@article {61, title = {Somatic Mutations in NEK9 Cause Nevus Comedonicus.}, journal = {Am J Hum Genet}, volume = {98}, year = {2016}, month = {2016 May 05}, pages = {1030-1037}, abstract = {

Acne vulgaris (AV) affects most adolescents, and of those affected, moderate to severe disease occurs in 20\%. Comedones, follicular plugs consisting of desquamated keratinocytes and sebum, are central to its pathogenesis. Despite high heritability in first-degree relatives, AV genetic determinants remain incompletely understood. We therefore employed whole-exome sequencing (WES) in nevus comedonicus (NC), a rare disorder that features comedones and inflammatory acne cysts in localized, linear configurations. WES identified somatic NEK9 mutations, each affecting highly conserved residues within its kinase or RCC1 domains, in affected tissue of three out of three NC-affected subjects. All mutations are gain of function, resulting in increased phosphorylation at Thr210, a hallmark of NEK9 kinase activation. We found that comedo formation in NC is marked by loss of follicular differentiation markers, expansion of keratin-15-positive cells from localization within the bulge to the entire sub-bulge follicle and cyst, and ectopic expression of keratin 10, a marker of interfollicular differentiation not present in normal follicles. These findings suggest that NEK9 mutations in NC disrupt normal follicular differentiation and identify NEK9 as a potential regulator of follicular homeostasis.

}, keywords = {Adolescent, Adult, Child, Female, Fluorescent Antibody Technique, High-Throughput Nucleotide Sequencing, Humans, Male, Mutation, Nevus, NIMA-Related Kinases, Prognosis, Skin Neoplasms, Young Adult}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2016.03.019}, author = {Levinsohn, Jonathan L and Sugarman, Jeffrey L and McNiff, Jennifer M and Antaya, Richard J and Choate, Keith A} } @article {190, title = {Somatic Activating RAS Mutations Cause Vascular Tumors Including Pyogenic Granuloma.}, journal = {J Invest Dermatol}, volume = {135}, year = {2015}, month = {2015 Jun}, pages = {1698-1700}, keywords = {Adolescent, Cell Proliferation, Child, Child, Preschool, Female, Gene Expression Regulation, Neoplastic, Granuloma, Pyogenic, Humans, Infant, Infant, Newborn, Male, Mutation, ras Proteins, Vascular Neoplasms}, issn = {1523-1747}, doi = {10.1038/jid.2015.55}, author = {Lim, Young H and Douglas, Stephanie R and Ko, Christine J and Antaya, Richard J and McNiff, Jennifer M and Zhou, Jing and Choate, Keith A and Narayan, Deepak} } @article {125, title = {Somatic p.T771R KDR (VEGFR2) Mutation Arising in a Sporadic Angioma During Ramucirumab Therapy.}, journal = {JAMA Dermatol}, volume = {151}, year = {2015}, month = {2015 Nov}, pages = {1240-3}, abstract = {

IMPORTANCE: Inhibition of angiogenesis is an effective anticancer strategy because neoplasms require a rich blood supply. Ramucirumab, approved by the US Food and Drug Administration in 2014 to treat gastric adenocarcinomas and non-small cell lung carcinomas, targets vascular endothelial growth factor 2 (VEGFR2). We identified a patient prescribed a regimen of irinotecan hydrochloride, cetuximab, and ramucirumab for metastatic rectal cancer (diagnosed in November 2013 and treated through early January 2015) who developed a new-onset, expanding vascular lesion on his right leg. Via exome sequencing, we found that the lesion contained a single somatic mutation in KDR (encodes VEGFR2), possibly in response to ramucirumab. Vascular tumors are not a known complication of antiangiogenic therapeutics.

OBSERVATIONS: Exome sequencing of the well-demarcated, blanching vascular lesion on the lateral right shin revealed a somatic p.T771R mutation in KDR, without evidence of other somatic mutations or loss of heterozygosity. Histological features included lobules of small vessels within the dermis, resembling a tufted angioma.

CONCLUSIONS AND RELEVANCE: A potential adverse effect of ramucirumab in combination therapy is the development of sporadic angiomas. The p.T771R mutation was previously implicated in autophosphorylation of VEGFR2 and reported in angiosarcomas alongside other driver mutations. Our observations suggest that this mutation confers a proliferative advantage in the setting of ramucirumab therapy. Patients receiving ramucirumab should be monitored for the development of new vascular lesions.

}, keywords = {Adult, Angiogenesis Inhibitors, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Camptothecin, Cetuximab, Hemangioma, Humans, Irinotecan, Male, Mutation, Rectal Neoplasms, Skin Neoplasms, Vascular Endothelial Growth Factor Receptor-2}, issn = {2168-6084}, doi = {10.1001/jamadermatol.2015.1925}, author = {Lim, Young H and Odell, Ian D and Ko, Christine J and Choate, Keith A} } @article {166, title = {Somatic V600E BRAF Mutation in Linear and Sporadic Syringocystadenoma Papilliferum.}, journal = {J Invest Dermatol}, volume = {135}, year = {2015}, month = {2015 Oct}, pages = {2536-2538}, keywords = {Biopsy, Needle, Child, Cystadenoma, Female, Gene Expression Regulation, Neoplastic, Humans, Immunohistochemistry, Mutation, Proto-Oncogene Proteins B-raf, Sweat Gland Neoplasms, Syringoma}, issn = {1523-1747}, doi = {10.1038/jid.2015.180}, author = {Levinsohn, Jonathan L and Sugarman, Jeffrey L and Bilguvar, Kaya and McNiff, Jennifer M and Choate, Keith A} } @article {286, title = {Somatic HRAS p.G12S mutation causes woolly hair and epidermal nevi.}, journal = {J Invest Dermatol}, volume = {134}, year = {2014}, month = {2014 Apr}, pages = {1149-1152}, keywords = {Adherens Junctions, Child, Exome, Female, Genes, ras, Hair, Hair Diseases, Hair Follicle, Humans, Intermediate Filaments, Mosaicism, Mutation, Nevus, Phenotype, ras Proteins, Sequence Analysis, DNA, Signal Transduction}, issn = {1523-1747}, doi = {10.1038/jid.2013.430}, author = {Levinsohn, Jonathan L and Teng, Joyce and Craiglow, Brittany G and Loring, Erin C and Burrow, T Andrew and Mane, Shrikant S and Overton, John D and Lifton, Richard P and McNiff, Jennifer M and Lucky, Anne W and Choate, Keith A} }