A case report of HLA-Cw6 and phenotype discordances in monozygotic twins with psoriasis: The role of epigenetic mechanism

Authors

  • Nuril Ilmi Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
  • Faridha Ilyas Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
  • Anni Adriani Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
  • Khairuddin Djawad Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.

Keywords:

disease severity, early onset, HLA-Cw6, monozygotic twins, psoriasis

Abstract

Psoriasis is a systemic autoimmune disease influenced by genetic and environmental factors. The gene HLA-Cw6 is one of the most strongly associated proteins in psoriasis development. Recently, studies regarding monozygotic twins with psoriasis revealed that phenotype concordance among monozygotic twins was approximately 35-72%. We present a case of 15-year-old monozygotic twins female with psoriasis that exhibited differ in both onset and severity. HLA-Cw6 expression was negative in the twin that exhibited minimal cutaneous manifestation compared to the one with a more severe clinical presentation. We hypothesized that. epigenetic modification played an important role in phenotypic differences even though both patients theoretically have similar DNA sequences. This paper may merit further investigation regarding the nuanced interactions between genetics and the environment towards the clinical outcome of psoriasis patients. 

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Published

2023-07-02

How to Cite

1.
Ilmi N, Ilyas F, Adriani A, Djawad K. A case report of HLA-Cw6 and phenotype discordances in monozygotic twins with psoriasis: The role of epigenetic mechanism. J Pak Assoc Dermatol [Internet]. 2023Jul.2 [cited 2025Jan.24];33(2):791-5. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/2226

Issue

Vol. 33 No. 2 (2023): April-June

Section

Case Reports

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