Presentation
The teeth numbers 12, 13, 14, 15, 22, 23, 24, 25, 32, 33, 34, 35, 37, 42, 43, 45, 44, 45, and 47 were present. Mobility was present in all the permanent teeth that were present. [hindawi.com]
Here, we are presenting an elaborate review of PLS, its etiopathogenesis, clinical presentation, and management options. Original paper can be viewed here: http://www.dovepress.com/papillonndas... [youtube.com]
On clinical examination, the patient presented with a senile facial appearance. [jofs.in]
Patients affected with autosomal dominant palmoplantar keratosis often present with malignancies of the esophagus and/or other malignancies (lymphomas, pancreas, breast, etc.). [accessanesthesiology.mhmedical.com]
We present a case of an otherwise healthy seven-year-old child with classical presentation of PLS with both dermatological and dental findings. [cureus.com]
Entire Body System
- Nail Abnormality
COMMON Features of the Disorder Sparse hair Blisters on soles of feet/palms of hand (palmoplantar keratosis) Skin infections Premature tooth loss (periodontitis) Inflammation around teeth Nail abnormalities PROGNOSIS Individuals with the disorder lose [evolvegene.com]
Nail abnormalities. Decreased sweating. [firstskinfoundation.org]
Gastrointestinal
- Abdominal Mass
A few days before admission, the mother noted an abdominal mass associated with right upper quadrant pain. The pain, which was dull, achy, intermittent, but not radiating, was not associated with vomiting, diarrhea, or jaundice. [pediatrics.aappublications.org]
- Abdominal Mass in the Right Upper Quadrant
A few days before admission, the mother noted an abdominal mass associated with right upper quadrant pain. The pain, which was dull, achy, intermittent, but not radiating, was not associated with vomiting, diarrhea, or jaundice. [pediatrics.aappublications.org]
- Odynophagia
Patient had stopped brushing because of teeth mobility hence associated odynophagia, pain, gingival swelling, and occasional bleeding. [jofs.in]
Jaw & Teeth
- Dental Caries
He was also referred to dental services for dental caries and delayed teething (Figure 3), and to an otolaryngologist to rule out nasal polyps. [cureus.com]
Skin
- Plantar Hyperkeratosis
(B) Plantar hyperkeratosis. Figure 1 (A) Severe destructive periodontitis. (B) Plantar hyperkeratosis. [academic.oup.com]
Anderson, The syndrome of palmar-plantar hyperkeratosis and premature periodontal destruction of the teeth, The Journal of Pediatrics, 1964, 65, 6, 895 CrossRef [onlinelibrary.wiley.com]
hyperkeratosis periodontal disease Descripción : The connection between palmar plantar hyperkeratosis and severe periodontal disease was first reported in 1924 by Papillon and Lefevre. [189.203.43.34]
- Palmoplantar Keratosis
Patients affected with autosomal dominant palmoplantar keratosis often present with malignancies of the esophagus and/or other malignancies (lymphomas, pancreas, breast, etc.). [accessanesthesiology.mhmedical.com]
Loss-of-function mutations in the cathepsin C gene result in periodontal disease and palmoplantar keratosis. Nat Genet 1999 ;23 (4):421-4. 16. Eickholz P, Kugel B, Pohl S, Naher H, Staehle HJ. [ayubmed.edu.pk]
Papillon-Lefèvre Syndrome: A Report of Three Siblings Author: Muddathir, Abdelkhalig Abstract: We reported an 18 year old Sudanese female patient, Gaali tribe, and another 2 males, brothers ages 10 and 8 years old, presented with diffuse trangrediens palmoplantar [khartoumspace.uofk.edu]
The palmoplantar keratotic phenotype vary from mild psoriasiform scaly skin to overt hyperkeratosis. Keratosis also affects other sites such as elbows and knees. [uniprot.org]
- Skin Disease
Keywords: Cathepsin C gene, Papillon-Lefevre syndrome, periodontitis INTRODUCTION Papillon-Lefevre syndrome belongs to a heterogeneous group of skin diseases that are characterized by hyperkeratosis of palms and soles. [ncbi.nlm.nih.gov]
The role of cathepsin C in the development of dermatological conditions in PLS is still unclear and may explain the nonsignificant correlation between the severity of skin disease and severity of oral infection [5, 7-9]. [karger.com]
- Skin Plaque
On examination, he was found to have an erythematous hyperkeratotic skin plaques and papules with scales over the planter and palmar aspect of both hands with similar lesions observed on both feet, legs, scalp, and ears with nail pitting. [cureus.com]
- Increased Sweating
Increased sweating ( hyperhidrosis ) is quite common and there is a tendency to fungal and bacterial infections of the feet. [dermnetnz.org]
Workup
The initial workup by a private physician included a complete blood count with differentials, liver function test, coagulation profile, urinalysis, and blood chemistry. All were normal. [pediatrics.aappublications.org]
Treatment
Management and treatment Treatment is based on oral retinoids which attenuate the palmoplantar keratoderma and slow the alveolar bone lysis. [rarediseases.info.nih.gov]
Orthodontic treatment in periodontal compromised cases is most challenging, light forces and controlled mechanics are important for adjunctive orthodontic treatment. [jdrntruhs.org]
Numerous treatment regimens for the periodontal disease seen in PLS can be found in the literature. [ncbi.nlm.nih.gov]
Treatment of the periodontal component of Papillon-Lefèvre syndrome. J Clin Periodontol 1986;13:6-10. 26. Eronat N, Ucar F, Kilinc G. [jisponline.com]
Prognosis
Prognosis Despite meticulous dental care, all patients eventually become edentulous at the beginning of adulthood. Life expectancy is normal. Last updated: 11/1/2012 [rarediseases.info.nih.gov]
COMMON Features of the Disorder Sparse hair Blisters on soles of feet/palms of hand (palmoplantar keratosis) Skin infections Premature tooth loss (periodontitis) Inflammation around teeth Nail abnormalities PROGNOSIS Individuals with the disorder lose [evolvegene.com]
All teeth with poor prognosis were extracted and extensive periodontal therapy was administered, and a special denture was constructed. No Reference information available - sign in for access. No Citation information available - sign in for access. [ingentaconnect.com]
[…] body diagrams and clinical photographs of each syndrome Bulleted text summarizing the patterns of inheritance, prenatal diagnosis, incidence, age of presentation, pathogenesis, key features, differential diagnosis, laboratory findings, management, and prognosis [books.google.com]
Etiology
The etiology of PLS is multifactorial with genetic, immunological, and microbial factors playing a role in etiopathogenesis. [hindawi.com]
Cathepsin C (CTSC) gene mutations are etiologic for PLS. The resultant loss of CTSC function is responsible for the severe periodontal destruction seen clinically. [ncbi.nlm.nih.gov]
In recent years the possibility that other etiologies may be involved has not been seriously considered. [scienceopen.com]
The etiopathogenesis of the syndrome is relatively obscure, and immunologic, genetic, or possible bacterial etiologies have been proposed. [jmedicalcasereports.biomedcentral.com]
Etiology of Periodontal Diseases (Part 4) provides a more comprehensive background in periodontal anatomy, physiology, and pathogenesis. [books.google.com]
Epidemiology
Epidemiology The prevalence is estimated between 1/250,000 and 1/1,000,000 individuals. The male to female ratio is 1:1. PLS is found in all ethnic groups. [rarediseases.info.nih.gov]
Detailed epidemiological study could not pinpoint any particular reason for this. References 1. Ohkawara A,Miura Y, Sapporo JI. Papillon-Lefevre syndrome. Arch Dermatol 1974; 109: 726-8 2. Griffiths WAD, Leigh IM, Marks R. [ijdvl.com]
& La Vecchia, C., 1999, In : International Journal of Epidemiology. 28, 4, p. 626-630 5 p. Research output : Contribution to journal › Article Case report. [moh-it.pure.elsevier.com]
Pathophysiology
Br Dent J 168, 27–29 (1990). https://doi.org/10.1038/sj.bdj.4807059 Download citation Published: 06 January 1990 Issue Date: 06 January 1990 DOI: https://doi.org/10.1038/sj.bdj.4807059 Further reading Therapeutic targeting of cathepsin C: from pathophysiology [nature.com]
[…] report. 61 Derindag G...Bilge OM 29789144 2019 45 Autophagic dysfunction in patients with Papillon-Lefèvre syndrome is restored by recombinant cathepsin C treatment. 61 Bullon P...Cordero MD 29410039 2018 46 Therapeutic targeting of cathepsin C: from pathophysiology [malacards.org]
Oral isotretinoin, discovered in the late 1960s, affects all the underlying pathophysiologic processes of acne and would be the ideal treatment if it did not have significant side effects. (2,9) During oral isotretinoin therapy, sebum production is reduced [de.slideshare.net]
Prevention
Located in 2026, Block C, Al Razi Building, Health Care City, Dubai, French Dental Clinic specializes in Orthognathic surgery as well as, its French qualified surgeons offer preventive, restorative, prosthodontic, Endodontic solutions for its patients [web.archive.org]
CASE REPORT Year : 2008 | Volume : 26 | Issue : 4 | Page : 171-174 Papillon-Lefevre syndrome: A case report Department of Pedodontics and Preventive Dentistry, The Oxford Dental College, Hospital and Research Centre, Bommanahalli, Hosur Road, Bangalore [jisppd.com]
Necessary preventive measures, i.e., scaling and oral prophylaxis therapy with antibiotics for 10 days were accomplished to preserve the remaining teeth and prevent the further resorption of alveolar bone in case 1 and case 3. [jidonline.com]
Diets low in phenylalanine and tyrosine may prevent complications. Acquired PPKs: Keratoderma climactericum – Seen in menopausal women, often associated with obesity or hypertension; pressure points on the soles of the feet are affected first. [visualdx.com]
If it achieves funding, they will provide "adequate remuneration for the provision of data and samples and invite you for co-authorship of any subsequent research publications." 11 JAN 2015 Science Patient compliance rates for SIT therapy to prevent peri-implantitis [efp.org]