RESUMEN
Dermatofibromas (DFs) are common, benign fibrous skin tumors that can occur at any skin site. In most cases, DFs are solitary and sporadic, but a few are multiple and familial, and the mechanisms leading to these lesions are currently unclear. Using exome sequencing, we have identified a heterozygous variant in a pedigree with autosomal dominant multiple familial DF within RND3 (c.692C>T,p.T231M) that encodes for the small GTPase RhoE, a regulator of the actin cytoskeleton. Expression of T231M-RhoE or RhoE depletion using CRISPR in human dermal fibroblasts increased proliferation and adhesion to extracellular matrix through enhanced ß1 integrin activation and more disorganized matrix. The enzyme PLOD2 was identified as a binding partner for RhoE, and the formation of this complex was disrupted by T231M-RhoE. PLOD2 promotes collagen cross-linking and activation of ß1 integrins, and depleting PLOD2 in T231M-RhoE-expressing cells reduced T231M-RhoE-mediated ß1 integrin activation and led to increased matrix alignment. Immunohistochemical analysis revealed reduced expression of RhoE but increased expression of PLOD2 in the dermis of DF skin samples compared with that of the controls. Our data show that loss of RhoE function leads to increased PLOD2 activation, enhancing integrin activation and leading to a disorganized extracellular matrix, contributing to DF.
Asunto(s)
Histiocitoma Fibroso Benigno , Neoplasias Cutáneas , Humanos , Integrina beta1/genética , Integrina beta1/metabolismo , Matriz Extracelular , Piel , Fibroblastos/metabolismo , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/metabolismoAsunto(s)
Displasia Ectodérmica , Epidermólisis Ampollosa de la Unión , Epidermólisis Ampollosa , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/genética , Epidermólisis Ampollosa/diagnóstico , Epidermólisis Ampollosa/genética , Epidermólisis Ampollosa de la Unión/diagnóstico , Epidermólisis Ampollosa de la Unión/genética , Humanos , Integrina beta4/genética , MutaciónRESUMEN
Autosomal recessive dystrophic epidermolysis bullosa (RDEB) is characterized by recurrent mucocutaneous blistering with non-healing ulcers which are often complicated by squamous cell carcinoma (SCC). Despite having as high as 80% death rate from SCC, RDEB still does not have an effective treatment. We report on the efficacy of single follicular unit extract (FUE) grafting to heal chronic ulcers of intermediate RDEB in a 54-year-old woman with extensive chronic wounds covering around 30% of the body surface area. On Day 17 post first graft session, the area of treated ulcers on her right upper back was reduced by 80%. Immunofluorescence study revealed positive type VII collagen expression along the epidermal and follicular basement membrane zone in the donor and recipient sites. A few grafted follicles continued to grow hair on the recipient sites. A total of 360 FUEs were grafted in nine sessions over five years, resulting in healing of most treated ulcers and reduced significantly her time for daily wound dressing. Importantly, FUE grafting using patient's own scalp follicles does not require any laboratory manipulation. It is safe and easy to perform. Autologous follicular grafting appears efficacious for healing of recalcitrant wounds and provides an innovative solution for RDEB patients with such wounds.
Asunto(s)
Epidermólisis Ampollosa Distrófica/cirugía , Folículo Piloso/cirugía , Trasplante Autólogo/métodos , Cicatrización de Heridas/fisiología , Femenino , Humanos , Persona de Mediana Edad , Úlcera/cirugíaAsunto(s)
Amiloidosis Familiar/genética , ADN/genética , Glicoproteínas de Membrana/genética , Mutación , Enfermedades Cutáneas Genéticas/genética , Amiloidosis Familiar/metabolismo , Análisis Mutacional de ADN , Humanos , Glicoproteínas de Membrana/metabolismo , Enfermedades Cutáneas Genéticas/metabolismoAsunto(s)
Dapsona/uso terapéutico , Lupus Eritematoso Cutáneo/complicaciones , Lupus Eritematoso Cutáneo/patología , Prurito/tratamiento farmacológico , Vasculitis Leucocitoclástica Cutánea/patología , Biopsia con Aguja , Humanos , Inmunohistoquímica , Lupus Eritematoso Cutáneo/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Multimorbilidad , Pronóstico , Prurito/complicaciones , Prurito/patología , Índice de Severidad de la Enfermedad , Enfermedades Cutáneas Vesiculoampollosas/complicaciones , Enfermedades Cutáneas Vesiculoampollosas/tratamiento farmacológico , Enfermedades Cutáneas Vesiculoampollosas/patología , Resultado del Tratamiento , Vasculitis Leucocitoclástica Cutánea/complicaciones , Vasculitis Leucocitoclástica Cutánea/tratamiento farmacológicoRESUMEN
Collagen is a rich component in skin that provides skin structure integrity; however, its contribution to the absorption and scattering properties of various types of skin has not been extensively studied. We considered the contribution of the collagen to the absorption spectrum of in vivo normal skin and keloids of 12 subjects derived from our diffuse reflectance spectroscopy (DRS) system in the wavelength range from 550 to 860 nm. It was found that the collagen concentration, the hemoglobin oxygen saturation, and the reduced scattering coefficient of keloids were remarkably different from that of normal skin. Our results suggest that our DRS system could assist clinicians in understanding the functional and structural condition of keloid scars. In the future, we will evaluate the accuracy of our system in the keloid diagnosis and investigate the applicability of our system for other skin-collagen-related studies.
Asunto(s)
Acné Queloide/diagnóstico , Acné Queloide/metabolismo , Colágeno/análisis , Hemoglobinas/análisis , Piel/química , Análisis Espectral/métodos , Biomarcadores/análisis , Humanos , Luz , Valores de Referencia , Reproducibilidad de los Resultados , Dispersión de Radiación , Sensibilidad y EspecificidadRESUMEN
Type 2 segmental manifestation of autosomal dominant dermatoses refers to pronounced segmental lesions superimposed on the ordinary nonsegmental phenotype, indicating loss of heterozygosity occurring at an early stage of embryogenesis. We describe a 20-year-old Taiwanese woman with typical lesions of neurofibromatosis type 1 (NF1) in the form of characteristic café-au-lait spots, neurofibromas, axillary freckling and Lisch nodules. In addition, a giant garment-like or "bathing-trunk" café-au-lait macule involved the lower half of the trunk, the buttocks, and parts of the thighs, being superimposed on the ordinary smaller spots of NF1. This large café-au-lait macule may be best explained as an example of type 2 segmental NF1. A novel mutation (3009delG) in exon 23 was also identified in this patient, which has not yet been described in sporadic and familial NF1.