Koutra Eleni, Lusmöller Elke, Fischer Judith, Komlosi Katalin, Stadler Rudolf, Gutzmer Ralf
Universitätsklinik für Dermatologie, Venerologie, Allergologie und Phlebologie, Johannes Wesling Klinikum Minden, Hans-Nolte-Str. 1, 32429, Minden, Deutschland.
Institut für Humangenetik, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Dermatologie (Heidelb). 2024 Jun;75(6):486-491. doi: 10.1007/s00105-024-05308-9. Epub 2024 Feb 16.
We report a case of a 29-year-old woman with subtle partial erythematous, partial hyperpigmented streaks along the Blaschko's lines on the right side of the body since early childhood. Primary DNA results of the skin and blood assay diagnosed focal dermal hypoplasia in mosaic form. The postzygotic mutation in the PORCN gene was only detectable in the affected skin and not in the blood assay. This article illustrates that clinically very discrete hypopigmentation and poikiloderma along Blaschko lines should raise awareness for robust diagnostic analysis in order to recognize this variable multisystem disease and to ensure an appropriate search for extracutaneous abnormalities and human genetic counseling, ideally before pregnancy. Careful correlation of clinical, histological, and genetic features along with close multidisciplinary cooperation of specialists from the fields of human genetics, dermatology, pediatrics, orthopedics and ophthalmology is crucial for final diagnosis, assessment of the prognosis and targeted genetic counseling of affected individuals.
我们报告了一例29岁女性病例,自幼年起,其身体右侧沿布拉斯科线出现细微的部分红斑、部分色素沉着条纹。皮肤和血液检测的初步DNA结果诊断为镶嵌型局灶性真皮发育不全。PORCN基因的合子后突变仅在受影响的皮肤中可检测到,而在血液检测中未检测到。本文表明,临床上沿布拉斯科线非常离散的色素减退和皮肤异色症应提高对进行全面诊断分析的认识,以便识别这种多变的多系统疾病,并确保在理想情况下,在怀孕前对皮肤外异常进行适当检查并提供人类遗传咨询。临床、组织学和遗传学特征的仔细关联,以及人类遗传学、皮肤科、儿科、骨科和眼科领域专家的密切多学科合作,对于最终诊断、预后评估以及对受影响个体进行针对性的遗传咨询至关重要。