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病例报告:一例梅勒达病诊断中的挑战以及使用司库奇尤单抗和阿达木单抗的治疗尝试

Case Report: Challenges in the Diagnosis of a Case of Mal de Meleda and a Therapeutic Attempt of Ixekizumab and Adalimumab.

作者信息

Dai Yuwei, Zheng Xiaodong, Zhang Qi, Hu Xia, Wang Peiguang, Yang Sen

机构信息

Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, China.

Institute of Dermatology, Anhui Medical University, Hefei, China.

出版信息

Front Med (Lausanne). 2022 Mar 10;9:821301. doi: 10.3389/fmed.2022.821301. eCollection 2022.

DOI:10.3389/fmed.2022.821301
PMID:35360724
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8961326/
Abstract

BACKGROUND

Mal de Meleda (MDM, OMIM 248300) is an autosomal recessive disease characterized by symmetrical and progressive palmoplantar hyperkeratosis soon after birth. Mutations in gene could lead to MDM. Clinically, MDM is easily misdiagnosed as other types of keratoderma due to phenotypic variation and overlap.

OBJECTIVE AND METHODS

A patient with suspected MDM was confirmed by the combination of next-generation sequencing and Exomiser, and the patient was attempted with the treatment of Ixekizumab and Adalimumab.

RESULTS

A homozygous mutation c.256G>A (p.Gly86Arg) in the gene was identified in the patient. The inflammatory erythemas on his hands, feet and buttocks were mildly relieved after the treatment of high dose of Ixekizumab.

CONCLUSIONS

Our findings helps to enhance the understanding of MDM. Ixekizumab may be a potential strategy to treat MDM.

摘要

背景

梅勒达病(MDM,OMIM 248300)是一种常染色体隐性疾病,其特征为出生后不久即出现对称性进行性掌跖角化过度。该基因的突变可导致MDM。临床上,由于表型变异和重叠,MDM很容易被误诊为其他类型的角化病。

目的与方法

一名疑似MDM的患者通过二代测序和Exomiser软件相结合得到确诊,并尝试使用司库奇尤单抗和阿达木单抗对该患者进行治疗。

结果

在该患者中鉴定出该基因的一个纯合突变c.256G>A(p.Gly86Arg)。高剂量司库奇尤单抗治疗后,他手部、足部和臀部的炎性红斑得到轻度缓解。

结论

我们的研究结果有助于增强对MDM的理解。司库奇尤单抗可能是治疗MDM的一种潜在策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/2e45ed81c8ca/fmed-09-821301-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/ed3b8339ad74/fmed-09-821301-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/54d34babf5af/fmed-09-821301-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/2e45ed81c8ca/fmed-09-821301-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/ed3b8339ad74/fmed-09-821301-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/54d34babf5af/fmed-09-821301-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7cb/8961326/2e45ed81c8ca/fmed-09-821301-g0003.jpg

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Case Report: Challenges in the Diagnosis of a Case of Mal de Meleda and a Therapeutic Attempt of Ixekizumab and Adalimumab.病例报告:一例梅勒达病诊断中的挑战以及使用司库奇尤单抗和阿达木单抗的治疗尝试
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本文引用的文献

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First report of Mal de Meleda with pseudo-ainhum treated with gabapentin in a 17-year-old Chinese girl.17岁中国女孩患伴有假自发性断指症的梅勒达病,用加巴喷丁治疗的首例报告。
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New Pathways for the Skin's Stress Response: The Cholinergic Neuropeptide SLURP-1 Can Activate Mast Cells and Alter Cytokine Production in Mice.皮肤应激反应的新途径:胆碱能神经肽 SLURP-1 可激活肥大细胞并改变小鼠细胞因子的产生。
Front Immunol. 2021 Mar 18;12:631881. doi: 10.3389/fimmu.2021.631881. eCollection 2021.
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Biochemical Basis of Skin Disease Mal de Meleda: SLURP-1 Mutants Differently Affect Keratinocyte Proliferation and Apoptosis.
遗传性少汗性外胚叶发育不良(Mal de Meleda)的皮肤疾病的生化基础:SLURP-1 突变体对角质形成细胞增殖和凋亡的影响不同。
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Mal de Meleda with homozygous mutation p.G86R in SLURP-1.伴有SLURP-1基因纯合突变p.G86R的梅勒达病
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Erythrokeratodermia variabilis et progressiva.进行性变异性红角皮病
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IL-22/STAT3-Induced Increases in SLURP1 Expression within Psoriatic Lesions Exerts Antimicrobial Effects against Staphylococcus aureus.白细胞介素-22/信号转导和转录激活因子3诱导银屑病皮损中SLURP1表达增加,对金黄色葡萄球菌发挥抗菌作用。
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Mal de Meleda: A Focused Review.遗传性少毛症:聚焦综述。
Am J Clin Dermatol. 2016 Feb;17(1):63-70. doi: 10.1007/s40257-015-0157-1.
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Erythrokeratodermia variabilis et progressiva allelic to oculo-dento-digital dysplasia.进行性红斑角化病可变型与眼-齿-指(趾)发育不良等位基因。
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