Mosaic abnormalities of the skin: review and guidelines from the European Reference Network for rare skin diseases.


Journal

The British journal of dermatology
ISSN: 1365-2133
Titre abrégé: Br J Dermatol
Pays: England
ID NLM: 0004041

Informations de publication

Date de publication:
03 2020
Historique:
accepted: 19 03 2019
pubmed: 29 3 2019
medline: 15 5 2021
entrez: 29 3 2019
Statut: ppublish

Résumé

Cutaneous mosaicism is an area of dermatology in which there has been an explosion of knowledge within the current decade. This has led to fundamental changes in the understanding of the conditions in this field, and to an ongoing paradigm shift in the approach to management of mosaic skin disorders. To lay out the general principles of mosaicism as they are currently understood, summarize the known cutaneous mosaic abnormalities of the skin with associated phenotypic and genotypic information, review the latest trials on targeted therapies and propose guidelines for the general approach to a patient with suspected mosaicism. This was a consensus expert review as part of the European Reference Network project (ERN-Skin). This study provides clinicians with a practical approach to the patient with suspected mosaicism, redefines mosaicism for the modern genetic era, and proposes a new classification system based on genetic mechanism. What's already known about this topic? Cutaneous mosaicism is a complex field of dermatology that encompasses most birthmarks, and many rare syndromes. Some cutaneous patterns are known to be seen in mosaicism. Very few treatment options are available for most mosaic abnormalities of the skin. Recent high-sensitivity genetic techniques have led to an explosion of knowledge about genotype and phenotype in the literature. What does this study add? Expert consensus from the European Reference Network project. Review of knowledge of confirmed mosaic abnormalities of the skin, including cutaneous phenotype, extracutaneous associated features and genotype. Proposed new classification of mosaic abnormalities of the skin by genetic mechanism and therefore inheritance potential. Practical tips on correct sample collection and genetic investigation. Review of trials of targeted therapies. Guidelines for a practical clinical approach to the patient with suspected mosaicism.

Sections du résumé

BACKGROUND
Cutaneous mosaicism is an area of dermatology in which there has been an explosion of knowledge within the current decade. This has led to fundamental changes in the understanding of the conditions in this field, and to an ongoing paradigm shift in the approach to management of mosaic skin disorders.
OBJECTIVES
To lay out the general principles of mosaicism as they are currently understood, summarize the known cutaneous mosaic abnormalities of the skin with associated phenotypic and genotypic information, review the latest trials on targeted therapies and propose guidelines for the general approach to a patient with suspected mosaicism.
METHODS
This was a consensus expert review as part of the European Reference Network project (ERN-Skin).
CONCLUSIONS
This study provides clinicians with a practical approach to the patient with suspected mosaicism, redefines mosaicism for the modern genetic era, and proposes a new classification system based on genetic mechanism. What's already known about this topic? Cutaneous mosaicism is a complex field of dermatology that encompasses most birthmarks, and many rare syndromes. Some cutaneous patterns are known to be seen in mosaicism. Very few treatment options are available for most mosaic abnormalities of the skin. Recent high-sensitivity genetic techniques have led to an explosion of knowledge about genotype and phenotype in the literature. What does this study add? Expert consensus from the European Reference Network project. Review of knowledge of confirmed mosaic abnormalities of the skin, including cutaneous phenotype, extracutaneous associated features and genotype. Proposed new classification of mosaic abnormalities of the skin by genetic mechanism and therefore inheritance potential. Practical tips on correct sample collection and genetic investigation. Review of trials of targeted therapies. Guidelines for a practical clinical approach to the patient with suspected mosaicism.

Identifiants

pubmed: 30920652
doi: 10.1111/bjd.17924
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

552-563

Informations de copyright

© 2019 British Association of Dermatologists.

Références

Blaschko A. Die Nervenverteilung in der Haut in ihrer Beziehung zu den Erkrankungen der Haut. In: Bericht erstattet dem VII. Congress der Deutschen Dermatologischen Gesellschaft. Wilhelm Braumüller: Breslau, 1901.
Jackson R. The lines of Blaschko: a review and reconsideration: observations of the cause of certain unusual linear conditions of the skin. Br J Dermatol 1976; 95:349-60.
Happle R. Lethal genes surviving by mosaicism: a possible explanation for sporadic birth defects involving the skin. J Am Acad Dermatol 1987; 16:899-906.
Happle R. Mosaicism in human skin. Understanding the patterns and mechanisms. Arch Dermatol 1993; 129:1460-70.
Poblete-Gutierrez P, Wiederholt T, Konig A et al. Allelic loss underlies type 2 segmental Hailey-Hailey disease, providing molecular confirmation of a novel genetic concept. J Clin Invest 2004; 114:1467-74.
Weinstein LS, Shenker A, Gejman PV et al. Activating mutations of the stimulatory G protein in the McCune-Albright syndrome. N Engl J Med 1991; 325:1688-95.
Paller AS, Syder AJ, Chan YM et al. Genetic and clinical mosaicism in a type of epidermal nevus. N Engl J Med 1994; 331:1408-15.
Ju YS, Martincorena I, Gerstung M et al. Somatic mutations reveal asymmetric cellular dynamics in the early human embryo. Nature 2017; 543:714-18.
Rahbari R, Wuster A, Lindsay SJ et al. Timing, rates and spectra of human germline mutation. Nat Genet 2016; 48:126-33.
Kinsler VA. An introduction to mosaicism. In: Harper Textbook of Pediatric Dermatology, 4th edn. Chichester: Wiley; in press.
Keppler-Noreuil KM, Sapp JC, Lindhurst MJ et al. Clinical delineation and natural history of the PIK3CA-related overgrowth spectrum. Am J Med Genet Part A 2014; 164A:1713-33.
Thomas AC, Zeng Z, Riviere JB et al. Mosaic activating mutations in GNA11 and GNAQ are associated with phakomatosis pigmentovascularis and extensive dermal melanocytosis. J Invest Dermatol 2016; 136:770-8.
Shirley MD, Tang H, Gallione CJ et al. Sturge-Weber syndrome and port-wine stains caused by somatic mutation in GNAQ. N Engl J Med 2013; 368:1971-9.
Groesser L, Herschberger E, Ruetten A et al. Postzygotic HRAS and KRAS mutations cause nevus sebaceous and Schimmelpenning syndrome. Nat Genet 2012; 44:783-7.
Levinsohn JL, Sugarman JL, Bilguvar K et al. Somatic V600E BRAF mutation in linear and sporadic syringocystadenoma papilliferum. J Invest Dermatol 2015; 135:2536-8.
Al-Olabi L, Polubothu S, Dowsett K et al. Mosaic RAS/MAPK variants cause sporadic vascular malformations which respond to targeted therapy. J Clin Invest 2018; 128:1496-1508.
Etchevers HC, Rose C, Kahle B et al. Giant congenital melanocytic nevus with vascular malformation and epidermal cysts associated with a somatic activating mutation in BRAF. Pigment Cell Melanoma Res 2018; 31:437-41.
Kinsler VA, Krengel S, Riviere JB et al. Next-generation sequencing of nevus spilus-type congenital melanocytic nevus: exquisite genotype-phenotype correlation in mosaic RASopathies. J Invest Dermatol 2014; 134:2658-60.
Lindhurst MJ, Sapp JC, Teer JK et al. A mosaic activating mutation in AKT1 associated with the Proteus syndrome. N Engl J Med 2011; 365:611-19.
Kinsler VA, Abu-Amero S, Budd P et al. Germline melanocortin-1-receptor genotype is associated with severity of cutaneous phenotype in congenital melanocytic nevi: a role for MC1R in human fetal development. J Invest Dermatol 2012; 132:2026-32.
Beachkofsky TM, Sapp JC, Biesecker LG et al. Progressive overgrowth of the cerebriform connective tissue nevus in patients with Proteus syndrome. J Am Acad Dermatol 2010; 63:799-804.
Twede JV, Turner JT, Biesecker LG et al. Evolution of skin lesions in Proteus syndrome. J Am Acad Dermatol 2005; 52:834-8.
Biesecker LG, Sapp JC. Proteus syndrome. GeneReviews. Available at: https://www.ncbi.nlm.nih.gov/books/NBK99495/ (accessed 22 May 2019).
Crenshaw MM, Goerlich CG, Ivey LE et al. Orthopaedic management of leg-length discrepancy in Proteus syndrome: a case series. J Pediatr Orthop 2018; 38:e138-44.
Fusco F, Conte MI, Diociauti A et al. Unusual father-to-daughter transmission of incontinentia pigmenti due to mosaicism in IP males. Pediatrics 2017; 140:e20162950.
Ejerskov C, Farholt S, Skovby F et al. Clinical presentations of 23 half-siblings from a mosaic neurofibromatosis type 1 sperm donor. Clin Genet 2016; 89:346-50.
Folster-Holst R, Nellen RG, Jensen JM et al. Molecular genetic support for the rule of dichotomy in type 2 segmental Darier disease. Br J Dermatol 2012; 166:464-6.
Loffeld A, McLellan NJ, Cole T et al. Epidermal naevus in Proteus syndrome showing loss of heterozygosity for an inherited PTEN mutation. Br J Dermatol 2006; 154:1194-8.
Torrelo A, Hernandez-Martin A, Bueno E et al. Molecular evidence of type 2 mosaicism in Gorlin syndrome. Br J Dermatol 2013; 169:1342-5.
Vazquez-Osorio I, Chmel N, Rodriguez-Diaz E et al. A case of mosaicism in ectodermal dysplasia-skin fragility syndrome. Br J Dermatol 2017; 177:e101-2.
Schuilenga-Hut PH, Scheffer H, Pas HH et al. Partial revertant mosaicism of keratin 14 in a patient with recessive epidermolysis bullosa simplex. J Invest Dermatol 2002; 118:626-30.
Happle R, Assim A. The lines of Blaschko on the head and neck. J Am Acad Dermatol 2001; 44:612-15.
Happle R. Mosaicism in Human Skin. Berlin Heidelberg: Springer-Verlag, 2014.
Kinsler VA, Larue L. The patterns of birthmarks suggest a novel population of melanocyte precursors arising around the time of gastrulation. Pigment Cell Melanoma Res 2018; 31:95-109.
Waelchli R, Aylett SE, Robinson K et al. New vascular classification of port-wine stains: improving prediction of Sturge-Weber risk. Br J Dermatol 2014; 171:861-7.
Haggstrom AN, Lammer EJ, Schneider RA et al. Patterns of infantile hemangiomas: new clues to hemangioma pathogenesis and embryonic facial development. Pediatrics 2006; 117:698-703.
Weitz NA, Bayer ML, Baselga E et al. The “biker-glove” pattern of segmental infantile hemangiomas on the hands and feet. J Am Acad Dermatol 2014; 71:542-7.
Krengel S, Scope A, Dusza SW et al. New recommendations for the categorization of cutaneous features of congenital melanocytic nevi. J Am Acad Dermatol 2013; 68:441-51.
Martins da Silva VP, Marghoob A, Pigem R et al. Patterns of distribution of giant congenital melanocytic nevi (GCMN): the 6B rule. J Am Acad Dermatol 2017; 76:689-94.
Keppler-Noreuil KM, Rios JJ, Parker VE et al. PIK3CA-related overgrowth spectrum (PROS): diagnostic and testing eligibility criteria, differential diagnosis, and evaluation. Am J Med Genet Part A 2015; 167A:287-95.
Mirzaa G, Timms AE, Conti V et al. PIK3CA-associated developmental disorders exhibit distinct classes of mutations with variable expression and tissue distribution. JCI Insight 2016; 1:87623.
Dutkiewicz AS, Ezzedine K, Mazereeuw-Hautier J et al. A prospective study of risk for Sturge-Weber syndrome in children with upper facial port-wine stain. J Am Acad Dermatol 2015; 72:473-80.
Happle R. Phacomatosis pigmentovascularis revisited and reclassified. Arch Dermatol 2005; 141:385-8.
Comi AM. Sturge-Weber syndrome and epilepsy: an argument for aggressive seizure management in these patients. Expert Rev Neurother 2007; 7:951-6.
Comi AM, Bellamkonda S, Ferenc LM et al. Central hypothyroidism and Sturge-Weber syndrome. Pediatr Neurol 2008; 39:58-62.
Lance EI, Sreenivasan AK, Zabel TA et al. Aspirin use in Sturge-Weber syndrome: side effects and clinical outcomes. J Child Neurol 2013; 28:213-18.
Comi A. Current therapeutic options in Sturge-Weber syndrome. Semin Pediatr Neurol 2015; 22:295-301.
Kuentz P, St-Onge J, Duffourd Y et al. Molecular diagnosis of PIK3CA-related overgrowth spectrum (PROS) in 162 patients and recommendations for genetic testing. Genet Med 2017; 19:989-97.
Kinsler VA, O'Hare P, Bulstrode N et al. Melanoma in congenital melanocytic naevi. Br J Dermatol 2017; 176:1131-43.
Ramaswamy V, Delaney H, Haque S et al. Spectrum of central nervous system abnormalities in neurocutaneous melanocytosis. Dev Med Child Neurol 2012; 54:563-8.
Waelchli R, Aylett SE, Atherton D et al. Classification of neurological abnormalities in children with congenital melanocytic naevus syndrome identifies MRI as the best predictor of clinical outcome. Br J Dermatol 2015; 173:739-50.
Waelchli R, Williams J, Cole T et al. Growth and hormone profiling in children with congenital melanocytic naevi. Br J Dermatol 2015; 173:1471-8.
Kinsler V, Shaw AC, Merks JH et al. The face in congenital melanocytic nevus syndrome. Am J Med Genet Part A 2012; 158A:1014-19.
Frascari F, Dreyfus I, Rodriguez L et al. Prevalence and risk factors of vitamin D deficiency in inherited ichthyosis: a French prospective observational study performed in a reference center. Orphanet J Rare Dis 2014; 9:127.
Boon LM, Vikkula M. Multiple cutaneous and mucosal venous malformations. GeneReviews. Available at: https://www.ncbi.nlm.nih.gov/books/NBK1967/ (accessed 22 May 2019).
Mazoyer E, Enjolras O, Laurian C et al. Coagulation abnormalities associated with extensive venous malformations of the limbs: differentiation from Kasabach-Merritt syndrome. Clin Lab Haematol 2002; 24:243-51.
Redondo P, Aguado L, Marquina M et al. Angiogenic and prothrombotic markers in extensive slow-flow vascular malformations: implications for antiangiogenic/antithrombotic strategies. Br J Dermatol 2010; 162:350-6.
Lee BB, Baumgartner I, Guideline Berlien P et al. Diagnosis and treatment of venous malformations. consensus document of the international union of phlebology (iup): updated-2013. Int Angiol 2015; 34:97-149.
Keppler-Noreuil KM, Lozier JN, Sapp JC et al. Characterization of thrombosis in patients with Proteus syndrome. Am J Med Genet Part A 2017; 173:2359-65.
Johnson EF, Davis DM, Tollefson MM et al. Vascular tumors in infants: case report and review of clinical, histopathologic, and immunohistochemical characteristics of infantile hemangioma, pyogenic granuloma, noninvoluting congenital hemangioma, tufted angioma, and kaposiform hemangioendothelioma. Am J Dermatopathol 2018; 40:231-9.
Keppler-Noreuil KM, Baker EH, Sapp JC et al. Somatic AKT1 mutations cause meningiomas colocalizing with a characteristic pattern of cranial hyperostosis. Am J Med Genet Part A 2016; 170:2605-10.
Gripp KW, Baker L, Kandula V et al. Nephroblastomatosis or Wilms tumor in a fourth patient with a somatic PIK3CA mutation. Am J Med Genet Part A 2016; 170:2559-69.
Polubothu S, McGuire N, Al-Olabi L et al. Does the gene matter? Genotype-phenotype and genotype-outcome associations in congenital melanocytic naevi. Br J Dermatol 2019; doi: 10.1111/bjd.18106.
Maertens O, De Schepper S, Vandesompele J et al. Molecular dissection of isolated disease features in mosaic neurofibromatosis type 1. Am J Hum Genet 2007; 81:243-51.
Kim IS, Kim ER, Nam HJ et al. Activating mutation of GS alpha in McCune-Albright syndrome causes skin pigmentation by tyrosinase gene activation on affected melanocytes. Hormone Res 1999; 52:235-40.
Do H, Dobrovic A. Sequence artifacts in DNA from formalin-fixed tissues: causes and strategies for minimization. Clin Chem 2015; 61:64-71.
Riviere JB, Mirzaa GM, O'Roak BJ et al. De novo germline and postzygotic mutations in AKT3, PIK3R2 and PIK3CA cause a spectrum of related megalencephaly syndromes. Nat Genet 2012; 44:934-40.
Wali GN, Felton SJ, McPherson T. Management of naevus sebaceous: a national survey of UK dermatologists and plastic surgeons. Clin Exp Dermatol 2018; 43:589-91.
Hsu MC, Liau JY, Hong JL et al. Secondary neoplasms arising from nevus sebaceus: a retrospective study of 450 cases in Taiwan. J Dermatol 2016; 43:175-80.
Santibanez-Gallerani A, Marshall D, Duarte AM et al. Should nevus sebaceus of Jadassohn in children be excised? A study of 757 cases, and literature review. J Craniofac Surg 2003; 14:658-60.
Neuhold JC, Friesenhahn J, Gerdes N et al. Case reports of fatal or metastasizing melanoma in children and adolescents: a systematic analysis of the literature. Pediatr Dermatol 2015; 32:13-22.
Hale EK, Stein J, Ben-Porat L et al. Association of melanoma and neurocutaneous melanocytosis with large congenital melanocytic naevi - results from the NYU-LCMN registry. Br J Dermatol 2005; 152:512-17.
Pilarski R, Burt R, Kohlman W et al. Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. J Natl Cancer Inst 2013; 105:1607-16.
Bubien V, Bonnet F, Brouste V et al. High cumulative risks of cancer in patients with PTEN hamartoma tumour syndrome. J Med Genet 2013; 50:255-63.
European Reference Network for Rare Skin Diseases (ERN-Skin). Available at: https://ern-skin.eu (accessed 22 May 2019).
Tinschert S, Naumann I, Stegmann E et al. Segmental neurofibromatosis is caused by somatic mutation of the neurofibromatosis type 1 (NF1) gene. Eur J Hum Genet 2000; 8:455-9.
Zlotogora J. Mutations in von Recklinghausen neurofibromatosis: an hypothesis. Am J Med Genet 1993; 46:182-4.
Rasmussen SA, Colman SD, Ho VT et al. Constitutional and mosaic large NF1 gene deletions in neurofibromatosis type 1. J Med Genet 1998; 35:468-71.
Nomura K, Umeki K, Hatayama I et al. Phenotypic heterogeneity in bullous congenital ichthyosiform erythroderma: possible somatic mosaicism for keratin gene mutation in the mildly affected mother of the proband. Arch Dermatol 2001; 137:1192-5.
van den Akker PC, Pasmooij AM, Meijer R et al. Somatic mosaicism for the COL7A1 mutation p.Gly2034Arg in the unaffected mother of a patient with dystrophic epidermolysis bullosa pruriginosa. Br J Dermatol 2015; 172:778-81.
Levinsohn JL, McNiff JM, Antaya RJ et al. A somatic p.G45E GJB2 mutation causing porokeratotic eccrine ostial and dermal duct nevus. JAMA Dermatol 2015; 151:638-41.
Bygum A, Fagerberg CR, Clemmensen OJ et al. Systemic epidermal nevus with involvement of the oral mucosa due to FGFR3 mutation. BMC Med Genet 2011; 12:79.
Sol-Church K, Stabley DL, Demmer LA et al. Male-to-male transmission of Costello syndrome: G12S HRAS germline mutation inherited from a father with somatic mosaicism. Am J Med Genet Part A 2009; 149A:315-21.
Adams DM, Trenor CC 3rd, Hammill AM et al. Efficacy and safety of sirolimus in the treatment of complicated vascular anomalies. Pediatrics 2016; 137:e20153257.
Parker VER, Keppler-Noreuil KM, Faivre L et al. Safety and efficacy of low-dose sirolimus in the PIK3CA-related overgrowth spectrum. Genet Med 2019; 21:1189-98.
Venot Q, Blanc T, Rabia SH et al. Targeted therapy in patients with PIK3CA-related overgrowth syndrome. Nature 2018; 558:540-6.
Lindhurst MJ, Yourick MR, Yu Y et al. Repression of AKT signaling by ARQ 092 in cells and tissues from patients with Proteus syndrome. Sci Rep 2015; 5:17162.
Kusters-Vandevelde HV, Willemsen AE, Groenen PJ et al. Experimental treatment of NRAS-mutated neurocutaneous melanocytosis with MEK162, a MEK-inhibitor. Acta Neuropathol Commun 2014; 2:41.
Kinsler VA, O'Hare P, Jacques T et al. MEK inhibition appears to improve symptom control in primary NRAS-driven CNS melanoma in children. Br J Cancer 2017; 116:990-3.
Bavle A, Shah R, Gross N et al. Encephalocraniocutaneous lipomatosis. J Pediatr Hematol Oncol 2018; 40:553-554.

Auteurs

V A Kinsler (VA)

Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K.
Genetics and Genomic Medicine, UCL Institute of Child Health, London, U.K.

O Boccara (O)

Department of Dermatology and Reference Centre for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris Descartes - Sorbonne Paris Cité, Institut Imagine, Paris, France.

S Fraitag (S)

Department of Pathology, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France.

A Torrelo (A)

Department of Dermatology, Hospital Infantil del Niño Jesús, Madrid, Spain.

P Vabres (P)

Department of Dermatology and Reference Centre for Rare Skin Diseases, Dijon University Hospital, Dijon, France.
GAD, Genetics of Anomalies of Development, University of Bourgogne, Dijon, France.

A Diociaiuti (A)

Dermatology Unit, Bambino Gesù Children's Hospital, Rome, Italy.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH