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More than just skin deep: faciocutaneous clues to genetic syndromes with malignancies.
[cowden syndrome]
Genetic
syndromes
with
dermatologic
findings
and
multisystemic
involvement
(
e
.
g
.
,
visceral
cancer
predisposition
)
are
underrecognized
.
Patients
may
have
incomplete
penetrance
and
variable
expressivity
;
some
patients
may
solely
exhibit
subtle
skin
signs
,
which
create
a
diagnostic
challenge
for
physicians
.
Interdisciplinary
diagnostic
knowledge
is
required
for
the
early
diagnosis
and
monitoring
of
patients
with
these
syndromes
.
Cutaneous
changes
in
the
face-
one
of
the
most
highly
exposed
areas
-can
be
easily
noticed
by
patients
themselves
,
their
families
and
friends
,
and
physicians
;
these
changes
may
serve
as
early
indicators
of
genetic
syndromes
with
malignancies
.
In
this
article
,
we
present
examples
of
genetic
syndromes
with
malignancies
for
which
a
thorough
faciocutaneous
examination
is
helpful
in
establishing
a
diagnosis
.
These
examples
include
lentiginosis-related
syndromes
(
e
.
g
.
,
Peutz-
Jeghers
syndrome
,
Carney
complex
)
,
photosensitivity
-related
syndromes
(
Bloom
syndrome
,
Rothmund-
Thomson
syndrome
)
,
and
hamartoma
-related
syndromes
(
Cowden
syndrome
,
multiple
endocrine
neoplasia
syndrome
,
tuberous
sclerosis
complex
,
Gardner
syndrome
,
Muir-
Torre
syndrome
)
.
The
characteristics
of
these
faciocutaneous
clues
are
summarized
and
discussed
.
Objective
evaluation
of
these
faciocutaneous
clues
in
combination
with
other
clinical
information
(
e
.
g
.
,
family
history
,
histopathological
findings
,
combination
with
other
concomitant
faciocutaneous
lesions
)
is
emphasized
to
narrow
the
diagnosis
.
The
list
of
genetic
syndromes
with
faciocutaneous
manifestations
is
still
expanding
.
Increased
awareness
of
faciocutaneous
markers
can
alert
physicians
to
underlying
syndromes
and
malignancies
,
render
earlier
screening
and
detection
of
associated
medical
issues
,
and
allow
for
genetic
counseling
of
family
members
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated