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[伴有血管性皮肤异常的综合征]

[Syndromes with vascular skin anomalies].

作者信息

Happle Rudolf

机构信息

Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Hauptstr. 7, 79104, Freiburg, Deutschland.

出版信息

Hautarzt. 2019 Jul;70(7):474-480. doi: 10.1007/s00105-019-4418-4.

Abstract

BACKGROUND

In many complex genetic syndromes, various distinct capillary nevi may serve as diagnostic clues.

OBJECTIVE

To render dermatologists in practice capable of recognizing and classifying such cutaneous markers.

MATERIAL AND METHODS

On the basis of the literature and own observations, this review describes 14 different syndromes associated with capillary nevi that can be recognized by dermatologists as a diagnostic indication.

RESULTS

The following capillary nevi can be distinguished for syndrome recognition: nevus flammeus of the Sturge-Weber syndrome (GNAQ), port-wine nevus of the Proteus type (AKT1), port-wine nevus of the PIK3CA-related overgrowth spectrum (PROS) type, midfacial port-wine patch of the PROS type, reticulate capillary nevus heralding megalencephaly-capillary nevus syndrome that is likewise part of PROS, cutis marmorata telangiectatica congenita (van Lohuizen syndrome), nevus roseus, nevus vascularis mixtus, rhodoid nevus (RASA1), nevus anemicus as a diagnostic indication of neurofibromatosis 1 and Carter-Mirzaa macules (STAMBP).

CONCLUSION

A diagnostic difficulty lies in the fact that not all syndromes associated with capillary nevi have been elucidated at the molecular level. For this reason, the preliminary dimension of the present review should be borne in mind. On the other hand, dermatologists in practice now have the fascinating chance to stimulate further advances in this particular field of knowledge by asking experts in dermatology, pediatrics or medical genetics how to solve the problem of molecular syndrome recognition in a puzzling case.

摘要

背景

在许多复杂的遗传综合征中,各种不同的毛细血管痣可作为诊断线索。

目的

使皮肤科医生在实践中能够识别和分类此类皮肤标志物。

材料与方法

基于文献和自身观察,本综述描述了14种与毛细血管痣相关的不同综合征,皮肤科医生可将其识别为诊断指征。

结果

为了综合征识别可区分出以下毛细血管痣:斯特奇-韦伯综合征(GNAQ)的焰色痣、变形杆菌型(AKT1)的葡萄酒色斑、PIK3CA相关过度生长谱系(PROS)型的葡萄酒色斑、PROS型的面中部葡萄酒色斑、预示巨头畸形-毛细血管痣综合征(同样是PROS的一部分)的网状毛细血管痣、先天性大理石样皮肤毛细血管扩张症(范·洛胡伊岑综合征)、玫瑰痣、混合性血管痣、类胡萝卜素痣(RASA1)、作为神经纤维瘤病1诊断指征的贫血痣以及卡特-米尔扎斑(STAMBP)。

结论

诊断困难在于并非所有与毛细血管痣相关的综合征在分子水平上都已阐明。因此应牢记本综述的初步范围。另一方面,实践中的皮肤科医生现在有一个极好的机会,通过向皮肤科、儿科或医学遗传学专家请教如何解决疑难病例中分子综合征识别的问题,来推动这一特定知识领域的进一步发展。

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