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July 10, 2018; 91 (2 Supplement 1) ArticleOpen Access

The biology of cutaneous neurofibromas

Consensus recommendations for setting research priorities

Jean-Philippe Brosseau, Dominique C. Pichard, Eric H. Legius, Pierre Wolkenstein, Robert M. Lavker, Jaishri O. Blakeley, Vincent M. Riccardi, Sharad K. Verma, Isaac Brownell, Lu Q. Le
First published July 9, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005788
Jean-Philippe Brosseau
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Dominique C. Pichard
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Eric H. Legius
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Pierre Wolkenstein
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Robert M. Lavker
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Jaishri O. Blakeley
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Vincent M. Riccardi
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Sharad K. Verma
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Isaac Brownell
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Lu Q. Le
From the Department of Dermatology (J.P.B., L.Q.L.), UT Southwestern Medical Center, Dallas, TX; Dermatology Branch (D.C.P., I.B.), Center for Cancer Research, National Cancer Institutes of Health, Bethesda, MD; Human Genetics Department (E.H.L.), University of Leuven, Belgium; Division Cancer Immunity Transplantation Infections (P.W.), Paris Est Créteil University, France; Department of Dermatology (R.M.L.), Northwestern University, Chicago, IL; Department of Neurology (J.O.B., S.K.V.), The Neurofibromatosis Therapeutic Acceleration Program, The Johns Hopkins University School of Medicine, Baltimore, MD; and The NF Institute (V.M.R.), La Crescenta, CA.
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Citation
The biology of cutaneous neurofibromas
Jean-Philippe Brosseau, Dominique C. Pichard, Eric H. Legius, Pierre Wolkenstein, Robert M. Lavker, Jaishri O. Blakeley, Vincent M. Riccardi, Sharad K. Verma, Isaac Brownell, Lu Q. Le
Neurology Jul 2018, 91 (2 Supplement 1) S14-S20; DOI: 10.1212/WNL.0000000000005788

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    Figure 1 Clinical cutaneous neurofibroma examples across body regions

    Cutaneous neurofibromas can develop on hair-bearing skin (A) or non-hair-bearing skin on the palm (B) or sole (C) (arrows).

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    Figure 2 Paracrine signaling working model in neurofibroma

    Schwann cells, which depend on the nerve and heregulin (HRG) to proliferate, secrete stem cell factor (SCF). SCF binds to the receptor kit on mast cell, which in turn stimulates collagen deposition through activation of fibroblast by the transforming growth factor–β (TGF-β).

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