Focal Dermal Hypoplasia

  • 文章类型: Case Reports
    戈尔茨-戈林综合征(GGS),也被称为局灶性真皮发育不全,是由PORCN基因的致病变异引起的一种罕见的X连锁疾病,其特征是几种异常,包括皮肤和肢体缺陷,多器官乳头状瘤,眼部畸形,和轻微的面部畸形。迄今为止,文献中只描述了大约300例。一名16岁的女性患者,出生时患有与GGS一致的多种先天性畸形,并通过基因检查证实,被转诊到我们的门诊进行甲状腺结节检查。甲状腺超声检查显示双侧结节性疾病,右叶有17毫米大的低回声结节。细针穿刺活检的细胞学检查可疑为恶性肿瘤。因此,她接受了甲状腺全切除术加右侧中央室淋巴结清扫术.组织学检查显示甲状腺乳头状癌(PTC)伴有淋巴结微转移。进行放射性碘(131-碘)治疗。在3个月和6个月的随访中,患者未出现超声或实验室PTC复发.据我们所知,我们报告了GGS患者中的首例PTC。由于甲状腺癌在儿童和青少年中很少见,我们假设PORCN致病变异可能是肿瘤易感性的原因.我们还对已经报道的GGS患者的临床发现进行了概述,并讨论了可能是这种罕见疾病的潜在致病机制。包括PORCN在肿瘤易感性中的作用。
    Goltz-Gorlin syndrome (GGS), also known as focal dermal hypoplasia, is a rare X-linked disorder caused by pathogenic variants in the PORCN gene and characterized by several abnormalities, including skin and limb defects, papillomas in multiple organs, ocular malformations, and mild facial dysmorphism. To date, only approximately 300 cases have been described in the literature. A 16-year-old female patient, born with multiple congenital dysmorphisms consistent with GGS and confirmed by genetic exam, was referred to our outpatient clinic for the workup of a thyroid nodule. A thyroid ultrasound showed a bilateral nodular disease with a 17-mm large hypoechoic nodule in the right lobe. Cytological exam of fine needle aspiration biopsy was suspicious for malignancy. Thus, she underwent total thyroidectomy plus lymphadenectomy of the right central compartment. A histological exam disclosed a papillary thyroid carcinoma (PTC) with lymph node micrometastases. Radioiodine (131-Iodine) therapy was performed. At 3- and 6-month follow-up, the patient did not present either ultrasound or laboratory PTC recurrence. To our knowledge, we report the first case of PTC in a patient with GGS. Since thyroid cancer is rare among children and adolescents, we hypothesize that the PORCN pathogenic variant could be responsible for tumor susceptibility. We also provide an overview of the clinical findings on GGS patients already reported and discuss the possible pathogenetic mechanism that may underlie this rare condition, including the role of PORCN in tumor susceptibility.
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  • 文章类型: Case Reports
    局灶性真皮发育不全(FDH),也被称为戈尔茨综合症,是文献中描述的罕见综合征。斑片状皮肤发育不全是最明显的征象。色素沉着过度,色素沉着减退,乳头状瘤,肢体缺陷,和口面表现也有报道。一名12岁的沙特女孩,家族史平淡无奇,患有FDH。通过基因研究证实了这一诊断。体格检查显示不对称的蛭状真皮萎缩条纹,毛细血管扩张伴色素沉着过度,左半脸色素减退,树干,和双边四肢。它沿着Blashko线出现。没有观察到精神损害。口腔内检查全身性牙菌斑诱发的牙龈炎伴红斑性牙龈增生。牙齿检查显示广泛的釉质发育不全伴异常牙齿形成,不对准,microdontia,间距和倾斜,和最小的龋齿。由于报告的FDH病例在全球范围内很少见,这种综合症尚未得到充分理解。由于该综合征的表现因病例而异,每个案例的管理都是独特的。这强调了报告FDH病例的重要性。
    Focal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare syndrome described in the literature. Patchy skin hypoplasia is the most evident sign. Hyperpigmentation, hypopigmentation, papillomas, limb defects, and orofacial manifestations have also been reported. A 12-year-old Saudi girl with unremarkable family history presented with FDH. The diagnosis was confirmed using a genetic study. Physical examination revealed asymmetrical streaks of vermiculate dermal atrophy, telangiectasia with hyperpigmentation, and hypopigmentation on the left half of the face, trunk, and bilateral extremities. It appears along Blashko lines. No mental impairment was observed. Intraoral examination generalized plaque-induced gingivitis with erythematous gingival hyperplasia. Examination of the teeth showed generalized enamel hypoplasia with abnormal tooth formations, malalignment, microdontia, spacing and tilting, and minimal caries. As reported cases of FDH are rare worldwide, this syndrome is yet to be fully understood. As the manifestation of the syndrome varies among cases, the management of each case is unique. This emphasizes the importance of reporting cases of FDH.
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  • 文章类型: Case Reports
    局灶性真皮发育不全(Goltz综合征)是一种遗传性多系统疾病,其特征主要是与面部相关的皮肤受累,骨骼,和眼睛异常。本系列的目的是阐明这种罕见的综合征和这些非典型的表现。
    我们的研究报告了五名摩洛哥患者的病例,这些患者表现出典型的Goltz综合征临床表现,并有一些罕见的表现。
    共评估了5例戈尔茨综合征患者。他们都是女性,只有一个家族病例。年龄从8个月到35岁不等。特征性Blaschkoid低色素沉着和色素沉着过度的皮肤病变,先天性结节性脂肪疝,所有患者均存在皮肤萎缩。80%的患者出现眼部表现。80%的患者出现颅面畸形。80%和40%的患者有身材矮小和智力延迟的记录,分别。所有患者均发现肢体异常。两个病人唇裂,其中一种不寻常的侧面裂痕。
    本系列无法进行基因检测。
    通过这项工作,我们将讨论Goltz综合征的不同临床体征和遗传方面以及对良好临床专业知识的兴趣。
    UNASSIGNED: Focal dermal hypoplasia (Goltz syndrome) is a genetic multisystem disorder characterized primarily by involvement of the skin associated to face, skeletal, and eyes anomalies. The objective of the present series is to shed light on this rare syndrome and these atypical manifestations.
    UNASSIGNED: Our study reports the case of five Moroccan patients who present typical clinical picture of the Goltz syndrome with some rare manifestations.
    UNASSIGNED: A total of 5 patients with Goltz syndrome were evaluated. All of them are female with one familial case. The age ranged from 8 months to 35 years. A characteristic Blaschkoid hypo- and hyper-pigmented skin lesions, congenital nodular fat herniation, and skin atrophy were present in all patients. Ocular manifestations were present in 80% of patients. Cranio-facial deformity was seen in 80% of patients. Short stature and intellectual delay were documented in 80% and 40% of patients, respectively. Limb abnormality was found in all patients. Two patients had a cleft lip, one of which unusual lateral facial cleft.
    UNASSIGNED: Genetic testing could not be performed in the present series.
    UNASSIGNED: Through this work we will discuss the different clinical signs and genetic aspects of Goltz syndrome and the interest of a good clinical expertise.
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  • 文章类型: Case Reports
    Goltz综合征是一种罕见的X连锁显性多系统疾病,表现为外胚层和中胚层衍生症状。皮肤表现包括先天性斑片状皮肤发育不全,先天性结节性脂肪疝,Blaschko系先天性色素沉着不足或过度,毛细血管扩张症,先天性脊状发育不良的指甲是这种疾病的典型特征。几乎所有的戈尔茨综合征病例都与女性新生儿相对应,而半合子病在男性中使该综合征成为胎儿。三X综合征是一种相对常见的先天性疾病,在发育和精神领域表现为轻度至无症状。这里报告的患者出生时患有影响眼睛的多系统异常,颅面区域,心血管系统,皮肤,和四肢。G-显带染色体研究显示47,XXX。由于其独特的皮肤表现,她被诊断出患有Goltz综合征。先天性宫颈皮肤缺损经保守治疗愈合。面部裂痕,唇腭裂,并用多种手术治疗成功。三重X综合征和Goltz综合征的组合非常罕见。我们描述了同时呈现两种综合症的表达。
    Goltz syndrome is a rare X-linked dominant multisystem disorder that presents with ectoderm and mesoderm-derived symptoms. Skin manifestations including congenital patchy skin aplasia, congenital nodular fat herniation, congenital hypo- or hyperpigmentation along Blaschko\'s lines, telangiectasia, and congenital ridged dysplastic nails are typical in this disorder. Almost all cases of Goltz syndrome correspond to female newborns and that hemizygosis makes the syndrome fetal in males. Triple X syndrome is a relatively common congenital disorder that presents with mild to no symptoms in the developmental and psychiatric realm. The patient reported here was born with multisystem anomaly affecting the eyes, craniofacial region, cardiovascular system, skin, and limbs. A G-banding chromosomal study revealed 47, XXX. She was diagnosed with Goltz syndrome owing to her distinctive skin manifestations. The congenital cervical skin defect healed with conservative treatment. The facial cleft, cleft lip-palate, and syndactyly were successfully treated with multiple surgical treatments. The combination of triple X syndrome and Goltz syndrome is very rare. We describe the expression of presenting with both syndromes simultaneously.
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  • 文章类型: Case Reports
    局灶性真皮发育不全(FDH),也被称为戈尔茨综合症,由影响外胚层和中胚层起源的组织以及各种器官和系统的不寻常的遗传性皮肤病组成,尤其是皮肤,骨头,眼睛,和口腔。虽然FDH的系统性表现已经有了很好的记录,口头表现尚未得到广泛讨论。我们介绍了一名22岁女性患者,有FDH病史,表现出各种全身和口腔表现。根据皮肤改变在出生时诊断出FDH。口外检查显示面部不对称,嘴唇和口周萎缩,上唇乳头状瘤,错牙合,釉质发育不全,和牙龈增生。粘膜病变,牙周病,并通过口腔手术治疗错牙合,牙周治疗和正畸治疗,分别。虽然FDH是一种罕见的综合征,卫生专业人员应了解其全身和口腔表现,以建立早期诊断和适当的治疗。
    Focal dermal hypoplasia (FDH), also known as Goltz syndrome, consists of an unusual genodermatosis that affects tissues of ectodermal and mesodermal origin and various organs and systems, especially skin, bones, eyes, and oral cavity. While systemic manifestations of FDH have been well documented, the oral manifestations have not been extensively discussed. We present a 22-year-old female patient with history of FDH that showed a variety of systemic and oral manifestations. FDH was diagnosed at birth based on cutaneous alterations. Extra and intraoral examination showed facial asymmetry, lip and perioral atrophy, upper lip papilloma, malocclusion, enamel hypoplasia, and gingival hyperplasia. Mucosal lesions, periodontal diseases, and malocclusion were treated by oral surgery, periodontal therapy and orthodontic treatment, respectively. Although FDH is an uncommon syndrome, health professionals should be aware of its systemic and oral manifestations to establish an early diagnosis and adequate treatment.
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  • 文章类型: Case Reports
    Focal dermal hypoplasia (Goltz syndrome), is an exceedingly rare X-linked dominant genetic disorder. It is a multisystem disease, but it is hallmarked by characteristic skin changes. Focal dermal hypoplasia typically occurs in females (90%), and males are thought to only survive through having either a sporadic new mutation or somatic mosaicism. This report details a 48-year-old male diagnosed with predominately unilateral focal dermal hypoplasia that was reviewed decades post his initial diagnosis. He presented with multiple atrophic hyperpigmented macules and fat herniation along the lines of Blaschko, across primarily the right side of the body. Skin biopsy is the mainstay for the diagnosis and therefore dermatologists need to be aware of the classical cutaneous findings of familial dermal hypoplasia to ensure accurate diagnosis. Familial dermal hypoplasia is best managed through the collective minds of multidisciplinary teams.
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  • 文章类型: Case Reports
    戈尔茨综合征或局灶性真皮发育不全(FDH),是一种主要涉及皮肤的X连锁优势状况,四肢和眼睛。在耳鼻喉科,FDH的描述很差,但可能导致阻塞性睡眠呼吸暂停的症状增加,需要手术。也有记录的病例是先天性听骨异常继发的混合性严重听力损失。更频繁地,出现吞咽困难症状的耳鼻喉诊所的患者,继发于乳头状瘤病。一名36岁的妇女表现出疼痛,已知诊断为FDH的刺激和吞咽困难。随后她接受了食道-胃-十二指肠镜检查,钡吞下和增强MRI颈部扫描。在研究中发现了淋巴样增生,患者接受了CO2激光对病变的全内镜检查,临床效果良好。本案例报告强调了多学科团队参与的必要性,以确保充分考虑管理选择。
    Goltz syndrome or focal dermal hypoplasia (FDH), is an X-linked dominant condition which predominantly involves the skin, limbs and eyes. In otolaryngology, FDH has been poorly described, but can result in increased symptoms of obstructive sleep apnoea requiring surgery. There have also been documented cases of mixed severe hearing loss secondary to congenital ossicular anomalies. More frequently, patients present to the ear-nose-throat clinic with symptoms of dysphagia, secondary to papillomatosis. A 36-year-old woman presented with pain, irritation and dysphagia with a known diagnosis of FDH. She was subsequently investigated with an oesophago-gastro-duodenoscopy, Barium Swallow and an MRI neck scan with contrast. Lymphoid hyperplasia was found on investigation and the patient underwent a panendoscopy with CO2 laser to the lesion with good clinical outcome. This case report highlights the need for multidisciplinary team involvement to ensure full consideration of management options.
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  • 文章类型: Case Reports
    Goltz-Gorlin syndrome (GGS) (focal dermal hypoplasia) is a very rare developmental disorder affecting ectodermal and mesodermal structures. The syndrome is inherited in an X-linked manner, with the majority of affected individuals being female. We report the case of a 51-year-old man presenting with congenital skin lesions, syndactyly, facial and thoracic asymmetry, inguinal and laryngeal papillomas, cryptorchidism, polythelia, and dental anomalies. Molecular genetic analysis confirmed the clinically suspected diagnosis of GGS by detecting a known pathogenic mutation in the PORCN gene, c.502G>A [p.(Gly168Arg)] in the mosaic state. Histopathological examinations of skin biopsies of affected individuals typically show focal dermal hypoplasia and fat herniation; despite numerous skin biopsies, these characteristics were not found in the patient involved. Instead, we observed a notable reduction and fragmentation of the elastic fibers in the upper dermis. A systematic literature review regarding the histopathological presence or absence of dermal hypoplasia and/or information on elastic fibers revealed 240 histopathological descriptions of 173 individuals. Absence of dermal hypoplasia was found in 21 biopsies (8.8%). Information on elastic fibers was given in 47 cases (19.6%), showing decrease/absence in 31 cases and fragmentation of elastic fibers in 11 cases. Therefore, the histopathological absence of dermal hypoplasia does not exclude the diagnosis of the GGS. Decrease and fragmentation of elastic fibers may represent new histopathological clues to the diagnosis of this rare syndrome. At the same time, GGS should be included in the histopathological differential diagnoses of elastolytic disorders.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    Focal dermal hypoplasia (FDH) or Goltz syndrome is a rare X-linked dominant multisystemic disease involving the ectoderm, mesoderm, and endoderm. About 95% of the cases appear de novo, and 90% of them are females. Recently, the studies revealed that FDH is caused by a mutation in the PORCN gene. We report a case of unilateral FDH or Goltz syndrome in a 16-year-old girl presenting with hypopigmented-reticulated atrophic macules and patches in a linear pattern distributed along the lines of Blaschko over the right side of the face and the right arm. Also she is having hypoplasia of the right breast with dental enamel abnormality and partial anodontia in the lower jaw. Sparse hair and partial alopecia on the right side (scalp, eyebrows, and eyelashes) were also observed.
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