Estudo exploratório da Síndrome Hipoplasia Cartilagem-Cabelo no Brasil: uma abordagem genômica, proteômica e de análise estrutural de RNA / Exploratory study of Hypoplastic Cartilage-Hair Syndrome in Brazil: a genomic, proteomic and RNA structural analysis approach

A Hipoplasia Cartilagem-Cabelo (do inglês, Cartilage Hair Hypoplasia; CHH) é uma doença autossômica recessiva descrita por McKusick et al., em 1964 em crianças da comunidade Amish. Clinicamente, os pacientes apresentam displasia óssea metafisária em diferentes graus de gravidade. Além disso, também pode ser observado hipotricose e imunodeficiência. Já no âmbito molecular, a condição se caracteriza por variantes patogênicas do gene RMRP. Apesar de ter sido delineada há quase 60 anos, ainda não existe uma correlação genótipo-fenótipo bem compreendida. Este trabalho é uma continuação do trabalho de mestrado realizado no IFF/Fiocruz, durante 2017 e 2018, no qual foi descrita uma coorte de 23 pacientes brasileiros com CHH em que foram encontradas diversas variantes patogênicas. Dentre estas, a variante g.196C>T destacou-se por sua elevada frequência no grupo estudado, diferentemente do observado em pacientes de outras nacionalidades, sugerindo um possível efeito fundador (EF) para a população brasileira. Esse trabalho teve por objetivo realizar diferentes ensaios moleculares para auxiliar na compreensão da CHH, além de investigar a hipótese de uma origem ancestral comum da variante g.196C>T. O estudo foi dividido em 4 eixos, sendo três relacionados às pesquisas de caráter exploratório dos mecanismos da doença e um dedicado à análise do EF. Dentro deste último, utilizando um painel de marcadores do tipo TAG SNPs cuidadosamente selecionados, foi observado que cromossomos de diferentes regiões brasileiras carregando o nucleotídeo T na posição196 do gene RMRP compartilharam o haplótipo T/C/G/A (16/17 haplótipos), apontando para uma origem comum desta substituição de base no gene RMRP. Adicionalmente, foram realizadas análises de proteômica comparativa, evidenciando que o perfil proteômico dos leucócitos de pacientes e controles expressam proteínas que traduzem vias moleculares distintas, além de apresentar diferenças de expressão de proteínas importantes relacionadas aos fenótipos clínicos da doença. Também foram realizados ensaios de RT-qPCR que mostraram que tanto os níveis do RNA RMRP, quanto dos dois pequenos RNAs derivados de RMRP, estavam significativamente reduzidos nos pacientes em relação ao grupo controle. Por fim, com o intuito de tentar prever o impacto das variantes na estrutura tridimensional do RNA, foi realizada uma análise in silico que mostrou que as alterações patogênicas identificadas nos pacientes ocorreram tanto em regiões conservadas entre espécies de mamíferos quanto em domínios essenciais para o complexo ribonucleoproteico. Duas alterações estão localizadas em regiões associadas à biogênese dos pequenos RNAs derivados de RMRP. Além disso, foi possível observar que certas variantes podem alterar o pareamento de bases e a topologia da estrutura das alças da molécula, o que poderia influenciar na montagem do complexo RNAse MRP. Em conjunto, os dados desta tese lançam luz sobre diversos pontos ainda não explorados para CHH, além de dar suporte para novos estudos que tenham por objetivo viabilizar uma medicina de precisão, contribuindo para minimizar os impactos da doença e para a promoção da qualidade de vida dos pacientes.

Cartilage Hair Hypoplasia (CHH) is an autosomal recessive disease described by McKusick et al. in 1964 in the Amish community. Clinically, patients present metaphyseal bone dysplasia in different degrees of severity. In addition, hypotrichosis and immunodeficiency may also be present. At the molecular level, the condition is characterized by pathogenic variants of the RMRP gene. Although CHH has been described more than 60 years ago, the genotype-phenotype correlation is still not well-understood. This work is a continuation of the dissertation carried out at IFF/Fiocruz, during 2017 and 2018, in which a cohort of 23 Brazilian patients with CHH was described and several pathogenic variants were found. Among these, the high frequency of g.196C>T variant in the studied group called our attention, unlike that observed in patients of other nationalities, suggesting a possible founder effect (EF) in the Brazilian population. This work aimed to perform different molecular assays to aid in the understanding of CHH, in addition to investigating the hypothesis of a common ancestral origin of the g.196C>T variant. The study was divided into 4 axes, three related to exploratory research on disease mechanisms and one dedicated to the analysis of EF. Within the latter, using a carefully selected panel of TAG SNPs markers, it was observed that chromosomes from different Brazilian regions carrying T at nucleotide 196 of the RMRP gene shared the T/C/G/A haplotype (16/17 haplotypes), indicating a common origin of this base substitution at position 196 of the RMRP gene. Additionally, comparative proteomics analysis was performed, showing that the proteomic profile of leukocytes from patients and controls express proteins that translate distinct molecular pathways, in addition to presenting differences in the expression of proteins related to important clinical phenotypes of the disease. RT-qPCR assays were also performed, which showed that both RMRP RNA levels and the two RMRP-derived small RNAs were significantly reduced in patients compared to the control group. Finally, in order to try to predict the impact of the variants on the three-dimensional structure of the RNA, an in silico analysis was performed which showed that the pathogenic alterations identified in the patients occurred both in regions conserved between mammalian species and in domains essential for the ribonucleoprotein complex. Two alterations are located in regions associated with the biogenesis of RMRP-derived small RNAs. In addition, it was possible to observe that certain variants can change the base pairing and the topology of the structure of the molecule's loops, which could influence the assembly of the RNAse MRP complex. Together, the data from this thesis shed light on several points not yet explored for CHH, in addition to providing support for new studies that aim to enable a precision medicine toward CHH patients, helping to minimize the impacts of the disease and to promote quality of life of patients.

Analysis of SMARCA2 gene mutation in a child with Nicolaides-Baraitser syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the molecular basisfor a child featuring short stature, abnormal facial features and developmental delay.@*METHODS@#Genomic DNA was extracted from peripheral blood samples from the child and his family members. Next-generation sequencing was carried out to screen the whole exomes of the core family. Detected variants were filtered and analyzed according to the standards and guidelines for the interpretation of sequence variants recommended by the American College of Medical Genetics and Genomics and the Association for Molecular Pathology.@*RESULTS@#Trio-based sequencing has identified a de novo variant c.3593T>G (p.Val1198Gly) in the SMARCA2 gene in the patient. The variant was located in the Helicase C-terminal domain and was classified as pathogenic based on the guidelines.@*CONCLUSION@#The patient was diagnosed with Nicolaides-Baraitser syndrome caused by SMARCA2 gene mutation.

Displasia ectodérmica: diagnóstico neonatal / Ectodermal dysplasia: neonatal diagnosis

Presentamos el caso de un neonato sin antecedentes familiares ni prenatales de importancia, con peso bajo para la edad, fascies envejecida, puente nasal ancho, hipotricosis, piel descamativa, apergaminada, seca y hepatomegalia, aparente hipohidrosis con episodios de hipertermia, fenotipo compatible con displasia ectodérmica hipohidrótica, por alteraciones en la diferenciación y desarrollo de estructuras ectodérmicas: piel, pelo, dientes y glándulas sudoríparas, alteración en las señales entre ectodermo y mesénquima, además de mayor riesgo de desarrollar alteraciones inmunológicas y en la supresión de tumores. Este paciente requiere cuidados dérmicos y evitar la hipertemia que puede ocasionar un daño cerebral fatal, tratamiento dental precoz para restaurar la función, monitoreo permanente de función auditiva y oftálmica, consejo genético a la familia; y al asociarse con inmunodeficiencia puede requerir terapias de restitución inmune, tratamientos agresivos de las infecciones asociadas y/o un trasplante de células madre hematopoyéticas, según la evolución clínica.

This is the case of a newborn without family history of important diseases, with low weight for age, aged fascies, broad nasal bridge, hypotrichosis, desquamative skin, parchment, dry and hepatomegaly, apparent hypohidrosis with episodes of hyperthermia, phenotype compatible with dysplasia ectodermic hypohydrotic, by alterations in the differentiation and development of ectodermal structures: skin, hair, teeth and sweat glands, alteration in the signals between ectoderm and mesenchyme, as well as a greater risk of developing immunological alterations and tumor suppression. This patient requires dermal care and avoids the hyperthermia that can cause fatal brain damage, early dental treatment to restore function, permanent monitoring of auditory and ophthalmic function, genetic counseling to the family, and to associate with immunodeficiency, probably, requires therapies of immune restitution, aggressive treatments of associated infections and / or a transplant of hematopoietic stem cells, according to the clinical evolution.

Hypotrichosis with juvenile macular dystrophy: a case report with molecular study / Hipotricose com distrofia macular juvenil: relato de caso com estudo molecular

ABSTRACT Hypotrichosis with juvenile macular dystrophy is a rare autosomal recessive disorder characterized by sparse scalp hair caused by hair follicle abnormalities as well as progressive retinal degeneration leading to blindness in the second or third decade of life. It is associated with mutations of the cadherin 3 (CDH3) gene, which result in abnormal expression of P-cadherin. Mutations in CDH3 are related to ectodermal dysplasia, ectrodactyly, and macular dystrophy. In this report, we describe an 11-year-old Iranian boy born with a missing left index fingernail and sparse scalp hair who later displayed macular pigmentary changes. Genetic testing of the CDH3 gene revealed a homozygous gene variant at exon 6 (640A>T). This novel in-frame mutation converts a lysine to a premature stop codon, altering synthesis of P-cadherin on chromosome 16q22.

RESUMO Hipotricose com distrofia macular juvenil (HDMJ) é uma doença autossômica recessiva rara caracterizada por rarefação capilar por alteração nos folículos pilosos e degeneracão progressiva da retina levando a cegueira na segunda e terceira década de vida. Associada a mutações no gene CDH3, resultando em expressão anormal de P-caderina. Mutações no gene CDH3 estão relacionados à displasia ectodérmica, ectrodactilia e distrofia macular. Neste relato descrevemos um menino Iraniano de 11 anos de idade, com ausência da unha na mão esquerda e rarefação capilar desde o nascimento, e que posteriormente apresentou alterações pigmentares maculares. Teste genético do gene CDH3 revelou uma variação homozigótica no exon 6 (640A>T). Essa mutação in-frame troca uma lisina por um codon de parada prematura, alterando a síntese da proteína P-caderina no cromossomo 16q22.

Efeitos da ingestão de cafeína durante a gestação e a lactação sobre a pele de ratas e de filhotes e sua relação com as concentrações séricas do cortisol materno / Effects of caffeine intake during pregnancy and lactation on the skin of rats and offspring and their relationship to maternal serum concentrations of cortisol

O objetivo deste trabalho foi verificar os efeitos da ingestão materna de diferentes doses de cafeína durante a gestação e a lactação, na pele de ratas-mães e filhotes, bem como sua relação com as concentrações séricas do cortisol materno. Vinte e quatro ratas Wistar adultas foram distribuídas em quatro grupos, representados pelo controle e tratados, com cafeína nas doses de 25, 50 e 100mg/kg. Os grupos tratados receberam cafeína por sonda orogástrica durante toda a gestação e a lactação. O controle recebeu água destilada como placebo. Foram avaliados e quantificados os diferentes tipos de folículos pilosos e a espessura da epiderme. A técnica de imuno-histoquímica, com o uso do anticorpo anti-CDC47, foi utilizada para avaliar a proliferação celular da epiderme e dos folículos pilosos das mães. Na mãe, também foram mensurados os níveis séricos de cortisol pela técnica da quimioluminescência. Os dados foram submetidos à análise de variância com comparação das médias pelos testes Kruskal-Wallis e SNK. Nos grupos tratados com cafeína nas doses de 25 e 50mg/kg, tanto as mães quanto seus filhotes apresentaram hipotricose e/ou alopecia focal. Apesar de a frequência de alterações macroscópicas das mães ter sido superior a dos filhotes, nestes as lesões, quando presentes, foram difusas. A análise histológica demonstrou calcinose de folículos pilosos nas mães e nos filhotes. Mas a morfometria somente revelou diferença significativa no número de folículos pilosos das mães, bem como redução significativa da proliferação celular dos folículos pilosos do grupo tratado com 50mg/kg de cafeína. Os níveis de cortisol materno somente foram significativamente elevados no grupo tratado com 100mg/kg de cafeína. Conclui-se que a cafeína ingerida pelas ratas gestantes e lactantes pode causar lesões cutâneas tanto nas mães quanto nos filhotes, caracterizadas por hipotricose e/ou alopecia, independentemente dos níveis séricos do cortisol materno.

The aim of this study was to investigate the effects of maternal caffeine intake during pregnancy and lactation on the skin of rats and their offspring, as well as their relationship to maternal serum levels of cortisol. 24 adult Wistar rats were equally divided into four groups represented by the control and treated with caffeine at doses of 25, 50 and 100mg/kg. The groups received caffeine by orogastric tube during the entire pregnancy and lactation. The control received distilled water as placebo. Different types of hair follicles and the thickness of the epidermis were assessed and quantified. Immunohystochemistry technique using antibody anti-CDC47 was used to evaluate cellular proliferation of the epidermis and hair follicles of the mothers. Also in the mothers, serum levels of cortisol were measured by the chemiluminescence technique. Data were submitted to analysis of variance comparing mediums by Kruskall Wallis Test and SNK. In groups treated with caffeine 25 and 50mg/kg, both mothers and their puppies had focal alopecia and/or hypotrichosis. Despite the higher frequency of macroscopic changes on the mothers, these lesions were diffuse when present on the puppies. Histological analysis showed calcinosis of hair follicles in the mothers and their puppies. But morphometry revealed significant difference in the number of hair follicles from mothers, as well as a significant reduction of cell proliferation of hair follicles in the group treated with 50mg/kg of caffeine. Maternal cortisol levels were significantly elevated in the group treated with 100mg/kg of caffeine. It is concluded that caffeine intake by pregnant and lactating rats can cause skin lesions in both the mothers and their offspring, characterized by alopecia and/or hypotrichosis, regardless of serum levels of maternal cortisol.

Monilethrix: a typical case report with microscopic and dermatoscopic findings

Monilethrix is a rare hereditary condition generally considered to be an autosomal dominant disorder with variable penetrance. A case of a 6-year-old girl without a familial background for this disease is reported. The diagnosis was made by optic microscopy and dermoscopy. A therapeutic trial with topical minoxidil was conducted.

Bazex-Dupre-Christol syndrome - a memorable family

Bazex-Dupre-Christol syndrome [BDCS] is clinically characterized by multiple basal cell carcinomas of the face occurring mainly during the second and third decade of life, follicular atrophoderma predominantly of the dorsum of hands and feet and generalized hypotrichosis, sometimes with pili torti and trichorrhexis nodosa. Common associated features are milia, hypohidrosis and calcifying epithelial tumours. We herein report four members of one family with BDC syndrome, a mother and her three daughters. In the mother and one daughter, the clinical picture was very typical with all major features, whereas in the others only follicular atrophoderma, milia and hypotrichosis were present. BDCS is a hereditary multiple BCC syndrome whose pattern of inheritance is thought to be X-linked dominant, which implies that all daughters of the affected mothers should have this disease. In this case three out of four daughters are suffering from BDCS but one is totally asymptomatic. To our knowledge, this is the first report of a family with BDC from Pakistan

Displasia ectodérmica hipohidróticaa en dos hermanas / Hypohidrotic ectodermal dysplasia in two sisters

La displasia ectodérmica hipohidrótica es un síndrome congénito, caracterizado por la tríada hipohidrosis, hipotricosis e hipodoncia no progresivas. La forma más común es lade herencia recesiva ligada al cromosoma X, aunque también existe una autosómica recesiva y otra dominante. Su tratamiento incluye un manejo interdisciplinario, con medidas de soporte para las manifestaciones clínicas del trastorno y el asesoramiento genético familiar.

Hypohidrotic ectodermal dysplasia is a congenital syndrome characterized by the triad of hypohidrosis, hypotrichosis and non-progressivehypodontia. The most common form is the one inherited in a recessive X-linked way, although there is also an autosomal recessive and a dominant ones. Treatment includes the interdisciplinary management, supportive for the clinical manifestations of the disorder and family genetic counseling.

Bazex Syndrome / Sindrome de Bazex

Acrokeratosis Paraneoplastica or Bazex syndrome is a dermatologic manifestation usually associated with the diagnosis of squamous cell carcinoma of the upper aerodigestive tract. We report a case with exuberant clinical manifestations, exemplifying the typical cutaneous lesions in this rare syndrome, in a patient with squamous cell carcinoma of the esophagus.

Acroceratose paraneoplásica ou síndrome de Bazex é uma manifestação cutânea paraneoplásica rara, geralmente associada a carcinoma de células escamosas do trato aerodigestivo superior. Relata-se um caso com manifestações clínicas exuberantes, ilustrativo quanto às lesões cutâneas típicas da síndrome, em paciente portadora de carcinoma de células escamosas do esôfago.

Do you know this syndrome? / Voce conhece esta sindrome?

POEMS syndrome is a unique clinical entity, the diagnosis of which is made when polyneuropathy and monoclonal gammopathy occur together, associated with other changes such as organomegaly, endocrinopathy, skin changes and papilledema. Cutaneous manifestations are heterogeneous, with diffuse cutaneous hyperpigmentation, hemangiomas and hypertrichosis occurring more frequently. We report the case of a 65- year-old female patient with this syndrome, diagnosed after 15 years of disabling peripheral neuropathy.

A síndrome de POEMS é uma entidade clínica única cujo diagnóstico é colocado quando existe polineuropatia e gamapatia monoclonal associada a outras alterações tais como organomegalia, endocrinopatia, alterações cutâneas e papiledema. As manifestações cutâneas são heterogéneas, sendo as mais frequentes a hiperpigmentação cutânea difusa, os hemangiomas e a hipertricose. Relata-se o caso de uma doente de 65 anos com essa síndrome diagnosticada após 15 anos de neuropatia periférica.

Graham-Little Piccardi Lassueur Syndrome: case report / Síndrome de Graham-Little Piccardi Lassueur: relato de caso

A 33-year-old woman presented with a 3-year history of progressive alopecia of the scalp. Past treatment with hydroxicloroquine did not show improvement. Physical examination revealed multiple areas of alopecia with atrophic aspect of the scalp, and axillary and pubic hypotrichosis. Dermoscopy showed hyperkeratosis and accentuation of follicular ostia. Anatomopathological examination revealed decrease in the number of hair follicles, upper perifollicular infiltrate and areas with fibrosis. The Piccardi-Lassueur-Graham-Little syndrome is a rare disorder, characterized by the triad of multifocal scarring alopecia of the scalp, keratotic follicular eruption and hypotrichosis of axillary and pubic regions. Management is a challenge and many medications tried have controversial results. We report a case of this rare syndrome which improved with corticoids.

Mulher, 33 anos, apresenta quadro de alopecia progressiva do couro cabeludo há 3 anos. Tratamento com hidroxicloroquina há 12 meses, sem apresentar melhora. Ao exame físico exibe múltiplas áreas de alopecia cicatricial no couro cabeludo, além de hipotricose axilar e pubiana. A dermatoscopia evidencia hipercetose folicular e acentuação dos óstios foliculares. O exame anatomopatológico revela diminuição do número de folículos pilosos, infiltrado perifolicular e fibrose. A síndrome de Graham-Little Piccardi Lassueur é uma dermatose rara, caracterizada pela tríade de alopecia cicatricial multifocal do couro cabeludo, ceratose folicular disseminada e hipotricose das regiões axilares e pubianas. A terapêutica desta dermatose é um desafio, muitas medicações relatadas tem resultados controversos. Relatamos o caso desta síndrome rara que apresentou melhora com corticoterapia.

Clinical investigation of a Chinese family with hypotrichosis simplex of the scalp and mutational analysis of CDSN gene / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze clinical symptoms and disease-causing mutations of corneodesmosin (CDSN) gene in a Chinese family affected with hypotrichosis simplex of the scalp and to establish a method for prenatal diagnosis.</p><p><b>METHODS</b>Family survey and clinical examinations were carried out to determine the inheritance pattern. Three patients and 7 unaffected relatives from the family, in addition with 100 unrelated healthy controls were recruited. Genomic DNA from peripheral blood leukocytes was extracted. Five pairs of primers were designed based on the CDSN gene sequence. Exons and flanking regions of the CDSN gene were amplified using polymerase chain reaction (PCR). Potential mutations were analyzed through direct sequencing and comparison by BLAST.</p><p><b>RESULTS</b>The type of alopecia of the family was diagnosed as hypotrichosis simplex of the scalp with an autosomal dominant inheritance pattern. A nonsense mutation (C717G) in cDNA sequence of the CDSN gene was identified in all three patients of the family, which resulted in a premature stop codon (Y239X). The same mutation was not found among healthy members of the family and 100 healthy controls.</p><p><b>CONCLUSION</b>A Chinese family was diagnosed with hypotrichosis simplex of the scalp, which was caused by a novel nonsense mutation (Y239X) in the CDSN gene.</p>

Two Cases of Hallermann-Streiff Syndrome Diagnosed in Early Neonatal Period

Hallermann-Streiff syndrome is a very rare congenital disorder, which is primarily characterized by the head and face abnormalities. Approximately 180 cases have been reported worldwide, including 8 cases in Korea since it was first described by Hallermann in 1893. Patients exhibit a bird-like face, hypotrichosis, atrophy of skin, dental abnormalities, proportionate nanism, and various ophthalmic disorders, including congenital cataracts and bilateral micropthalmia. As a result of many life-threatening complications, such as respiratory and cardiac difficulties, many patients die during infancy. We report here two cases of HSS diagnosed immediately after birth with literature reviews. They showed two additional characteristics, including chubby cheeks and antenatal ultrasonographic findings, which have not been mentioned in previous reports.

Hypohidrotic Ectodermal Dysplasia Associated with Glucose-6-Phosphate Dehydrogenase Deficiency

Hypohidrotic ectodermal dysplasia (HED) is a syndrome characterized by hypodontia, hypotrichosis, and partial or total ecrine sweat gland deficiency. The most prevalent form of HED is inherited as an X linked pattern. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is an X-linked recessive disease, which leads to hemolytic anemia and jaundice. It is expressed in males, while heterozygous females are usually clinically normal. A 12-year-old boy with the complaints of hair and eyebrow disturbances, teeth disfigurement, decreased sweating, and xerosis presented to the outpatient clinic. Dermatological examination revealed sparse hair and eyebrows, conical-shaped teeth, xerosis, syndactylia, transverse grooves, and discoloration of nails. Laboratory findings indicated anemia. His 3-year-old sister also had sparse hair and eyebrows, xerosis, and syndactylia. We learned that the patient had a previous history of neonatal jaundice and a diagnosis of G-6-PD deficiency. Although it has been shown that loci of ectodermal dysplasia and G-6-PD deficiency genes are near to one another, we did not find any case study reporting on occurrence of these two genetic diseases together. With the aspect of this rare and interesting case, the relationship between HED and G-6-PD deficiency was defined.

Non-familial Generalized Hypotrichosis Simplex / 대한피부과학회지

Hypotrichosis simplex is a descriptive term of hair loss without other ectodermal or systemic abnormalities. Hypotrichosis simplex with non-familial and generalized types has been seldom reported. A 30-year-old man visited our clinic complaining of scalp hair loss since birth. There was no hair on the arms, axillae and legs. He had relatively scanty eyebrows and pubic hairs. None of his family members had known health problems or any hereditary disease. Hair shaft examination based on electron microscopy did not reveal any structural abnormalities. Microscopic examination of a scalp biopsy specimen showed a reduced number of hair follicles with vellus hairs replacing terminal hairs. Herein we report a rare and interesting case of non-familial generalized hypotrichosis simplex.

Algoritmo para as alopécias cicatriciais e suas opções de tratamento / Algorithm for approaching scar alopecia and treatment options

A cirurgia plástica dispõe de um variado arsenal de técnicas para o tratamento das alopéciascicatriciais. A correção cirúrgica dos defeitos do couro cabeludo deve começar por uma sistematizaçãoda classificação das lesões. A proposta de um algoritmo tem por objetivo organizarde maneira racional as opções para cada caso, sem, no entanto, substituir o julgamento e acriatividade do cirurgião. Este trabalho apresenta um raciocínio clínico que poderá facilitara escolha da melhor opção cirúrgica para corrigir cicatrizes do couro cabeludo.

Plastic surgery has a varied arsenal of techniques for the treatment of scar alopecia. Thesurgical correction of scalp defects should begin with a systematic classification of thetype of injury. An algorithm has been developed that rationalizes and organizes the surgicaloptions in each case, without attempting to replace the surgeon’s judgment and creativity.This paper presents a clinical analysis that could assist the selection of the best surgicalalternative for different cases of scar alopecia.

Acrokeratosis Paraneoplastica with Adenocarcinoma of the Colon Treated with Topical Tretinoin

Acrokeratosis paraneoplastica, or Bazex syndrome, is one of the paraneoplastic syndromes. The characteristic skin lesions include palmoplantar keratoderma, psoriasiform skin lesions, hyperpigmentation, and nail dystrophy. The most common associated neoplasms are squamous cell carcinoma of the upper respiratory tract and other kinds of tumors with cervical lymph node metastasis. A 63-year-old woman presented with an 11 month history of hyperkeratotic lesions on the palms and soles. Ten months before she had been diagnosed with adenocarcinoma of the colon and undergone a left hemicolectomy. We report a case of acrokeratosis paraneoplastica associated with colon cancer which persisted after removal of the primary cancer, but resolved with topical tretinoin treatment.

A case of Hallermann-Streiff syndrome with aphakia / 소아과

Hallermann-Streiff syndrome is a rare disease. Approximately 150 cases have been reported, including 6 cases in Korea. The authors experienced a case of Hallermann-Streiff syndrome in a 6-year-old female with aphakia. The syndrome is characterized by a bird-like face, dental abnormalities, hypotrichosis, atrophy of the skin, bilateral microphthalmia, and proportionate dwarfism. A brief review of the literature was conducted.

A Case of Anhidrotic Ectodermal Dysplasia with Atrophic Rhinitis / 대한이비인후과학회지

Anhidrotic ectodermal dysplasia is a rare genetic disorder characterized by absence or diminished numbers of structures derived from the ectoderm, and it is reported to be inherited as an x-linked recessive trait. It is recognized clinically by anhidrosis, hypotrichosis, anodontia or reduced numbers of teeth with deformed shape and characteristic facial features. In addition, otolaryngological manifestations include atrophic rhinitis, sensorineural hearing loss, and conductive hearing loss and satyr ear, among others. Early diagnosis of anhidrotic ectodermal dysplasia can prevent fatal hyperpyrexia and appropriate genetic counseling can be followed to make a reasonable future plans for the pediatric patient. A 2-month-old infant was referred with symptoms of intermittent nasal obstruction and crust formation in both nasal cavities. The nasal endoscope demonstrated atrophic changes of nasal mucosa and radiologic study showed an unerupted conical shaped tooth. The diagnosis of anhidrotic ectodermal dysplasia was confirmed with the finger impression test that revealed deficiency of sweat pores. We report a case of anhidrotic ectodermal dysplasia with a review of the literature.

A Case of Familial Basaloid Follicular Hamartoma Syndrome / 대한피부과학회지

Basaloid follicular hamartoma is a benign adnexal tumor consisting of basaloid cells with follicular differentiation. It can present as a solitary lesion, multiple lesions, or an autosomal dominant inherited syndrome (basaloid follicular hamartoma syndrome). Basaloid follicular hamartoma syndrome is a rare adnexal tumor genodermatosis, which is characterized by autosomal dominant inheritance, histologically proven basaloid follicular hamartomas and associated findings including hypotrichosis, palmar/plantar pitting and hypohidrosis, etc. Herein, we report a case of 4-year-old girl with familial generalized basaloid follicular hamartoma syndrome.