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http://dx.doi.org/10.1016/j.jdcr.2021.09.047DOI Listing

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Article Synopsis
  • Primary atopic disorders (PAD) are rare genetic conditions caused by specific gene variants that affect skin and immune function, making diagnosis challenging among common allergic disease cases.
  • Identifying PAD requires recognizing clinical red flags like family history and unusual infections, as conventional lab tests are inadequate for definitive diagnosis.
  • Whole-genome sequencing (WGS) enhances diagnostic efficiency and accuracy, but requires careful interpretation and collaboration among specialists to effectively manage PAD cases.
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Background: Inborn errors of immunity (IEI), formerly referred to as primary immunodeficiencies, manifest with a wide range of symptoms such as increased susceptibility to infections, immune dysregulation, and autoinflammation. Although most cases manifest in childhood, onset during the neonatal period is rare but potentially critical.

Summary: In this review, we discuss the diverse clinical presentations of IEI and the specific challenges they pose to neonatologists.

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Newborn Skin: Part I. Common Rashes and Skin Changes.

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  • Rashes in newborns are common and usually harmless, but infections should be considered if there are pustules or vesicles, especially if the baby appears unwell or has risk factors for infections.
  • Congenital cytomegalovirus can lead to serious issues like hearing loss and neurodevelopmental delays, with skin signs such as petechiae, while congenital syphilis shows up as copper-red lesions on the hands and feet that crust over time.
  • Some rashes, like erythema toxicum neonatorum, are normal and temporary, while conditions like neonatal and infantile acne can differ, with milia being present at birth; transient changes like cutis marmor
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Autosomal recessive gene and consecutive collodion baby.

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  • Autosomal recessive congenital ichthyosis is a rare genetic disorder that affects skin keratinization, leading to issues like dryness and scaling.
  • The overall prevalence for related conditions, such as lamellar ichthyosis and congenital ichthyosiform erythroderma, is about 1 in 200,000 to 300,000 people.
  • The majority of mutations causing this condition are missense and frameshift mutations, making up 80% of cases; the patient mentioned has a mutation in the R-type arachidonate 12-lipoxygenase gene.
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