CARD14-associated papulosquamous eruption: A spectrum including features of psoriasis and pityriasis rubra pilaris - 16/08/18
Abstract |
Background |
Heterozygous mutations in caspase recruitment domain family member 14 gene (CARD14) have been shown to be associated with psoriasis and familial pityriasis rubra pilaris (PRP). Many subjects with CARD14 mutations display features of both disorders, which can result in diagnostic uncertainty. In addition, these eruptions are often recalcitrant to conventional psoriasis therapies such as methotrexate, oral retinoids, and tumor necrosis factor-α inhibitors.
Objective |
We sought to describe the clinical characteristics, family history, and response to therapy in subjects with papulosquamous eruptions due to mutations in CARD14.
Methods |
Subjects were referred for genetic testing as part of a registry of subjects with inherited disorders of keratinization. DNA was isolated from blood or saliva, and multiplex targeted sequencing or whole exome sequencing was performed. Clinical histories of subjects with CARD14 mutations were reviewed.
Results |
We identified 15 kindreds with CARD14-associated papulosquamous eruption (CAPE). Characteristic features of CAPE include early age of onset; prominent involvement of the cheeks, chin, and ears; family history of psoriasis or PRP; minimal response to conventional topical and systemic psoriasis therapies; and improvement with ustekinumab.
Limitations |
Relatively small sample size.
Conclusions |
Many subjects with CARD14 mutations display characteristics of both psoriasis and PRP. We propose the term CARD14-associated papulosquamous eruption to describe this spectrum of disease. Subjects with clinical features suggestive of CAPE should undergo CARD14 sequencing and may benefit from treatment with ustekinumab.
Le texte complet de cet article est disponible en PDF.Key words : CARD14, genetics, pityriasis rubra pilaris, psoriasis, treatment, ustekinumab
Abbreviations used : CAPE, IL, NF-κB, PRP
Plan
Dr Craiglow and Boyden contributed equally to this work. |
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Drs Milstone and Paller also contributed equally. |
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Funding sources: Supported in part by National Institutes of Health (grants R01 AR068392 [to Dr Choate] and R01 AR050266 [to Dr Bowcock]), the Foundation for Ichthyosis and Related Skin Types and Dermatology Foundation (to Dr Craiglow), and the Yale Center for Mendelian Genomics (grant U54 HG006504). |
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Disclosure: Dr Choate has received honoraria from Janssen Biotech and Abbvie. Drs Craiglow, Boyden, Hu, Virtanen, Su, Rodriguez, McCarthy, Luna, Larralde, Humphrey, Holland, Hogeling, Hidalgo-Matlock, Ferrari, Fernandez-Faith, Drolet, Cordoro, Bowcock, Antaya, Ashack, Ashack, Lifton, Milstone, and Paller have no conflicts of interest to disclose. |
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Reprints not available from the authors. |
Vol 79 - N° 3
P. 487-494 - septembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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