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[Erythrokeratodermia variabilis (EKV)--a disorder due to altered epidermal expression of gap junction proteins].

Abstract
Erythrokeratodermia variabilis (EKV) is a rare autosomal dominant genodermatosis with disturbed epidermal differentiation. Its clinical picture varies from transient, fast moving erythema to persistent brown hyperkeratoses. The gene defect in EKV was recently located on the short arm of chromosome 1 encoding the gap junction protein connexin 31. We report on a 48-year-old patient with sharply circumscribed, scaling erythema on the extremities, buttocks and trunk starting since 30 years of age. Histological investigation showed orthokeratotic hyperkeratosis with focal parakeratosis overlying an acanthotic epidermis. Immunohistochemistry revealed a decreased expression of the gap junction protein connexin 31 as well as increased expression of connexin 43. At the ultrastructural level, widened intercellular spaces in the upper epidermis were present with regular desmosomes, adherens junctions and gap junctions. Epidermal cell proliferation and differentiation are regulated by gap junctions. The mutation in connexin 31 is regarded therefore as causal for the clinical picture of the EKV. The unique upregulation of connexin 43 may occur as a consequence of the Cx31 mutation and temporarily compensate for this defect.
AuthorsSonja Ständer, Antje Stadelmann, Otto Traub, Heiko Traupe, Dieter Metze
JournalJournal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 3 Issue 5 Pg. 354-8 (May 2005) ISSN: 1610-0379 [Print] Germany
Vernacular TitleErythrokeratodermia variabilis (EKV)--eine Störung der epidermalen Expression von Gap-Junction-Proteinen.
PMID16372802 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Connexins
  • Keratolytic Agents
  • GJB3 protein, human
  • Acitretin
Topics
  • Acitretin (administration & dosage, therapeutic use)
  • Chromosomes, Human, Pair 1 (genetics)
  • Connexins (genetics)
  • Epidermal Cells
  • Epidermis (pathology)
  • Humans
  • Immunohistochemistry
  • Keratolytic Agents (administration & dosage, therapeutic use)
  • Male
  • Microscopy, Electron
  • Middle Aged
  • Mutation
  • Skin Diseases, Genetic (diagnosis, drug therapy, genetics, pathology)
  • Time Factors

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