色素失禁症1例

色素失禁症是一种罕见的主要发生于女婴的X连锁遗传性皮肤病。本文报道1例出生时躯干及四肢即出现红斑和脓疱性皮损,组织病理符合色素失禁症。     

色素失禁症1家系NEMO基因新致病突变报道

【摘要】 目的 对1个色素失禁症家系进行基因诊断,以明确致病基因突变位点。方法 收集整理该家系所有患者的临床资料。提取该家系中患者、健康人、100例无关健康对照外周静脉血细胞DNA,针对NEMO基因外显子区及其侧翼序列进行Sanger测序。结果 该家系4代共4例患者,均有典型皮损,其他症状各有差异。基因测序示先证者及其他3例患者均存在NEMO基因8号外显子的杂合无义突变c.1153C>T（p.Gln385X）,编码区第1153位碱基由C突变为T,导致肽链第385位谷氨酰胺密码子（CAG）变成终止密码子（TAG）,14例健康亲属和100例健康对照未发现该突变。该突变与色素失禁症符合共分离,数据库查询显示其为新发无义突变,美国遗传学与基因组学学会指南判定致病证据为极强致病位点。结论 NEMO基因突变c.1153C>T与该家系色素失禁症发病有关。     

Hypomelanosis of Ito: a case report with clinical and ultrastructural data

Hypomelanosis of Ito (HI) is an uncommon skin disorder characterized by the presence of hypochromic areas associated with visceral abnormalities, the most common being neurological, muscular, skeletal and ocular. The authors describe a typical case of hypomelanosis of Ito in a 7-year-old child. The patient was obese, suffered from scoliosis, flat feet and had a bilateral genu valgus. No neurological, ophthalmological or dental malformations were noted. An electron microscopic study of a hypomelanotic area showed decreased functional activity in the melanocytes, which contained only a few rudimentary cytoplasmatic projections and poorly developed organelles. In addition, there was a reduction in the number of mature melanosomes.     

Unusual hyperpigmented patches,an undeveloped breast and a cataract in a female with incontinentia pigmenti

A 19‐year‐old female and her mother visited our department with a history of unusual reticular brown‐black patches on their trunks and limbs since infancy. Besides the obviously fulsome hyperpigmentation, the daughter also showed other unusual clinical manifestations such as generalized hypohidrosis, especially on the hyperpigmented patches, cicatricial alopecia, a cataract on her right eye, abnormal teeth and a right dysplastic breast. The mother had a median diastema between her maxillary central incisors, hypoplasia of the enamel, hypohidrosis and hyperpigmented patches on her left thoracic region. Analysis of the NEMO (NF‐κB essential modulator) gene in the patient and her mother revealed a deletion of exons 4–10. Their EDA and EDAR genes were normal.     

Incontinencia pigmenti. Estudio descriptivo de la experiencia en dos centros hospitalarios

IntroductionIncontinentia pigmenti is a rare genodermatosis of inheritance linked to the X chromosome that affects tissues derived from ectoderm. The aim of the study is to review, as completely as possible, the cases diagnosed in paediatric patients in two hospitals.Material and methodsA retrospective cross-sectional study was carried out, using the clinical, analytical, radiological, and genetic data of paediatric patients diagnosed with incontinentia pigmenti from 2004 to 2018. The data collected were analysed and evaluated at a multidisciplinary level.ResultsA total of thirteen patients diagnosed with incontinentia pigmenti were included in the study. All of them were female. A genetic study was performed on 11 patients, which confirmed findings compatible with incontinentia pigmenti in 10 of them. Extracutaneous involvement associated with the disease was observed at neurological level (radiological findings in 6 cases, and clinical expression in 3 of them), ophthalmological level (4 cases), dental level (7 cases), and haematological level (4 cases).ConclusionsA presentation is given of the most complete study published so far of incontinentia pigmenti in Spain. In this study, the results of the disease manifestations were similar to the largest case series published internationally, which reinforces the importance of a multidisciplinary study and follow-up.     

X inactivation patterns in two syndromes with probable X-linked dominant, male lethal inheritance

For Incontinentia pigmenti Bloch-Sulzberger (IP) and Aicardi syndrome, an X-linked dominant transmission with lethality in hemizygous males has been proposed. The typical transition from inflammation to verrucous hypertrophy and hyperpigmented skin areas in IP suggests a gradual replacement of defective cells by normal cells. This would imply a preferential inactivation of the X chromosome carrying the IP gene with a proliferative advantage of this cell population. We have confirmed this hypothesis by demonstrating that the same X chromosome is preferentially active in fibroblasts grown from normal and hyperpigmented skin of an affected girl. In contrast, X inactivation was random in a girl with Aicardi syndrome.     

Destructive Encephalopathy in Incontinentia Pigmenti: A Case Report

We report a 2-day-old neonate with incontinentia pigmenti combined with destructive encephalopathy. Generalized seizures developed soon after birth; characteristic papulovesicles and hyperpigmented linear streaks appeared several days later. The brain CT scan showed multiple low density areas with cortical atrophy and ventricular enlargement. Histopathological examination favored the diagnosis of incontinentia pigmenti. Although a series of microbiological examinations failed to identify any infectious agent, the patient was still treated vigorously with anticonvulsants, systemic antibiotics, and acyclovir from the beginning of hospitalization. However, the seizures persisted, and the patient died 26 days after birth. Our report suggests that incontinentia pigmenti with encephalopathy may have a fatal prognosis.     

Central nervous system involvement in incontinentia pigmenti: cranial MRI of two siblings

Incontinentia pigmenti is an uncommon neurocutaneous syndrome characterised by skin lesions, dental and ocular abnormalities and central nervous system involvement. We report the cranial MRI findings in two sisters with this condition. These include hypoplasia of the corpus callosum, enlargement of the lateral ventricles and periventricular white-matter lesions. One girl also had unilateral microphthalmia and rostral agenesis of the corpus callosum, a feature not previously described. Received: 24 September 1996 Accepted: 24 June 1997     

Genetic counselling in hypomelanosis of Ito: case report and review

A 27-year-old male with hypomelanosis of Ito (HI) is reported. One of his two children had a postaxial ray defect of one leg but neither had cutaneous features of HI. Somatic mosaicism for a gene defect lethal to ectodermal derivatives offers the best explanation for HI in males, with consequent negligible recurrence risk. The limb defect is considered coincidental. The excess of girls with HI could be due to a female cohort with incontinentia pigmenti (IP) which may be indistinguishable: counselling of females must therefore take account of possible X-linked inheritance.