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Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital anomalies, so the condition can be considered as an ID–overweight syndrome. Case Description: We evaluated a child presenting with DD/ID and a craniofacial phenotype reminiscent of a Pitt–Hopkins syndrome (PTHS)-like condition. We performed a clinical exome analysis on his biological sample, as well as an in silico prediction of the obtained data. At the same time, we interrogated the DeepGestalt technology powered by Face2Gene (F2G), using a frontal image of the proband, and clinically reviewed the earlier CHUJANS patients. In this child, we found a novel PHIP pathogenetic variant, which we corroborated through a protein modeling approach. The F2G platform supported the initial clinical hypothesis of a PTHS-like condition, while the clinical review highlighted the lack of the main frequent CHUJANS clinical features in this child. Conclusions: The unusual clinical presentation of this novel patient resembles a PTHS-like condition. However, a novel variant in PHIP has been unexpectedly detected, expanding the phenotypic spectrum of CHUJANS. Notably, PTHS (MIM#610954), which is a different ID syndrome caused by heterozygous variants in TCF4 (MIM*610954), is not classically considered in the differential diagnosis of CHUJANS nor has been cited in the previous studies. This could support other complex diagnoses and invite further patients' descriptions. [ABSTRACT FROM AUTHOR]

Bullous pemphigoid (BP) is the most common autoimmune bullous disease: it most commonly affects individuals over 70 years old and impacts severely on their quality of life. BP represents a paradigm for an organ-specific autoimmune disease and is characterized by circulating IgG autoantibodies to hemidesmosomal components: BP180 and BP230. While the crucial role of these autoantibodies in triggering BP inflammatory cascade is fully acknowledged, many ancillary etiologicalmechanisms need to be elucidated yet. Cutaneous melanoma is due to a malignant transformation of skin melanocytes, that produce and distribute pigments to surrounding keratinocytes. Melanoma is the most fatal skin cancer because of its increasing incidence and its propensity to metastasize. Several data such as: i) reported cases of concomitant melanoma and BP; ii) results from association studies; iii) BP onset following immune check-point inhibitors therapy; iv) expression of BP antigens in transformed melanocytes; and vi) circulating autoantibodies to BP antigens in melanoma patients suggest an intriguing, although unproven, possible association between melanoma and BP. However, a possible causative link is still debated and the putative pathogenetic mechanism underlying this association is unclear. This review aims to describe and discuss the possible relationship between BP and melanoma and give an overview of the speculations for or against this association. Of note, if demonstrated, this association could unwrap considerations of clinical relevance that represent new research frontiers. [ABSTRACT FROM AUTHOR]

Bullous pemphigoid (BP) is the most common autoimmune bullous disease, whose main autoantigens are hemidesmosomal components BP180 and BP230. Although recent studies found no association between COVID-19 vaccines and BP, since mass vaccinations started, more than 90 vaccine-associated BP cases have been reported. To find an agreement among real-life clinical observations and recent epidemiologic data, we further investigated this topic. A total of 64 patients with BP onset in 2021 were demographically, clinically, and serologically characterized: 14 (21.9%) vaccine-associated patients (VA) developed BP within 5 weeks from the first/second vaccine dose. VA and vaccine-non-associated (VNA) patients had similar demographics and clinical and immunological characteristics. Noteworthy, the monthly distribution of BP onset during mass vaccinations paralleled vaccine administration to the elderly in the same catchment area. Additionally, in 2021, BP onsets in April–May and June–July significantly increased (p = 0.004) and declined (p = 0.027), respectively, compared to the three years before vaccination campaigns (2018–2020). Interestingly, VA and VNA patients showed statistically significant differences in the use of inhalers and diuretics. Our findings suggest that the COVID-19 vaccine may constitute an accelerating factor that, together with other triggering factors, could act in genetically predisposed individuals with possible sub-clinical autoreactivity against BP antigens, slightly accelerating BP onset. [ABSTRACT FROM AUTHOR]

Background: Non‐photosensitive trichothiodystrophies (TTDs) are a diverse group of genodermatoses within the subset of conditions known as "sulphur‐deficient brittle hair" syndromes. A part of them has only recently been identified, revealing novel causative genes and very rare phenotypes of these genetic skin disorders. At the same time, the molecular basis of previously published and unresolved cases has been revealed through the introduction of innovative genetic techniques. We have previously described the facial phenotype of patients with the Photosensitive form of TTD during childhood. This study marks the beginning of an effort to expand the analysis to include individuals of the same age who do not have photosensitivity. Methods: A total of 26 facial portraits of TTD paediatric patients with Non‐photosensitivity from the literature were analysed using computer‐aided technologies, and their facial features were examined through a detailed clinical review. Results: Distinct facial features were identified in both Photosensitive and Non‐photosensitive TTDs. Conclusion: The present study has comprehensively elucidated the facial features in TTDs, encompassing the Non‐photosensitive clinical spectrum. [ABSTRACT FROM AUTHOR]

The article in Experimental Dermatology discusses a case study of a 12-year-old boy with palmoplantar keratoderma and woolly hair, which are associated with a variant in the DSP gene. The boy showed symptoms such as hyperkeratosis on his feet and fingers, as well as abnormal hair characteristics. Genetic testing revealed a variant in the DSP gene, leading to a reduction in desmoplakin protein expression. The study highlights the importance of genomic investigations in carriers of this variant to understand the associated phenotype. [Extracted from the article]

The neurodevelopmental disorder known as Helsmoortel‐van der Aa syndrome (HVDAS, MIM#616580) or ADNP syndrome (Orphanet, ORPHA:404448) is a multiple congenital anomaly (MCA) condition, reported as a syndrome in 2014, associated with deleterious variants in the ADNP gene (activity‐dependent neuroprotective protein; MIM*611386) in several children. First reported in the turn of the century, ADNP is a protein with crucial functions for the normal development of the central nervous system and with pleiotropic effects, explaining the multisystemic character of the syndrome. Affected individuals present with striking facial dysmorphic features and variable congenital defects. Herein, we describe a novel case series of HVDAS Italian patients, illustrating their clinical findings and the related genotype–phenotype correlations. Interestingly, the cutaneous manifestations are also extensively expanded, giving an important contribution to the clinical characterization of the condition, and highlighting the relation between skin abnormalities and ADNP defects. [ABSTRACT FROM AUTHOR]

This article examines the impact of the COVID-19 pandemic on the number of first diagnosis and follow-up visits for patients with pemphigus, bullous pemphigoid, scleroderma, psoriasis, and vitiligo. The study found that there was a reduction in both first diagnosis and follow-up visits for these diseases during the pandemic compared to the pre-pandemic years. This suggests that many patients may have avoided or delayed medical care during the pandemic, potentially increasing the risk of complications. The authors recommend adopting telehealth for first diagnosis and making specific treatments available at home to mitigate the impact of future pandemics. [Extracted from the article]

The article explores the use of indirect immunofluorescence on salt-split skin sections to diagnose bullous pemphigoid (BP) and mucous membrane pemphigoid (MMP) in patients. The study compares the sensitivity and specificity of human and monkey skin samples in detecting autoantibodies from BP and MMP patients. While human skin proved more sensitive in detecting BP autoantibodies, monkey skin showed higher sensitivity for MMP autoantibodies due to differences in antigen expression. The study suggests carefully selecting the appropriate substrate to enhance the diagnostic performance of the immunofluorescence technique. [Extracted from the article]

This article discusses a case of bullous pemphigoid (BP), a skin disorder characterized by blistering and erosions. The standard diagnostic method for BP involves the detection of IgG autoantibodies and/or C3 complement fraction at the dermo-epidermal junction (DEJ). However, this particular case presented with linear deposits of IgM at the DEJ, along with non-classical clinical features. The significance of IgM in cutaneous immunopathology is not well understood, and the existence of IgM-mediated BP has been a topic of debate. The patient was treated with oral corticosteroids and eventually achieved complete clinical remission. [Extracted from the article]

Autoimmune bullous diseases are a heterogeneous group of rare conditions clinically characterized by the presence of blisters and/or erosions on the skin and the mucous membranes. Practically, they can be divided into two large groups: the pemphigoid group and the pemphigus group, depending on the depth of the autoimmune process on the skin. A family history of autoimmune diseases can often be found, demonstrating that genetic predisposition is crucial for their development. Moreover, numerous environmental risk factors, such as solar radiation, drugs, and infections, are known. This study aimed to evaluate how seasonality can affect the trend of bullous pemphigoid and pemphigus vulgaris, especially considering the number of hospitalizations recorded over the course of individual months. The total number of hospitalizations in the twelve months of the year was evaluated. Moreover, blood chemistry assay and, for some patients, enzyme-linked immunosorbent assay were executed to evaluate antibodies. Regarding the severity of the disease, the bullous pemphigoid area index and the pemphigus disease area index score systems were used. Results showed a complex interplay between environmental factors such as seasons and autoimmune conditions. [ABSTRACT FROM AUTHOR]