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An Atypical Presentation of Dyskeratosis Congenita in a Child With a Familial RTEL1 Mutation. 家族性 RTEL1 基因突变儿童先天性角化病的非典型表现
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-18 DOI: 10.1111/pde.15750
Faiza Ahmed,Kristina Blegen,Michelle Tarbox
Dyskeratosis congenita (DC) is a rare inherited bone marrow disease that classically presents with the triad of oral leukoplakia, nail dystrophy, and reticular hyperpigmentation. It is most commonly caused by a defect in the DKC1 gene involved in telomere stability. Malignant progression of oral leukoplakia to squamous cell carcinoma (SCC) is rare in DC, especially in younger patients, and cutaneous SCC is only reported in 1.5% of cases of DC. Here we report a case of a 12-year-old female with a familial heterozygous RTEL1 (regulator of telomere elongation helicase 1) gene mutation associated with a severe phenotype of DC characterized by multiple cutaneous SCCs.
先天性角化不良症(DC)是一种罕见的遗传性骨髓疾病,通常表现为口腔白斑、指甲营养不良和网状色素沉着三联征。它最常见的病因是参与端粒稳定性的 DKC1 基因缺陷。口腔白斑恶性发展为鳞状细胞癌(SCC)的病例在 DC 中非常罕见,尤其是在年轻患者中,皮肤 SCC 仅占 DC 病例的 1.5%。在此,我们报告了一例 12 岁女性的家族性杂合子 RTEL1(端粒伸长调节器螺旋酶 1)基因突变病例,该病例伴有以多发性皮肤 SCC 为特征的严重 DC 表型。
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引用次数: 0
Infantile hemangioma precursor lesions on day of life 1: A Mayo Clinic retrospective case series 出生第 1 天的婴儿血管瘤前体病变:梅奥诊所的回顾性病例系列
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-18 DOI: 10.1111/pde.15616
Frank Z. Jing, Beija K. Villalpando, Megha M. Tollefson
BackgroundInfantile hemangiomas (IHs), the most prevalent vascular tumors in infancy, are generally understood to be absent at birth, appearing in the initial weeks of life during their proliferative stage. While the classic presentation is recognizable, the precursor lesion of IHs may be misinterpreted as other entities, including vascular malformations.MethodsA retrospective, single‐center study was conducted, examining neonates with photographed IH precursor lesions on day of life (DOL) 1 and matured classical IHs. The study spanned from 2017 to 2023.ResultsThe case series is comprised of nine neonates all exhibiting precursor lesions on DOL 1. A comparative display of photographs featuring precursor lesions and classic IH is presented. Further tabulated information for each case includes IH locations, subsequent treatment modalities, and further diagnostic workup if necessary.ConclusionsImproving recognition of precursor lesions increases diagnostic accuracy, decreasing unnecessary workup. This, in turn, allows dermatologists to confidently employ close follow‐up management strategies. Additionally, in cases of extensive involvement, recognition of the precursor lesion allows for expedited investigation for syndromes such as PHACE (posterior fossa malformations, hemangioma, arterial anomalies, coarctation of the aorta/cardiac defects, and eye abnormalities) and LUMBAR (lower body IH, urogential anomalies, ulceration, myelopathy, bony deformities, anorectal malformations, arterial anomalies, and renal anomalies).
背景婴儿血管瘤(IHs)是婴儿期最常见的血管肿瘤,一般认为其出生时并不存在,而是在出生后最初几周的增殖期出现。虽然IHs的典型表现是可以识别的,但其前驱病变可能会被误解为其他实体,包括血管畸形。研究方法开展了一项回顾性单中心研究,对出生后第1天(DOL)拍摄到IH前驱病变的新生儿和成熟的典型IHs进行了检查。该研究的时间跨度为 2017 年至 2023 年。结果该病例系列由 9 例新生儿组成,均在出生后第 1 天出现前驱病变,并对前驱病变和典型 IH 的照片进行了对比展示。每个病例的进一步表格信息包括 IH 位置、后续治疗方式以及必要的进一步诊断工作。结论提高对前驱病变的识别能力可提高诊断的准确性,减少不必要的检查,从而使皮肤科医生能够自信地采取密切的后续管理策略。此外,在广泛受累的病例中,识别前驱病变可加快对 PHACE(后窝畸形、血管瘤、动脉异常、主动脉瓣狭窄)等综合征的检查、和 LUMBAR(下半身 IH、泌尿系统异常、溃疡、脊髓病变、骨骼畸形、肛门直肠畸形、动脉异常和肾脏异常)。
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引用次数: 0
Survey of Sun Exposure Levels, Sun Protection Behavior, and Skin Cancer Risk Awareness in Junior Tennis Players. 青少年网球运动员日晒水平、防晒行为和皮肤癌风险意识调查。
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-18 DOI: 10.1111/pde.15756
Mia H Thiele,Margaret S Lee,Jens J Thiele
Despite a growing number of young adults developing skin cancers, little is known about the sun-protective behavior of high school athletes exposed to high levels of UV radiation, such as junior tennis players. To investigate the frequency and quality of their sun protective behaviors, a web-based, anonymous survey was conducted among tennis players at high school varsity matches and United States Tennis Association tournaments in Southern California. Although 92.6% of the 81 respondents indicated they play during peak sun intensity hours, 46.9% stated they do not regularly wear sunscreen, 27.2% do not routinely wear hats or visors, only 9.9% wear protective eyewear, and 4.9% wear UV-protective clothing; furthermore, 87.5% of junior tennis players stated they are not very familiar with skin cancer, but 73.8% would like to learn more about it. The results of this study demonstrate a lack of consistent sun protective behavior among junior tennis players, providing a rationale for the development of targeted educational campaigns to increase skin cancer risk awareness and more effective sun-protective behavior.
尽管罹患皮肤癌的年轻人越来越多,但人们对暴露在高水平紫外线辐射下的高中运动员(如青少年网球运动员)的防晒行为却知之甚少。为了调查他们防晒行为的频率和质量,我们对参加南加州高中校队比赛和美国网球协会锦标赛的网球运动员进行了网络匿名调查。虽然 81 名受访者中有 92.6% 表示他们在日照最强烈的时段打球,但 46.9% 的人表示他们没有定期涂抹防晒霜,27.2% 的人没有定期戴帽子或遮阳帽,只有 9.9% 的人佩戴防护眼镜,4.9% 的人穿着防紫外线的衣服;此外,87.5% 的青少年网球运动员表示他们对皮肤癌不是很了解,但 73.8% 的人希望了解更多相关知识。这项研究的结果表明,青少年网球运动员缺乏持续的防晒行为,这为开展有针对性的教育活动提供了理由,以提高对皮肤癌风险的认识和更有效的防晒行为。
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引用次数: 0
Obesity in Pediatric Hidradenitis Suppurativa: A Scoping Review 小儿化脓性扁桃体炎患者的肥胖问题:范围界定综述
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-12 DOI: 10.1111/pde.15746
Shanti Mehta, Dea Metko, Joseph M. Lam
The relationship between HS and obesity, while well established in adult patients, has drawn increased attention in pediatric patients given the rising prevalence of pediatric obesity worldwide. This review aims to consolidate existing evidence of the relationship between HS and obesity in the pediatric population and to hypothesize about reasons for an association between the two conditions. Our cohort comprised 2911 patients with a mean age of 11.4 years at the age of onset of HS, and based on body mass index (BMI), 42.3% of patients were classified as obese (BMI > 30), and 14% were overweight (BMI 25–29.9). Our findings indicate an association between obesity and HS in pediatric patients, which may be explained through numerous mechanisms, including shared genetic factors, hereditary relationships, and the impact of HS on adolescents’ quality of life.
HS 与肥胖之间的关系虽然在成人患者中已得到充分证实,但由于全球范围内儿科肥胖症的发病率不断上升,因此儿科患者也越来越受到关注。本综述旨在整合现有证据,说明 HS 与肥胖在儿科人群中的关系,并假设这两种疾病之间存在关联的原因。根据体重指数(BMI),42.3%的患者被归类为肥胖(BMI 30),14%为超重(BMI 25-29.9)。我们的研究结果表明,儿科患者的肥胖与 HS 之间存在关联,这可能是由多种机制造成的,包括共同的遗传因素、遗传关系以及 HS 对青少年生活质量的影响。
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引用次数: 0
Recalcitrant extensive dermatophytosis in twin brothers with APECED syndrome 患有 APECED 综合征的孪生兄弟中的难治性大面积皮癣病
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-11 DOI: 10.1111/pde.15736
Aysha Najeeb, Vishal Gaurav, Pankhuri Dudani, Shukla Das, Somesh Gupta
Chronic mucocutaneous candidiasis (CMC) is characterized by recurrent infections with Candida spp., often linked to primary immunodeficiencies. We report a case of two 8‐year‐old monozygotic twin brothers presenting with extensive dermatophytosis, later diagnosed with autoimmune polyendocrinopathy, candidiasis, and ectodermal dystrophy (APECED) syndrome due to a homozygous p.M1V mutation in the AIRE gene. The twins exhibited widespread skin and nail infection, along with malabsorption, dental caries, and other autoimmune manifestations. This case highlights the novel presentation of extensive dermatophytosis in APECED, underscoring the variability in clinical expression even within a single family.
慢性皮肤粘膜念珠菌病(CMC)的特点是反复感染念珠菌属,通常与原发性免疫缺陷有关。我们报告了一例 8 岁单卵双胞胎兄弟的病例,他们患有广泛的皮肤癣菌病,后被诊断为自身免疫性多内分泌病、念珠菌病和外胚层营养不良(APECED)综合征,其病因是 AIRE 基因的同源突变 p.M1V。这对双胞胎表现出广泛的皮肤和指甲感染,同时伴有吸收不良、龋齿和其他自身免疫表现。该病例突显了 APECED 中广泛的皮癣病的新表现形式,强调了即使在一个家族中,临床表现也是多变的。
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引用次数: 0
Dissecting Cellulitis and Alopecic and Aseptic Nodules of the Scalp in Pediatric Patients: An Atypical Age of Presentation Observed in Two Cases 小儿患者头皮的剥脱性蜂窝织炎、脱发性和无菌性结节:两个病例的非典型发病年龄
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-11 DOI: 10.1111/pde.15754
Anabell Andrea Lima‐Galindo, Leslie Monserrat Garza‐García, Valeria Olvera‐Rodríguez, Miguel Bonifacio Favela‐Galvez, Jorge Ocampo‐Candiani, Erika Alba‐Rojas
Dissecting cellulitis of the scalp (DCS) is a rare inflammatory condition that progresses from papules and pustules to nodules and abscesses, ultimately leading to cicatricial alopecia. It primarily affects African men between the ages of 15 and 62, with exceptionally low prevalence in children. A milder form, described as “alopecic and aseptic nodules of the scalp” (AANS), presents as aseptic nodules associated with non‐scarring alopecia and has a good prognosis. We report two atypical cases of DCS in Hispanic pediatric patients: an 18‐month‐old female infant and an 11‐year‐old male child who had a rapid and favorable clinical resolution consistent with AANS.
头皮剥脱性蜂窝织炎(DCS)是一种罕见的炎症,会从丘疹和脓疱发展为结节和脓肿,最终导致卡他性脱发。它主要影响 15 至 62 岁的非洲男性,儿童发病率特别低。病情较轻的病例被称为 "头皮脱发性和无菌性结节"(AANS),表现为无菌性结节伴非瘢痕性脱发,预后良好。我们报告了两例西班牙裔儿科患者的非典型 DCS 病例:一名是 18 个月大的女婴,另一名是 11 岁的男童,他们的临床症状缓解迅速且良好,与 AANS 一致。
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引用次数: 0
Phenotypes, Genetics, and Estimated Prevalence of Focal Dermal Hypoplasia (Goltz Syndrome): A Single‐Center Report 局灶性真皮发育不全(戈尔茨综合征)的表型、遗传和估计患病率:单中心报告
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-11 DOI: 10.1111/pde.15752
Laura Krogh Herlin, Morten Krogh Herlin, Hanne Vinter, Jenny Blechingberg, Brian Nauheimer Andersen, Casper Kruse, Mette Sommerlund
BackgroundFocal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare ectodermal dysplasia that primarily affects the skin, skeleton, and eyes. It is an X‐linked dominant disorder, predominantly seen in females, caused by pathogenic variants in PORCN.MethodsWe characterized a case series of four genetically confirmed FDH patients (three females, one male) at Aarhus University Hospital, Denmark. We estimated the FDH prevalence from our local cohort and nationwide registry data.ResultsThree patients had characteristic dermatological findings suspicious for FDH and confirmed by targeted PORCN analysis. One patient had an atypical presentation with several malformations but only subtle skin changes and was diagnosed following trio exome‐sequencing analysis. Skin atrophy with fat herniations and telangiectasias were typical cutaneous findings. Limb malformations included oligodactyly (cleft foot), syndactyly, and polydactyly. Eye abnormalities included coloboma and microphthalmos. Facial dysmorphology was defined by asymmetry, thin upper lip, and malformed ears. One patient developed a giant cell bone tumor, which is a rare feature of FDH. Dental findings included enamel hypoplasia with vertical grooving and irregular crowns. Four PORCN variants were identified, including three not previously reported in the literature.We estimated a regional point prevalence in Western Denmark of 1.6 cases per million population (95% confidence intervals (CI): 0.7–3.7 per million) and a nationwide registry‐based point prevalence of 1.2 cases per million population (95% CI: 0.6–2.4 per million).ConclusionsFDH is an extremely rare and complex multisystem disorder of variable presentation, which requires close multidisciplinary collaboration for diagnosis and patient care.
背景局灶性真皮发育不全(FDH)又称戈尔茨综合征,是一种罕见的外胚层发育不良,主要影响皮肤、骨骼和眼睛。它是一种 X 连锁显性遗传病,主要见于女性,由 PORCN 的致病变体引起。方法我们对丹麦奥胡斯大学医院的四例经基因证实的 FDH 患者(三女一男)进行了病例分析。我们根据当地队列和全国范围的登记数据估算了 FDH 的患病率。结果三名患者的特征性皮肤病发现疑似 FDH,并通过针对性的 PORCN 分析得到证实。一名患者表现不典型,有多个畸形,但皮肤仅有细微变化,经三组外显子测序分析后确诊。皮肤萎缩伴脂肪疝和毛细血管扩张是典型的皮肤症状。肢体畸形包括少指畸形(足裂)、并指畸形和多指畸形。眼部畸形包括巨眼球和小眼球。面部畸形表现为不对称、上唇薄和耳朵畸形。一名患者出现了巨细胞骨肿瘤,这是 FDH 的罕见特征。牙科检查结果包括釉质发育不全,伴有垂直沟纹和不规则牙冠。我们估计丹麦西部地区的点流行率为每百万人中有 1.6 例(95% 置信区间 (CI):每百万人中有 0.7-3.7 例),全国登记点流行率为每百万人中有 1.2 例(95% 置信区间 (CI):每百万人中有 0.6-2.4 例)。
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引用次数: 0
The Successful Use of Upadacitinib as Monotherapy for Hidradenitis Suppurativa and Ulcerative Colitis in the Setting of Refractory Disease 奥帕他替尼作为单药疗法成功用于治疗难治性化脓性扁桃体炎和溃疡性结肠炎
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-11 DOI: 10.1111/pde.15759
Meryem T. Ok, Paul B. Googe, Christopher J. Sayed, Craig Burkhart, Ajay S. Gulati, Elizabeth L. Nieman
Hidradenitis suppurativa (HS) and ulcerative colitis (UC) are associated chronic inflammatory conditions with complex disease courses and potential for overlapping therapeutic management. We describe a case of severe pediatric HS and UC that were poorly controlled despite several standard‐of‐care therapies, including infliximab and ustekinumab. Transitioning the patient to upadacitinib monotherapy resulted in clinical improvement of both her UC and HS within 3 months, and she was then able to be weaned off her other systemic therapies. While upadacitinib is not currently FDA‐approved for HS or pediatric UC, this case report shows promise for upadacitinib monotherapy for both of these complex inflammatory disorders.
化脓性扁桃体炎(HS)和溃疡性结肠炎(UC)是相关的慢性炎症,病程复杂,治疗方法有可能重叠。我们描述了一例严重的小儿化脓性结肠炎和溃疡性结肠炎患者,尽管他们接受了包括英夫利昔单抗和乌司替尼在内的多种标准疗法,但病情控制不佳。将患者转为使用达帕替尼单药治疗后,她的 UC 和 HS 在 3 个月内都得到了临床改善,随后她就可以停用其他系统疗法了。虽然目前达帕替尼尚未获得 FDA 批准用于治疗 HS 或儿科 UC,但这一病例报告显示了达帕替尼单药治疗这两种复杂炎症性疾病的前景。
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引用次数: 0
5q14.3 Microdeletion Syndrome With Simultaneous Involvement of MEF2C and RASA1. Clinical Case and Review of the Literature 同时累及 MEF2C 和 RASA1 的 5q14.3 微缺失综合征。临床病例及文献综述
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-11 DOI: 10.1111/pde.15748
José González Rodríguez, Eduardo de‐la‐Rosa Fernández, Irene Loizate Sarrionandia, Elsa Benítez García, Maria Herrero Moyano, Héctor Juan Morales Moreno, José Suárez Hernández
5q14.3 microdeletion syndrome is a rare condition involving multiple genes such as MEF2C and RASA1 and is potentially classified as a neurocutaneous syndrome. Deletion of the MEF2C gene accounts for the majority of clinical manifestations, including global developmental delay, intellectual disability, seizures, and behavioral disorders. RASA1 deletion is linked to capillary malformations with arteriovenous malformations (CM‐AVM). Until now, only 17 cases have been described with deletions of both genes. We present the first case described in Spain with the microdeletion in the 5q14.3 cytoband simultaneously affecting both MEF2C and RASA1, exhibiting the typical manifestations of this entity, and review the published cases to date.
5q14.3 微缺失综合征是一种罕见的疾病,涉及 MEF2C 和 RASA1 等多个基因,有可能被归类为神经皮肤综合征。MEF2C 基因缺失导致大多数临床表现,包括全面发育迟缓、智力障碍、癫痫发作和行为障碍。RASA1 基因缺失与毛细血管畸形伴动静脉畸形(CM-AVM)有关。迄今为止,仅有 17 例病例同时存在这两个基因的缺失。我们介绍了西班牙第一例同时影响 MEF2C 和 RASA1 的 5q14.3 细胞带微缺失病例,该病例表现出这一实体的典型表现,并回顾了迄今为止已发表的病例。
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引用次数: 0
A severe case of reactive infectious mucocutaneous eruption associated with two possible triggers: Coronavirus and group A streptococcus 一例伴有两种可能诱因的反应性传染性粘膜糜烂重症病例:冠状病毒和 A 组链球菌
IF 1.5 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-09-10 DOI: 10.1111/pde.15744
Ivan Rodriguez, Andrew T. Kwong, Minnelly Luu, Scott D. Worswick
Reactive infectious mucocutaneous eruption (RIME) is a newly defined condition characterized by mucocutaneous blistering secondary to upper respiratory infections and encompasses Mycoplasma pneumoniae‐induced rash and mucositis, broadening the disease spectrum to include various infectious etiologies. We present a severe RIME case involving a 5‐year‐old female with concurrent coronavirus NL63 and group A streptococcus infections. Diagnosis complexity stemmed from overlapping clinical features with other severe mucocutaneous eruptions such as Stevens‐Johnson syndrome/toxic epidermal necrolysis/drug‐induced necrolysis. This case underscores the need for comprehensive infectious workup and emphasizes the clinical diagnostic spectrum of drug‐induced and infection‐induced desquamative skin and mucosal disease.
反应性传染性粘膜糜烂(RIME)是一种新定义的疾病,其特征是继发于上呼吸道感染的粘膜水疱,包括肺炎支原体诱发的皮疹和粘膜炎,将疾病谱扩大到包括各种感染病因。我们介绍了一例严重的 RIME 病例,患者是一名 5 岁女性,同时患有冠状病毒 NL63 和 A 组链球菌感染。诊断的复杂性源于与其他严重粘膜糜烂(如史蒂文斯-约翰逊综合征/毒性表皮坏死溶解症/药物性坏死溶解症)重叠的临床特征。本病例强调了进行全面感染检查的必要性,并强调了药物和感染引起的脱屑性皮肤和粘膜疾病的临床诊断范围。
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引用次数: 0
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Pediatric Dermatology
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