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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
"variable expressivity"
symptom
cowden syndrome
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