Patients with xeroderma pigmentosum complementation groups C, E and V do not have abnormal sunburn reactions

Summary Background Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is divided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have been considered a cardinal featu...

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Veröffentlicht in:British journal of dermatology (1951) 2013-12, Vol.169 (6), p.1279-1287
Hauptverfasser: Sethi, M., Lehmann, A.R., Fawcett, H., Stefanini, M., Jaspers, N., Mullard, K., Turner, S., Robson, A., McGibbon, D., Sarkany, R., Fassihi, H.
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container_end_page 1287
container_issue 6
container_start_page 1279
container_title British journal of dermatology (1951)
container_volume 169
creator Sethi, M.
Lehmann, A.R.
Fawcett, H.
Stefanini, M.
Jaspers, N.
Mullard, K.
Turner, S.
Robson, A.
McGibbon, D.
Sarkany, R.
Fassihi, H.
description Summary Background Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is divided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have been considered a cardinal feature of classical XP. However, it has recently become clear that not all patients have abnormal sunburn reactions. Objectives To examine sunburn reactions in a cohort of patients with XP and correlate this to the complementation group. Methods Sixty patients with XP attending the U.K. National XP Service from 2010 to 2012 were studied. Their history of burning after minimal sun exposure was assessed using a newly developed sunburn severity score. The age at which the first skin cancer was histologically diagnosed in each patient, and the presence of any neurological abnormality, was also recorded. Results Sunburn severity scores were abnormally high in patients with XP‐A, XP‐D, XP‐F and XP‐G compared with non‐XP controls. There was no significant difference in sunburn score of patients with XP‐C, XP‐E and XP‐V compared with controls (P > 0·05). Patients with XP‐C, XP‐E and XP‐V were more likely to have skin cancer diagnosed at an earlier age than those with severe sunburn on minimal sun exposure. In addition, patients with XP with severe sunburn had an increased frequency of neurological abnormalities. Conclusions Not all patients with XP have a history of severe and prolonged sunburn on minimal sun exposure. The normal sunburn response of patients with XP‐C, XP‐E and XP‐V may relate to the preservation of transcription‐coupled DNA repair in these groups. Those with a history of severe sunburn on minimal sun exposure developed their first skin cancer at an older age compared with patients with XP‐C, XP‐E and XP‐V, but they had an increased frequency of neurological abnormalities. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. What's already known about this topic? Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is characterized by pigmentary skin changes, significantly increased risk of skin cancer, and progressive neurological disease in about 25% of cases. It is subdivided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have previously been considered a ca
doi_str_mv 10.1111/bjd.12523
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It is divided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have been considered a cardinal feature of classical XP. However, it has recently become clear that not all patients have abnormal sunburn reactions. Objectives To examine sunburn reactions in a cohort of patients with XP and correlate this to the complementation group. Methods Sixty patients with XP attending the U.K. National XP Service from 2010 to 2012 were studied. Their history of burning after minimal sun exposure was assessed using a newly developed sunburn severity score. The age at which the first skin cancer was histologically diagnosed in each patient, and the presence of any neurological abnormality, was also recorded. Results Sunburn severity scores were abnormally high in patients with XP‐A, XP‐D, XP‐F and XP‐G compared with non‐XP controls. There was no significant difference in sunburn score of patients with XP‐C, XP‐E and XP‐V compared with controls (P &gt; 0·05). Patients with XP‐C, XP‐E and XP‐V were more likely to have skin cancer diagnosed at an earlier age than those with severe sunburn on minimal sun exposure. In addition, patients with XP with severe sunburn had an increased frequency of neurological abnormalities. Conclusions Not all patients with XP have a history of severe and prolonged sunburn on minimal sun exposure. The normal sunburn response of patients with XP‐C, XP‐E and XP‐V may relate to the preservation of transcription‐coupled DNA repair in these groups. Those with a history of severe sunburn on minimal sun exposure developed their first skin cancer at an older age compared with patients with XP‐C, XP‐E and XP‐V, but they had an increased frequency of neurological abnormalities. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. What's already known about this topic? Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is characterized by pigmentary skin changes, significantly increased risk of skin cancer, and progressive neurological disease in about 25% of cases. It is subdivided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have previously been considered a cardinal feature of classical XP. Recent data from a cohort of patients with XP at the National Institutes of Health in the U.S.A. have shown that about a third of their patients with XP have never sunburned. What does this study add? Not all patients with classical XP have severe and prolonged sunburn reactions. There is a correlation between response to sun exposure and XP complementation group. Patients with XP‐C, XP‐E and XP‐V have sunburn reactions normal for skin‐type compared with unaffected controls. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. This has important diagnostic and prognostic implications. See also the Commentary by Kraemer et al</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/bjd.12523</identifier><identifier>PMID: 23889214</identifier><identifier>CODEN: BJDEAZ</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Age of Onset ; Biological and medical sciences ; Burns ; Case-Control Studies ; Dermatology ; Female ; Hereditary diseases of the skin. Congenital diseases of the skin. Haemangioma of the skin, of mucosae and of soft tissue ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Melanoma - ethnology ; Melanoma - mortality ; Melanoma - pathology ; Middle Aged ; Nervous System Diseases - ethnology ; Nervous System Diseases - mortality ; Nervous System Diseases - pathology ; Skin involvement in other diseases. Miscellaneous. General aspects ; Skin Neoplasms - ethnology ; Skin Neoplasms - pathology ; Sunburn - ethnology ; Sunburn - mortality ; Sunburn - pathology ; Traumas. Diseases due to physical agents ; Xeroderma Pigmentosum - ethnology ; Xeroderma Pigmentosum - mortality ; Xeroderma Pigmentosum - pathology ; Young Adult</subject><ispartof>British journal of dermatology (1951), 2013-12, Vol.169 (6), p.1279-1287</ispartof><rights>2013 British Association of Dermatologists</rights><rights>2015 INIST-CNRS</rights><rights>2013 British Association of Dermatologists.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3933-5f266079233b5834fa3f493e829bf26f1d726c2c20944af33bf1a163322462d93</citedby><cites>FETCH-LOGICAL-c3933-5f266079233b5834fa3f493e829bf26f1d726c2c20944af33bf1a163322462d93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjd.12523$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjd.12523$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=28079333$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23889214$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sethi, M.</creatorcontrib><creatorcontrib>Lehmann, A.R.</creatorcontrib><creatorcontrib>Fawcett, H.</creatorcontrib><creatorcontrib>Stefanini, M.</creatorcontrib><creatorcontrib>Jaspers, N.</creatorcontrib><creatorcontrib>Mullard, K.</creatorcontrib><creatorcontrib>Turner, S.</creatorcontrib><creatorcontrib>Robson, A.</creatorcontrib><creatorcontrib>McGibbon, D.</creatorcontrib><creatorcontrib>Sarkany, R.</creatorcontrib><creatorcontrib>Fassihi, H.</creatorcontrib><title>Patients with xeroderma pigmentosum complementation groups C, E and V do not have abnormal sunburn reactions</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary Background Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is divided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have been considered a cardinal feature of classical XP. However, it has recently become clear that not all patients have abnormal sunburn reactions. Objectives To examine sunburn reactions in a cohort of patients with XP and correlate this to the complementation group. Methods Sixty patients with XP attending the U.K. National XP Service from 2010 to 2012 were studied. Their history of burning after minimal sun exposure was assessed using a newly developed sunburn severity score. The age at which the first skin cancer was histologically diagnosed in each patient, and the presence of any neurological abnormality, was also recorded. Results Sunburn severity scores were abnormally high in patients with XP‐A, XP‐D, XP‐F and XP‐G compared with non‐XP controls. There was no significant difference in sunburn score of patients with XP‐C, XP‐E and XP‐V compared with controls (P &gt; 0·05). Patients with XP‐C, XP‐E and XP‐V were more likely to have skin cancer diagnosed at an earlier age than those with severe sunburn on minimal sun exposure. In addition, patients with XP with severe sunburn had an increased frequency of neurological abnormalities. Conclusions Not all patients with XP have a history of severe and prolonged sunburn on minimal sun exposure. The normal sunburn response of patients with XP‐C, XP‐E and XP‐V may relate to the preservation of transcription‐coupled DNA repair in these groups. Those with a history of severe sunburn on minimal sun exposure developed their first skin cancer at an older age compared with patients with XP‐C, XP‐E and XP‐V, but they had an increased frequency of neurological abnormalities. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. What's already known about this topic? Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is characterized by pigmentary skin changes, significantly increased risk of skin cancer, and progressive neurological disease in about 25% of cases. It is subdivided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have previously been considered a cardinal feature of classical XP. Recent data from a cohort of patients with XP at the National Institutes of Health in the U.S.A. have shown that about a third of their patients with XP have never sunburned. What does this study add? Not all patients with classical XP have severe and prolonged sunburn reactions. There is a correlation between response to sun exposure and XP complementation group. Patients with XP‐C, XP‐E and XP‐V have sunburn reactions normal for skin‐type compared with unaffected controls. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. This has important diagnostic and prognostic implications. See also the Commentary by Kraemer et al</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age of Onset</subject><subject>Biological and medical sciences</subject><subject>Burns</subject><subject>Case-Control Studies</subject><subject>Dermatology</subject><subject>Female</subject><subject>Hereditary diseases of the skin. Congenital diseases of the skin. Haemangioma of the skin, of mucosae and of soft tissue</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Melanoma - ethnology</subject><subject>Melanoma - mortality</subject><subject>Melanoma - pathology</subject><subject>Middle Aged</subject><subject>Nervous System Diseases - ethnology</subject><subject>Nervous System Diseases - mortality</subject><subject>Nervous System Diseases - pathology</subject><subject>Skin involvement in other diseases. Miscellaneous. General aspects</subject><subject>Skin Neoplasms - ethnology</subject><subject>Skin Neoplasms - pathology</subject><subject>Sunburn - ethnology</subject><subject>Sunburn - mortality</subject><subject>Sunburn - pathology</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Xeroderma Pigmentosum - ethnology</subject><subject>Xeroderma Pigmentosum - mortality</subject><subject>Xeroderma Pigmentosum - pathology</subject><subject>Young Adult</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtP3DAUhS1EBQNl0T-AvEEqEgHbN3GSZTu8OowoC2ilbizHsSGQ2Kmd8Pj39XQGWOGN5evvnKN7EPpCySGN56i6rw8pyxisoQkFniWMAqyjCSEkT0jJYRNthXBPCAWSkQ20yaAoSkbTCWqv5NBoOwT81Ax3-Fl7V2vfSdw3t12cuzB2WLmub_XiGWFn8a13Yx_w9ACfYGlr_AvXDls34Dv5qLGsrIsOLQ6jrUZvsddSLXThM_pkZBv0zureRjenJ9fT82T-8-zH9Ns8UVACJJlhnJO8ZABVVkBqJJi0BF2wsopfhtY544opRso0lSZShkrKARhLOatL2EZfl769d39HHQbRNUHptpVWuzEImvKM5lkKPKL7S1R5F4LXRvS-6aR_EZSIRbkiliv-lxvZ3ZXtWHW6fiNf24zA3gqQQcnWeGlVE965Ii4FsDA6WnJPTatfPk4U32fHr9HJUtGEQT-_KaR_EDyHPBO_L8_E7OLPxXx-PhOX8A_5MZ8C</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Sethi, M.</creator><creator>Lehmann, A.R.</creator><creator>Fawcett, H.</creator><creator>Stefanini, M.</creator><creator>Jaspers, N.</creator><creator>Mullard, K.</creator><creator>Turner, S.</creator><creator>Robson, A.</creator><creator>McGibbon, D.</creator><creator>Sarkany, R.</creator><creator>Fassihi, H.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201312</creationdate><title>Patients with xeroderma pigmentosum complementation groups C, E and V do not have abnormal sunburn reactions</title><author>Sethi, M. ; Lehmann, A.R. ; Fawcett, H. ; Stefanini, M. ; Jaspers, N. ; Mullard, K. ; Turner, S. ; Robson, A. ; McGibbon, D. ; Sarkany, R. ; Fassihi, H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3933-5f266079233b5834fa3f493e829bf26f1d726c2c20944af33bf1a163322462d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age of Onset</topic><topic>Biological and medical sciences</topic><topic>Burns</topic><topic>Case-Control Studies</topic><topic>Dermatology</topic><topic>Female</topic><topic>Hereditary diseases of the skin. Congenital diseases of the skin. Haemangioma of the skin, of mucosae and of soft tissue</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Melanoma - ethnology</topic><topic>Melanoma - mortality</topic><topic>Melanoma - pathology</topic><topic>Middle Aged</topic><topic>Nervous System Diseases - ethnology</topic><topic>Nervous System Diseases - mortality</topic><topic>Nervous System Diseases - pathology</topic><topic>Skin involvement in other diseases. Miscellaneous. General aspects</topic><topic>Skin Neoplasms - ethnology</topic><topic>Skin Neoplasms - pathology</topic><topic>Sunburn - ethnology</topic><topic>Sunburn - mortality</topic><topic>Sunburn - pathology</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Xeroderma Pigmentosum - ethnology</topic><topic>Xeroderma Pigmentosum - mortality</topic><topic>Xeroderma Pigmentosum - pathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sethi, M.</creatorcontrib><creatorcontrib>Lehmann, A.R.</creatorcontrib><creatorcontrib>Fawcett, H.</creatorcontrib><creatorcontrib>Stefanini, M.</creatorcontrib><creatorcontrib>Jaspers, N.</creatorcontrib><creatorcontrib>Mullard, K.</creatorcontrib><creatorcontrib>Turner, S.</creatorcontrib><creatorcontrib>Robson, A.</creatorcontrib><creatorcontrib>McGibbon, D.</creatorcontrib><creatorcontrib>Sarkany, R.</creatorcontrib><creatorcontrib>Fassihi, H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sethi, M.</au><au>Lehmann, A.R.</au><au>Fawcett, H.</au><au>Stefanini, M.</au><au>Jaspers, N.</au><au>Mullard, K.</au><au>Turner, S.</au><au>Robson, A.</au><au>McGibbon, D.</au><au>Sarkany, R.</au><au>Fassihi, H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patients with xeroderma pigmentosum complementation groups C, E and V do not have abnormal sunburn reactions</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2013-12</date><risdate>2013</risdate><volume>169</volume><issue>6</issue><spage>1279</spage><epage>1287</epage><pages>1279-1287</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><coden>BJDEAZ</coden><abstract>Summary Background Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is divided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have been considered a cardinal feature of classical XP. However, it has recently become clear that not all patients have abnormal sunburn reactions. Objectives To examine sunburn reactions in a cohort of patients with XP and correlate this to the complementation group. Methods Sixty patients with XP attending the U.K. National XP Service from 2010 to 2012 were studied. Their history of burning after minimal sun exposure was assessed using a newly developed sunburn severity score. The age at which the first skin cancer was histologically diagnosed in each patient, and the presence of any neurological abnormality, was also recorded. Results Sunburn severity scores were abnormally high in patients with XP‐A, XP‐D, XP‐F and XP‐G compared with non‐XP controls. There was no significant difference in sunburn score of patients with XP‐C, XP‐E and XP‐V compared with controls (P &gt; 0·05). Patients with XP‐C, XP‐E and XP‐V were more likely to have skin cancer diagnosed at an earlier age than those with severe sunburn on minimal sun exposure. In addition, patients with XP with severe sunburn had an increased frequency of neurological abnormalities. Conclusions Not all patients with XP have a history of severe and prolonged sunburn on minimal sun exposure. The normal sunburn response of patients with XP‐C, XP‐E and XP‐V may relate to the preservation of transcription‐coupled DNA repair in these groups. Those with a history of severe sunburn on minimal sun exposure developed their first skin cancer at an older age compared with patients with XP‐C, XP‐E and XP‐V, but they had an increased frequency of neurological abnormalities. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. What's already known about this topic? Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder of DNA repair. It is characterized by pigmentary skin changes, significantly increased risk of skin cancer, and progressive neurological disease in about 25% of cases. It is subdivided into eight complementation groups: XP‐A to XP‐G (classical XP) and XP variant (XP‐V). Severe and prolonged sunburn reactions on minimal sun exposure have previously been considered a cardinal feature of classical XP. Recent data from a cohort of patients with XP at the National Institutes of Health in the U.S.A. have shown that about a third of their patients with XP have never sunburned. What does this study add? Not all patients with classical XP have severe and prolonged sunburn reactions. There is a correlation between response to sun exposure and XP complementation group. Patients with XP‐C, XP‐E and XP‐V have sunburn reactions normal for skin‐type compared with unaffected controls. Physicians need to be aware that about half of all patients with XP will present without a history of abnormal sunburn. This has important diagnostic and prognostic implications. See also the Commentary by Kraemer et al</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>23889214</pmid><doi>10.1111/bjd.12523</doi><tpages>9</tpages></addata></record>
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source MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current)
subjects Adolescent
Adult
Age of Onset
Biological and medical sciences
Burns
Case-Control Studies
Dermatology
Female
Hereditary diseases of the skin. Congenital diseases of the skin. Haemangioma of the skin, of mucosae and of soft tissue
Humans
Kaplan-Meier Estimate
Male
Medical sciences
Melanoma - ethnology
Melanoma - mortality
Melanoma - pathology
Middle Aged
Nervous System Diseases - ethnology
Nervous System Diseases - mortality
Nervous System Diseases - pathology
Skin involvement in other diseases. Miscellaneous. General aspects
Skin Neoplasms - ethnology
Skin Neoplasms - pathology
Sunburn - ethnology
Sunburn - mortality
Sunburn - pathology
Traumas. Diseases due to physical agents
Xeroderma Pigmentosum - ethnology
Xeroderma Pigmentosum - mortality
Xeroderma Pigmentosum - pathology
Young Adult
title Patients with xeroderma pigmentosum complementation groups C, E and V do not have abnormal sunburn reactions
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