先天性角化不良研究进展

先天性角化不良是一种少见的先天遗传性皮肤病，其临床三联征包括：甲板营养不良，口腔或阴道等可出现白斑，皮肤异色症样的色素沉着。先天性角化不良是与编码角化不良蛋白基因、编码端粒酶的RNA组份基因、编码端粒酶的逆转录酶基因突变及其他未确认的致病基因突变引起的基因病，其遗传方式有：X-性联隐性遗传、常染色体显性遗传及常染色体隐性遗传。治疗上还缺乏有效的治疗方法。文中从先天性角化不良的发病机制、突变类型、临床表型以及治疗方面综述先天性角化不良的研究进展。     

先天性角化不良研究新进展

先天性角化不良(DC)是一种罕见的遗传性皮肤病,其临床特征为皮肤色素沉着、甲营养不良、黏膜白斑和骨髓增生障碍。分子遗传学研究显示,本病存在遗传异质性,其遗传方式为X连锁隐性遗传、常染色体显性遗传和常染色体隐性遗传3种,目前发现前2种遗传类型的致病基因为DKC1和TERC。该病治疗比较棘手,目前尚无根治方法。     

中国X连锁型先天性角化不良家系基因突变的研究

X连锁型先天性角化不良是X染色体隐性遗传性疾病,临床主要表现为网状色素沉着及色素减退,黏膜白斑,甲营养不良三联症,是由编码角化不良蛋白（dyskerin）的DKC1基因突变所致。DKC1基因位于Xq28,长1.5kb,基因高度保守。     

常染色体隐性遗传先天性角化不良一例及TERT基因突变研究

【摘要】 目的 报告1例常染色体隐性遗传先天性角化不良,检测其致病基因突变情况。方法 采集先证者及其父母外周血,提取基因组DNA,以100例健康人作为对照,运用Illumina Nextseq500测序仪检测先证者家系皮肤病相关基因编码区域的序列突变情况,致病性突变经PCR?Sanger测序验证。运用生物信息学软件Clustalw2.0、PyMOL、PolyPhen?2、SIFT及FATHMM分别对基因突变位点的保守性、蛋白结构变化及致病性进行预测。结果 先证者临床表现为颈胸部网状皮肤异色、腋窝点状色素沉着,部分趾甲萎缩、表面粗糙及口腔黏膜白斑,血常规及肝功能指标部分异常。基因检测显示,先证者携带TERT基因c.2452G>A（p.Val818Met）与c.2594G>A（p.Arg865His）复合杂合突变,其中c.2452G>A突变在HGMD中未见收录。母亲携带c.2452G>A杂合突变,父亲及100例健康对照TERT基因未见突变。生物信息软件分析显示,多个物种TERT蛋白在818与865位氨基酸位点分别为高度保守与完全保守,基因突变后对应蛋白结构存在差异。依先证者临床表现、基因检测、辅助检查及生物信息分析结果,最终诊断为常染色体隐性遗传先天性角化不良。结论 TERT基因c.2594G>A（p.Arg865His）与c.2452G>A（p.Val818Met）复合杂合突变可能是导致该先证者临床表型的原因。     

常染色体隐性遗传性鱼鳞病致病基因研究进展

常染色体隐性遗传性鱼鳞病（autosomal recessive congenital ichthyosis,ARCI）是一种罕见的以表皮分化异常、角化过度为特点的角化性皮肤病,可分为3种亚型：丑角样鱼鳞病、先天性非大疱性鱼鳞病样红皮病及板层状鱼鳞病。ARCI具有高度的遗传异质性,迄今已经发现了15个致病基因,该文就已发现的致病基因进行综述。     

先天性角化不良与端粒酶、端粒相关基因的研究进展

先天性角化不良是一种具有遗传异质性的皮肤遗传病,其临床特征为黏膜白斑、甲营养不良、皮肤异色症、骨髓衰竭、肿瘤易感性以及其他系统损害.目前研究表明,其发病与端粒的长度缩短相关.端粒酶组分的基因突变可导致端粒酶活性的降低,使端粒缩短.概述引起端粒酶活性降低、端粒缩短的端粒酶组分的多个相关基因的研究进展,进一步阐明先天性角化不良的发病机制.

Abstract：

Dyskeratosis congenita (DC) is a rare skin disorder with heterogeneity, which is characterized by mucosal leukoplakia, nail dystrophy, abnormal skin pigmentation, bone marrow failure, cancer predisposition and other system damage. Currently, it is revealed that the pathogenesis of DC is related to the shortening of telomere length. Gene mutation of telomerase complex may result in a decline in telomerase activity and shortening of telomere length. This paper presents the advances in researches of telomerase complex genes responsible for reduction in telomerase activity and shortening of telomerase length, which may facilitate further elucidation of DC pathogenesis.     

局部应用他扎罗汀治疗先天性鱼鳞病

先天性鱼鳞病是一组角化异常的遗传性疾病 ,除了Ｘ性联隐性遗传鱼鳞病 (ＸＲＩ)、常染色体显性遗传寻常鱼鳞病 (ＡＤＩＶ) ,还有几种无相关疾病的板层状鱼鳞病或表皮松解性鱼鳞病。常染色体隐性遗传板层状鱼鳞病可区分为红皮型和非红皮型 (ＮＥＡＲＬＩ)。表皮松解角化过度是Ｂｒｏｃｑ大疱性先天性鱼鳞病样红皮症和Ｓｉｅｍｅｎｓ大疱性鱼鳞病 (ＩＢＳ)的共同特征。该文主要评价局部外用他扎罗汀治疗先天性鱼鳞病的临床疗效和耐受性。方法和结果 :共有 1 2例患者参与了这项半侧、自身对照、开放性研究。其中有 4例ＸＲＩ,3例ＮＥＡＲＬＩ,3…     

先天性甲肥厚伴皮肤淀粉样变及色素沉着过度——一种独特的变种

先天性甲肥厚是一种罕见的伴发外胚叶缺陷的遗传性皮肤病,临床上可分两种主要类型:Jadassohn-Lewandowsky型是以甲肥厚为特征,伴有掌跖角化过度及多汗症,易患足跖摩擦性水疱、毛囊角化及口腔粘膜白斑病.Jackson-Lawler型少见,这两型相似,但后型缺乏口腔粘膜变化,有齿发育不良及皮肤囊肿.虽然先天性甲肥厚通常为常染色体显性遗传,但近年来有报告以隐性遗传的方式遗传.本文报道的5例患者系两个亲属,年龄为3～59岁,具有相同的特征性的色素沉着过度伴先天性     

点状掌跖角化病遗传学研究进展

点状掌跖角化病是一种以掌跖部不规则分布、进行性加重的角化性丘疹为特征的常染色体显性遗传性皮肤病.目前已报道AAGAB基因和COL14A1基因是点状掌跖角化病致病基因,除此之外,可能还存在其他致病基因.迄今为止,在多个种族或民族点状掌跖角化病家系中已发现39种AAGAB基因突变和1个COL14A1基因突变位点.AAGAB基因突变导致其编码的p34蛋白功能缺失或不足,使表皮生长因子受体再循环发生障碍,角质形成细胞发生过度增殖,导致点状掌跖角化病发生.COL14A1基因突变的致病性有待于蛋白质功能学研究、体外细胞实验以及该基因突变在其他点状掌跖角化病家系内重复性验证等进一步证实.     

常染色体显性板层状鱼鳞病:一种新型先天性鱼鳞病的超微结构特征

板层状鱼鳞病或称无大疱性先天性鱼鳞病至今被认为是一种常染色体隐性遗传的单基因性疾病。通过脂质化学分析,WiIliams等近来提出鉴别红皮病型与非炎症型常染色体隐性遗传的板层状鱼鳞病(ARLI)是可能的。作者最近见到一个家族连续三代遗传的4例板层状鱼鳞病患者,从而为第三型无大疱性先天性鱼鳞病一常染色体显性板层状鱼鳞病(ADLI)提供了遗传性证据。作者研究了2例ADLI患者(一例9岁的女孩和其27岁的母亲)的皮肤组织学。光镜:表皮棘层增厚及轻度乳头瘤状,覆以明显的过度角化,伴灶状角化不全,颗粒层增厚,甚至在角化不全部位亦然,在基底细胞层见到少数规     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.