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      • Record: found
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      • Article: found

      Segmental Acne versus Mosaic Conditions with Acne Lesions

      case-report

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          Abstract

          Acne rarely presents in segmental patterns, which are encountered only in cutaneous mosaicism. We report herein two cases of segmentally arranged acne and systematically review the literature on the topic. Beside already known mosaic conditions which may show primary lesions typical of acne, i.e. nevus comedonicus, Happle-Tinschert syndrome, acne superimposed on epidermal nevi and mosaic Apert syndrome, we introduce the possibility that acne itself may present in a mosaic form. As from the extremely small casuistics retrieved, segmental acne is not present at birth, follows Blaschko lines, is polymorphous in nature and occurs on locations typical of common acne.

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          Most cited references24

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          Epidermal mosaicism producing localised acne: somatic mutation in FGFR2.

          A O Wilkie, C Munro (1998)
          Article 0 comments Cited 21 times – based on 0 reviews     Review now
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            Superimposed segmental manifestation of polygenic skin disorders.

            Rudolf Happle (2007)
            In common acquired skin disorders with a polygenic background such as psoriasis, a linear or otherwise segmental arrangement may sometimes be noted. The segmental involvement tends to be rather severe and may be associated with milder, nonsegmental lesions of the same disorder. Such cases may be best explained by an early postzygotic event in the form of loss of heterozygosity involving one of the genes that predispose to the disorder. The following pertinent examples are reviewed in this article: psoriasis vulgaris, pustular psoriasis, atopic dermatitis, lichen planus, systemic lupus erythematosus, pemphigus vulgaris, vitiligo, graft-versus-host disease, granuloma annulare, erythema multiforme, and drug eruption to ibuprofen. Such cases should not be categorized as a "type 2 segmental manifestation" because this term exclusively applies to monogenic traits, whereas in polygenic disorders the more descriptive term "superimposed segmental manifestation" seems appropriate. The concept of early loss of heterozygosity offers a plausible explanation as to why: the segmental involvement tends to appear at a rather young age and often precedes the development of milder, nonsegmental lesions of the same disorder; the segmental lesions are notoriously difficult to treat; and family members may show the disorder in its nonsegmental form. On the other hand, the theory of isolated versus superimposed segmental manifestation may help to elucidate the origin of polygenic skin disorders at the molecular level.
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              Becker's nevus: an androgen-mediated hyperplasia with increased androgen receptors.

              C Longcope, Rachel Person (1984)
              Becker's nevus is an uncommon, unilateral, hyperpigmented, hairy cutaneous hamartoma which usually begins in adolescence. Its clinical features and its occurrence mainly in male individuals suggest that androgen stimulation may play a role in its pathogenesis. Androgen receptor assays were performed in a 16-year-old patient with a Becker's nevus. The patient coincidentally had acanthosis nigricans. Lesional tissue showed an androgen receptor level of 634.1 fm/mg protein. A specimen from the contralateral left pectoral area showed no dectectable androgen receptor activity (less than 2.0 fm/mg protein). These results suggest that exquisite androgen sensitivity and stimulation may explain the clinical manifestations of Becker's nevus.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): DRM
                Journal ID (nlm-ta): Dermatology
                Journal ID (doi): 10.1159/issn.1018-8665
                Title: Dermatology
                Publisher: S. Karger AG
                ISSN (Print): 1018-8665
                ISSN (Electronic): 1421-9832
                Publication date Subscription-year: 2012
                Publication date (Print): May 2012
                Publication date (Electronic): 27 March 2012
                Volume: 224
                Issue: 1
                Pages: 10-14
                Affiliations
                Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Fla., USA
                Author notes
                *Dr. Daniele Torchia, Via della Scala 58, IT–50123 Florence (Italy), Tel. +39 055 289 659, E-Mail daniele.torchia@unifi.it
                Article
                Publisher ID: 336797 Other ID: Dermatology 2012;224:10–14
                DOI: 10.1159/000336797
                PubMed ID: 22456681
                SO-VID: 9f42802e-a3d3-4b65-a411-7b5dc9692a63
                Copyright © © 2012 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 20 July 2011
                Date accepted : 17 January 2012
                Page count
                Figures: 1, Tables: 3, Pages: 5
                Categories
                Subject: Case and Review

                ScienceOpen disciplines: Oncology & Radiotherapy,Pathology,Surgery,Dermatology,Pharmacology & Pharmaceutical medicine
                Keywords: Blaschko,Acne,Apert syndrome,Segmental,Basal cell nevus,Becker nevus,Mosaic,Linear,Mosaicism,Nevus comedonicus
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy, Pathology, Surgery, Dermatology, Pharmacology & Pharmaceutical medicine
                Keywords: Blaschko, Acne, Apert syndrome, Segmental, Basal cell nevus, Becker nevus, Mosaic, Linear, Mosaicism, Nevus comedonicus

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