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[儿童皮肤脆性遗传性疾病]

[Genetic diseases with skin fragility in children].

作者信息

Gewert Stella, Trefzer Laura

机构信息

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

出版信息

Dermatologie (Heidelb). 2024 Dec;75(12):913-923. doi: 10.1007/s00105-024-05431-7. Epub 2024 Nov 28.

Abstract

BACKGROUND

Genetic diseases leading to skin fragility are clinically and genetically heterogeneous. Dermatologists and pediatricians should be familiar with the variability of manifestations and manifestation age, in order to differentiate these rare diseases from more common causes of blistering, such as infectious (impetigo contagiosa, herpes infection) or traumatic causes (burns, scalds). This is essential to initiate appropriate diagnostic measures, provide information on treatment and prevention and to refer to specialized centers.

OBJECTIVES

The classification of the diseases discussed here is based on the clinical appearance, the histologic cleavage level, and genetic alterations. These diseases are all rare and pathogenetically only partially understood. Treatment methods are mostly symptomatic; causal therapies are the exception. Thanks to advances in mutation detection methods and the assumption of costs for massive parallel sequencing (since 2021) by health insurance companies, rare diseases have moved from the focus of academic research into everyday clinical practice. Due to the rarity, variability of the phenotype and, in many cases, high need for care, it is important in everyday clinical practice to be able to apply a pathway for suspected diagnoses and to work together with specialized colleagues and care centers.

MATERIALS AND METHODS

This study provides an overview of genetic diseases with skin fragility in childhood.

RESULTS AND DISCUSSION

Knowledge of the underlying mechanisms leading to skin fragility in childhood can help to recognize rare differential diagnoses from more common infectious and traumatic causes of blistering. This is necessary to enable adequate treatment and referral to specialized care centers and colleagues.

摘要

背景

导致皮肤脆弱的遗传性疾病在临床和遗传方面具有异质性。皮肤科医生和儿科医生应熟悉其表现形式及发病年龄的变异性,以便将这些罕见疾病与水疱形成的更常见原因区分开来,如水疱形成的更常见原因,如传染性(脓疱疮、疱疹感染)或创伤性原因(烧伤、烫伤)。这对于启动适当的诊断措施、提供治疗和预防信息以及转诊至专业中心至关重要。

目的

此处讨论的疾病分类基于临床表现、组织学分裂水平和基因改变。这些疾病均很罕见,其发病机制仅部分为人所知。治疗方法大多为对症治疗;病因治疗则为例外情况。由于突变检测方法的进步以及自2021年起健康保险公司承担大规模平行测序的费用,罕见疾病已从学术研究的焦点转向日常临床实践。鉴于其罕见性、表型的变异性以及在许多情况下对护理的高需求,在日常临床实践中能够应用疑似诊断的路径并与专业同事及护理中心合作非常重要。

材料与方法

本研究概述了儿童期具有皮肤脆弱性的遗传性疾病。

结果与讨论

了解导致儿童皮肤脆弱的潜在机制有助于从水疱形成的更常见传染性和创伤性原因中识别罕见的鉴别诊断。这对于实现充分治疗并转诊至专业护理中心和同事处是必要的。

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