Yaşar Şirin, Ersanli Ayşegül, Göktay Fatih, Aytekin Sema, Cebeci Dua, Güneş Pembegül
Department of Dermatology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Department of Ophthalmology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
J Dermatol. 2017 Jan;44(1):29-35. doi: 10.1111/1346-8138.13510. Epub 2016 Jul 21.
Partial unilateral lentiginosis (PUL) is a rare pigmentation disorder characterized by numerous lentigines with sharp margins in the midline in one or more dermatomes. Its segmental pattern suggests that this presentation accompanied by café-au-lait spots, Lisch nodule or neurofibromas has a close relationship with mosaic neurofibromatosis type 1 or segmental neurofibromatosis (NF) in particular. In a group of 16 patients with PUL, who presented at the dermatology outpatient clinic between 1998 and 2015, an examination was made of consanguineous marriage in the family history, the presence of a similar lesion or NF in first-degree relatives, neurofibroma in the physical examination, the involvement pattern, axillary/inguinal freckling and the presence and number of café-au-lait spots. The ophthalmological examination investigated Lisch nodule and optic glioma. The skeletal system was examined for NF involvement. Of 16 patients, 13 (81.2%) were female and three (18.8%) were male with a mean age of 31.19 years (range, 15-48). There was no family history of PUL in any case. Consanguineous marriage was absent in 15 patients (93.8%). While there were accompanying café-au-lait spots in three patients (18.8%). Lisch nodule was an accompanying finding in three patients (18.8%). Axillary freckling was detected in four (25%) patients. Neurofibroma was found in only one patient. Although café-au-lait spots, axillary freckling, neurofibroma and Lisch nodule were present in a small number of the patients, the presence of the findings may be considered to be specific to NF suggests that PUL is a variant of mosaic NF-1. Genetic studies will help to further elucidate this subject.
部分单侧雀斑样痣(PUL)是一种罕见的色素沉着障碍,其特征为在一个或多个皮节的中线处有许多边界清晰的雀斑样痣。其节段性模式表明,这种伴有咖啡斑、Lisch结节或神经纤维瘤的表现尤其与1型镶嵌型神经纤维瘤病或节段性神经纤维瘤病(NF)密切相关。在1998年至2015年间到皮肤科门诊就诊的16例PUL患者中,对其家族史中的近亲结婚情况、一级亲属中是否存在类似病变或NF、体格检查中的神经纤维瘤、受累模式、腋窝/腹股沟雀斑以及咖啡斑的存在情况和数量进行了检查。眼科检查调查了Lisch结节和视神经胶质瘤。对骨骼系统进行了NF受累情况检查。16例患者中,13例(81.2%)为女性,3例(18.8%)为男性,平均年龄31.19岁(范围15 - 48岁)。所有病例均无PUL家族史。15例患者(93.8%)无近亲结婚情况。3例患者(18.8%)伴有咖啡斑。3例患者(18.8%)伴有Lisch结节。4例(25%)患者检测到腋窝雀斑。仅1例患者发现神经纤维瘤。虽然少数患者存在咖啡斑、腋窝雀斑、神经纤维瘤和Lisch结节,但这些发现的存在可能被认为是NF所特有的,这表明PUL是镶嵌型NF - 1的一种变体。基因研究将有助于进一步阐明这一问题。