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A homozygous nonsense mutation within the dystonin gene coding for the coiled-coil domain of the epithelial isoform of BPAG1 underlies a new subtype of autosomal recessive epidermolysis bullosa simplex.
[epidermolysis bullosa simplex]
Epidermolysis
bullosa
(
EB
)
is
a
group
of
autosomal
dominant
and
recessive
blistering
skin
diseases
in
which
pathogenic
mutations
have
been
reported
in
13
different
genes
encoding
structural
proteins
involved
in
keratinocyte
integrity
,
as
well
as
cell-matrix
or
cell-cell
adhesion
.
We
now
report
an
inherited
skin
fragility
disorder
with
a
homozygous
nonsense
mutation
in
the
dystonin
gene
(
DST
)
that
encodes
the
coiled-coil
domain
of
the
epithelial
isoform
of
bullous
pemphigoid
antigen
1
,
BPAG
1
-
e
(
also
known
as
BP
230
)
.
The
mutation
,
p
.
Gln
1124
X
,
leads
to
the
loss
of
hemidesmosomal
inner
plaques
and
a
complete
absence
of
skin
immunostaining
for
BPAG
1
-
e
,
as
well
as
reduced
labeling
for
plectin
,
the
beta
4
integrin
subunit
,
and
for
type
XVII
collagen
.
The
38
-
year
-old
affected
individual
has
lifelong
generalized
trauma-induced
spontaneous
blisters
and
erosions
,
particularly
around
the
ankles
.
In
addition
,
he
experiences
episodic
numbness
in
his
limbs
,
which
started
at
the
age
of
37
years
.
These
neurological
symptoms
may
also
be
due
to
DST
gene
mutation
,
although
he
has
a
concomitant
diagnosis
of
CADASIL
(
cerebral
arteriopathy
,
autosomal
dominant
,
with
subcortical
infarcts
and
leukoencephalopathy
)
,
a
cerebral
small
-vessel
arteriopathy
,
which
thus
complicates
the
genotype-phenotype
interpretation
.
With
regard
to
skin
blistering
,
the
clinicopathological
findings
expand
the
molecular
basis
of
EB
by
identifying
BPAG
1
-
e
pathology
in
a
new
form
of
autosomal
recessive
EB
simplex
.
Diseases
Validation
Diseases presenting
"skin diseases"
symptom
cutaneous mastocytosis
dentinogenesis imperfecta
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
fabry disease
harlequin ichthyosis
inclusion body myositis
junctional epidermolysis bullosa
kindler syndrome
lamellar ichthyosis
oculocutaneous albinism
papillon-lefèvre syndrome
sneddon syndrome
systemic capillary leak syndrome
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