title: Nevus vascularis mixtus (cutaneous vascular twin nevi) associated with intracranial vascular malformation of the Dyke-Davidoff-Masson type in two patients.
abstract: The term twin spotting refers to phenotypes characterized by the spatial and temporal co-occurrence of two (or more) different nevi arranged in variable cutaneous patterns, and can be associated with extra-cutaneous anomalies. Several examples of twin spotting have been described in humans including nevus vascularis mixtus, cutis tricolor, lesions of overgrowth, and deficient growth in Proteus and Elattoproteus syndromes, epidermolytic hyperkeratosis of Brocq, and the so-called phacomatoses pigmentovascularis and pigmentokeratotica. We report on a 28-year-old man and a 15-year-old girl, who presented with a previously unrecognized association of paired cutaneous vascular nevi of the telangiectaticus and anemicus types (naevus vascularis mixtus) distributed in a mosaic pattern on the face (in both patients) and over the entire body (in the man) and a complex brain malformation (in both patients) consisting of cerebral hemiatrophy, hypoplasia of the cerebral vessels and homolateral hypertrophy of the skull and sinuses (known as Dyke-Davidoff-Masson malformation). Both patients had facial asymmetry and the young man had facial dysmorphism, seizures with EEG anomalies, hemiplegia, insulin-dependent diabetes mellitus (IDDM), autoimmune thyroiditis, a large hepatic cavernous vascular malformation, and left Legg-Calvé-Perthes disease (LCPD) [LCPD-like presentation]. Array-CGH analysis and mutation analysis of the RASA1 gene were normal in both patients.
authors.affiliation: Chair of Pediatrics, Department of Educational Sciences, University of Catania, Catania, Italy. m.ruggieri@unict.it
authors.forename: Martino
authors.initials: M
authors.lastname: Ruggieri
authors.forename: Pietro
authors.initials: P
authors.lastname: Milone
authors.forename: Piero
authors.initials: P
authors.lastname: Pavone
authors.forename: Raffaele
authors.initials: R
authors.lastname: Falsaperla
authors.forename: Agata
authors.initials: A
authors.lastname: Polizzi
authors.forename: Rosario
authors.initials: R
authors.lastname: Caltabiano
authors.forename: Marco
authors.initials: M
authors.lastname: Fichera
authors.forename: Anna Lia
authors.initials: AL
authors.lastname: Gabriele
authors.forename: Angela
authors.initials: A
authors.lastname: Distefano
authors.forename: Rocco
authors.initials: R
authors.lastname: De Pasquale
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Salpietro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Micali
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pavone
mesh_terms: D000293:Adolescent; D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009506:Nevus / Q000150:complications* / Q000175:diagnosis; D012867:Skin / Q000473:pathology; D054079:Vascular Malformations / Q000175:diagnosis