[Genetic diseases with skin fragility in children].

Stella Gewert, Laura Trefzer
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Abstract

Background: Genetic diseases leading to skin fragility are clinically and genetically heterogeneous. Dermatologists and pediatricians should be familiar with the variability of manifestations and manifestation age, in order to differentiate these rare diseases from more common causes of blistering, such as infectious (impetigo contagiosa, herpes infection) or traumatic causes (burns, scalds). This is essential to initiate appropriate diagnostic measures, provide information on treatment and prevention and to refer to specialized centers.

Objectives: The classification of the diseases discussed here is based on the clinical appearance, the histologic cleavage level, and genetic alterations. These diseases are all rare and pathogenetically only partially understood. Treatment methods are mostly symptomatic; causal therapies are the exception. Thanks to advances in mutation detection methods and the assumption of costs for massive parallel sequencing (since 2021) by health insurance companies, rare diseases have moved from the focus of academic research into everyday clinical practice. Due to the rarity, variability of the phenotype and, in many cases, high need for care, it is important in everyday clinical practice to be able to apply a pathway for suspected diagnoses and to work together with specialized colleagues and care centers.

Materials and methods: This study provides an overview of genetic diseases with skin fragility in childhood.

Results and discussion: Knowledge of the underlying mechanisms leading to skin fragility in childhood can help to recognize rare differential diagnoses from more common infectious and traumatic causes of blistering. This is necessary to enable adequate treatment and referral to specialized care centers and colleagues.

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[儿童皮肤脆弱遗传病]。
背景:导致皮肤脆弱的遗传性疾病在临床和基因上都是异质性的。皮肤科医生和儿科医生应熟悉表现形式和表现年龄的多变性,以便将这些罕见疾病与更常见的水疱病因区分开来,如感染性疾病(传染性脓疱疮、疱疹感染)或外伤性疾病(烧伤、烫伤)。这对于采取适当的诊断措施、提供治疗和预防信息以及转诊到专科中心至关重要:本文讨论的疾病分类是基于临床表现、组织学裂解程度和基因改变。这些疾病都很罕见,病因也只有部分清楚。治疗方法大多是对症治疗,因果疗法是个例外。由于突变检测方法的进步以及医疗保险公司对大规模平行测序费用的承担(自 2021 年起),罕见病已从学术研究的重点转向日常临床实践。由于罕见病的罕见性、表型的多变性以及在许多情况下对护理的高需求,在日常临床实践中,能够应用疑似诊断路径并与专业同事和护理中心合作非常重要:本研究概述了儿童期皮肤脆弱的遗传性疾病:对导致儿童皮肤脆弱的潜在机制的了解有助于从更常见的感染性和外伤性水疱病因中识别罕见的鉴别诊断。这对于提供适当的治疗和转诊至专业护理中心及同事是非常必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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