title: Skin biopsy is helpful for the diagnosis of incontinentia pigmenti at late stage (IV): a series of 26 cutaneous biopsies.
abstract: BACKGROUND
  Hypochromic streaks can be the only cutaneous sign of incontinentia pigmenti (IP) in adulthood (stage IV). Discovery of such lesions in an adult female with no family history of IP is essential for appropriate genetic counselling.
  
  
  OBJECTIVE
  To describe and to validate the histological features of residual skin lesions in adult IP.
  
  
  METHODS
  The analysis and comparison of skin biopsies of 26 women affected with molecularly confirmed IP.
  
  
  RESULTS
  Most biopsies showed slight atrophy and some scattered apoptotic cells in the epidermis, epidermal hypopigmentation and reduced melanocyte number. The dermis appeared thickened and homogeneous and revealed a complete absence of hair follicles (23/26) and sweat glands (22/26). There was no melanin incontinence or inflammatory cells, and the elastic network was normal.
  
  
  CONCLUSIONS
  These features lead unequivocally to the diagnosis of a stage IV IP skin lesion. Consequently, histology is a major confirmatory criterion for diagnoses of these mild clinical forms of IP. It is therefore a useful tool in genetic counselling and prenatal diagnosis. Moreover, the observations described here may contribute to understanding the physiopathology of the late stages of IP.
authors.affiliation: Department of Pathology, National Reference Centre for Genodermatoses (Maladies Génétiques à Expression Cutanée MAGEC), Necker-Enfants Malades Hospital, AP-HP, Université Paris-Descartes, Paris, France. sylvie.fraitag@nck.aphp.fr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Fraitag
authors.forename: Aude
authors.initials: A
authors.lastname: Rimella
authors.forename: Yves
authors.initials: Y
authors.lastname: de Prost
authors.forename: Nicole
authors.initials: N
authors.lastname: Brousse
authors.forename: Smail
authors.initials: S
authors.lastname: Hadj-Rabia
authors.forename: Christine
authors.initials: C
authors.lastname: Bodemer
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D006801:Humans; D007184:Incontinentia Pigmenti / Q000175:diagnosis*