenal cortical tumor (ACT) was suspected. On magnetic resonance imaging (MRI) a unilateral, encapsulated tumor was found which was subsequently removed surgically. Tissue was investigated histologically and for chemosensitivity in primary cell cultures. Although there were some risk factors for malignancy, the tumor was found to be a typical adenoma. Despite this histology, tumor cells survived in culture and were sensitive to cisplatin in combination with gemcitabine or paclitaxel. At surgery, the patient was started on hydrocortisone replacement which was unsuccessfully tapered over 3 months. Full recovery of the hypothalamus-pituitary-adrenal axis occurred only after 3 years. CONCLUSIONS The diagnosis of a hormonally active adrenocortical tumor is often delayed because of atypical presentation. Cortisol replacement following unilateral tumor excision is mandatory and may be required for months or years. Individualized chemosensitivity studies carried out on primary cultures established from the tumor tissue itself may provide a tool in evaluating the effectiveness of chemotherapeutic drugs in the event that the adrenocortical tumor may prove to be carcinoma.
Collapse
Affiliation(s)
- Kerstin Hagemann
- Department of Pediatrics, Division of Endocrinology and Diabetology, University Children's Hospital, Inselspital, Bern, Switzerland
| | | | | | | | | | | |
Collapse
|
19
|
Affiliation(s)
- Marcia Ramos-E-Silva
- Sector of Dermatology and Post Graduation Course of Dermatology, University Hospital Clementino Fraga Filho andSchool of Medicine, Federal University of Rio de Janeiro, 22280-020 Rio de Janeiro, Brazil.
| | | | | |
Collapse
|
20
|
Kara M, Ozçakar L, Kara G, Malas FU, Aksoy S, Kaymak B. Hypertrichosis after surgery for cubital tunnel syndrome. Rheumatol Int 2011; 32:285-6. [PMID: 21240491 DOI: 10.1007/s00296-010-1777-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 12/30/2010] [Indexed: 11/27/2022]
|
21
|
Moreno-Giménez JC, Camacho-Martínez FM. [Sporadic anterior cervical hypertrichosis]. Actas Dermosifiliogr 2009; 100:833-836. [PMID: 19889313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
|
22
|
Morssinkhof MAG, Colombijn RM, Giltay JC. [Diagnostic images (417) A girl with a 'tail' Lumbosacral hypertrichosis (faun tail)]. Ned Tijdschr Geneeskd 2009; 153:884. [PMID: 19475871] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
23
|
Gordeladze MR, Khachapuridze NS, Pagava IK. [Faun tail--isolated sacrolumbar hypertrichosis in pediatric endocrinology]. Georgian Med News 2009:74-77. [PMID: 19202225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
3 girls with Faun tail are presented. Local hairiness in the sacrolumbar area was associated with spinal dysraphism, tethered cord, intradural lipoma, meningomyelocele and dyastematomyelia, all confirmed by MRI. Moderate neurological findings were present in one case only. In all the cases the primary diagnosis of the principal spinal pathology was established by endocrinologist (two patients were referred by dermatologists, one by ortopaedist). This indicates that a physician of any specialty may have to establish the primary neurological diagnosis. Hence, the awareness of the possible connection between the neurological pathology and the cutaneous symptoms, including local hypertrichosis, is of major significance.
Collapse
|
24
|
|
25
|
Abstract
Hirsutism is defined as the excessive growth of terminal hair on the face and body of a female in a typical male pattern distribution. Hirsutism is a common clinical problem in women and the treatment depends on the cause of hirsutism. Untreated hirsutism can be associated with considerable loss of self-esteem and psychological morbidity. Hyperandrogenemia is the key trigger for excess hair growth. Polycystic ovary syndrome and idiopathic hirsutism are the most common cause of hirsutism. As with all medical problems, investigation begins with a careful history, examination and then investigation directed at the possible cause. A raised serum testosterone level of > 150 ng/dl (5.2 nmol/l) should prompt further investigations to exclude an underlying androgen-secreting tumour. The treatment of hirsutism is most effective using combination therapy, including lifestyle therapies, androgen suppression, peripheral androgen blockage and cosmetic treatments. Women should be warned not to expect improvement or at least 3-6 months after therapy is begun and lifelong therapy may be needed to prevent recurrence. The current review discusses definition, pathogenesis, differential diagnosis, diagnostic strategies, management, guidelines and the authors' recommendations about hirsutism.
Collapse
Affiliation(s)
- A Mofid
- Department of Internal Medicine, Tehran University of Medical Sciences, Sina Hospital, Tehran, Iran.
| | | | | | | |
Collapse
|
26
|
Affiliation(s)
- Martijn V Heitink
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands.
| | | | | | | |
Collapse
|
27
|
Rashid RM, White LE. A hairy development in hypertrichosis: a brief review of Ambras syndrome. Dermatol Online J 2007; 13:8. [PMID: 18328202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Ambras syndrome was described less than 20 years ago. The initial report focused on the subtle, but important distinguishing characteristics that separate this from other forms of congenital hypertrichosis. This review, we examine this fascinating syndrome, and the current scientific perspectives in discussion. This review will help increase and expand our knowledge base of this uncommon syndrome, and should encourage future dermatologic analysis and reports on Ambras syndrome.
Collapse
|
28
|
Affiliation(s)
- Carlos Baptista Barcaui
- Clínica Dermatológica de Ipanema, Rua Farme de Amoedo, 106 Ipanema, Rio de Janeiro, Brazil 22420-020.
| |
Collapse
|
29
|
Affiliation(s)
- Annelie J E Vulink
- Diakonessenhuis Utrecht, Department of Internal Medicine, Division of Medical Oncology, Utrecht, The Netherlands
| | | |
Collapse
|
30
|
Abstract
Stiff skin syndrome is a rare disorder characterized by pronounced skin induration, mild hypertrichosis and limited joint mobility, predominantly on the buttocks and thighs. Many heterogeneous cases have been reported under the name of stiff skin syndrome. We present a case of stiff skin syndrome from China, the diagnosis based on the patient's typical clinical and histopathological features.
Collapse
Affiliation(s)
- S Geng
- Department of Dermatology, Second Hospital of Xian Jiaotong University, 157 Xiwu Road, Xi'an, Shaanxi Province, China.
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
Hypertrichosis in a newborn girl infant of a diabetic mother with congenital hypothyroidism is reported. Both neonatal hyperinsulism and increased testosterone levels were documented. The hypertrichosis resolved after 3 months' of thyroxine replacement treatment. The possible causal association between hypothyroidism, and hypertrichosis has not been previously reported in neonatal period. Thyroid function should be evaluated in all newborn babies with hypertrichosis or abnormal distribution of body hair.
Collapse
Affiliation(s)
- M Akcakus
- Department of Pediatrics, School of Medicine, Erciyes University, Kayseri, Turkey
| | | | | | | | | | | |
Collapse
|
32
|
Aghaei S, Dastgheib L. Acquired eyelash trichomegaly and generalized hypertrichosis associated with breast anomaly. Dermatol Online J 2006; 12:19. [PMID: 16638412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Acquired eyelash trichomegaly is a rare condition. We present a 23-year-old woman with acquired trichomegaly and generalized hypertrichosis from childhood. The patient also exhibited bilateral nipple retraction and unilateral left-sided accessory nipple. According to our knowledge the association between trichomegaly, hypertrichosis, and breast anomaly has not been reported.
Collapse
Affiliation(s)
- Shahin Aghaei
- Department of Dermatology, Jahrom Medical School, Jahrom, Iran.
| | | |
Collapse
|
33
|
|
34
|
Affiliation(s)
- Paolo Rosina
- Department of Biomedical and Surgical Science, University of Verona, Verona, Italy.
| | | | | | | | | |
Collapse
|
35
|
Affiliation(s)
- Robert L Rosenfield
- Department of Pediatrics and Medicine, University of Chicago, Pritzker School of Medicine, Chicago, IL 60637, USA.
| |
Collapse
|
36
|
Abstract
The rare condition in which one side of the body seems to grow faster than the other is called hemihypertrophy. This may be accepted as normal, but there are certain serious conditions that may be associated with this type of growth pattern. Congenital hypertrichosis is believed to be a genetic disorder that is inherited or occurs as a result of spontaneous mutation. The incidence of generalised congenital hypertrichosis is about one in a billion. A seven-month-old female case was brought to the hospital with growth and hairiness complaints, which were more apparent in the right side of the face, the right arm and the right leg. Physical examination showed more apparent hypertrophy and hypertrichosis, which covered the entire right side of the body beginning from the face and including the lower extremities and the genitalia. Hypertrichosis was more evident above the right scapula and on the right leg. The diameter of the right upper extremity and the right lower extremity were measured at 13 mm and 14 mm thicker than the left side, respectively. The infant did not have teeth yet and had totally normal nail growth. Skeletal structure, cardiovascular, respiratory, urogenital, central nervous system and eye examinations were all normal. Results of all laboratory analyses, including genetic examination, and those of the imaging techniques were found to be normal. We hereby present the rare co-presence of hemihypertrophy and hemihypertrichosis, for which we could not identify an etiological cause and which is the third such case in the literature.
Collapse
Affiliation(s)
- Saadet Akarsu
- Department of Pediatrics, Firat University Faculty of Medicine, Elazig, Turkey
| | | | | | | | | |
Collapse
|
37
|
Affiliation(s)
- Sarah L Chamlin
- Division of Dermatology, Children's Memorial Hospital, Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
38
|
Kambegawa A. [Androstanediol, androstanediol glucuronide]. Nihon Rinsho 2005; 63 Suppl 8:457-60. [PMID: 16149550] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
|
39
|
Kashiwagi B. [Androstenedione]. Nihon Rinsho 2005; 63 Suppl 8:347-50. [PMID: 16149526] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Bunzo Kashiwagi
- Department of Urology, Gunma University Graduate School of Medicine
| |
Collapse
|
40
|
Suzuki H. [Sex hormone binding globulin (SHBG)]. Nihon Rinsho 2005; 63 Suppl 8:461-3. [PMID: 16149551] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Hiroyoshi Suzuki
- Department of Urology, Chiba University Graduate School of Medicine
| |
Collapse
|
41
|
Shibata Y. [Androsterone]. Nihon Rinsho 2005; 63 Suppl 8:351-2. [PMID: 16149527] [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] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Yasuhiro Shibata
- Department of Urology, Gunma University Graduate School of Medicine
| |
Collapse
|
42
|
Calikoğlu E, Oztaş P, Yavuzer Anadolu R, Catal F, Görpelioğlu C. Faun tail with aplasia cutis congenita and diastematomyelia. Dermatology 2005; 209:333-4. [PMID: 15539899 DOI: 10.1159/000080859] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
43
|
Ro YS, Ko JY. Linear congenital Becker nevus. Cutis 2005; 75:122-4. [PMID: 15773534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Becker nevus is an acquired disorder that usually manifests in late childhood or adolescence as a hyperpigmented hypertrichotic patch usually located on the upper trunk or proximal upper extremities. Only a few cases of congenital and familial Becker nevus have been described. Although the lesions may have various shapes, they consistently have a geographic or blocklike configuration in an irregular fashion; a linear pattern has rarely been reported. We describe a case of linear congenial Becker nevus following Blaschko line that appeared at birth on the right shoulder, with hypertrichosis developing 4 years later.
Collapse
Affiliation(s)
- Young-Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea.
| | | |
Collapse
|
44
|
|
45
|
|
46
|
Abstract
We report a patient with features of acromegaloid facial appearance syndrome and hypertrichosis. Her parental history suggests an autosomal recessive form of inheritance.
Collapse
|
47
|
Blum A, Röhm S, Grossmann S, Röcken M. Obligatory paraneoplasias of the skin. Dtsch Med Wochenschr 2003; 128:2195-9. [PMID: 14562218 DOI: 10.1055/s-2003-42973] [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] [Indexed: 10/27/2022]
Affiliation(s)
- A Blum
- Universitäts-Hautklinik Tübingen.
| | | | | | | |
Collapse
|
48
|
Abstract
BACKGROUND Lasers permit treatment of unwanted excess hair with less discomfort than other methods of epilation. Many lasers with different parameters are now available from which the dermatologist can choose. Improved clinical results are made possible by the high specificity and selectivity of the laser systems to pigmented hair because of the use of an appropriate wavelength with the proper pulse and duration. OBJECTIVES We aimed to compare the results of treatment of skin types IV, V, and VI using three different laser systems. METHODS One hundred female patients were compared using different laser systems: 35 patients underwent epilation using a Nd-Yag laser, 33 patients using an Alexandrite laser, and 32 patients using a Diode laser. RESULTS Follow up 12 months after the multiple treatments (three to six sessions) showed an insignificant difference between these three groups (35-40%). CONCLUSION Our findings indicate that all three laser systems tested can be used for dark skin; however, one should select a system that minimizes side-effects, primarily hypo- and hyper-pigmentation, especially when used for skin types IV, V, and VI.
Collapse
Affiliation(s)
- Ibrahim Galadari
- Faculty of Medicine and Health Sciences, Dubai, United Arab Emirates.
| |
Collapse
|
49
|
Algermissen B, Toppe F, Henz BM, Berlien HP, Haas N. Hypertrichotic plaque-type blue naevus--a novel type of dermal melanocytosis: report of an unusual case. Acta Derm Venereol 2002; 82:61-2. [PMID: 12013205 DOI: 10.1080/000155502753600957] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
50
|
López-Barrantes O, Torrelo A, Mediero IG, Zambrano A, Happle R. Nevoid hypertrichosis and hypomelanosis. Eur J Dermatol 2002; 12:583-5. [PMID: 12459534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
A girl with multiple lesions of nevoid hypertrichosis and linear hypopigmentation following Blaschko's lines is presented. She had no extracutaneous anomalies. We hypothesize that this unusual coexistence of skin lesions may represent a further example of "twin spotting".
Collapse
Affiliation(s)
- Olivia López-Barrantes
- Department of Dermatology, Hospital del Ni o Jes s, Menéndez Pelayo 65, 28009-Madrid, Spain
| | | | | | | | | |
Collapse
|