A splicing variant in XPA results in delayed onset of clinical features of xeroderma pigmentosum

Journal of Investigative Dermatology
Open Access

Clinical Summary

View source

What was studied

Two unrelated Cypriot XP-A patients homozygous for c.389G>A (p.R130K) were described, with clinical phenotypes and fibroblast-based assays of nucleotide excision repair (TC-NER, GG-NER) and XPA protein levels.

Key findings

Both patients’ fibroblasts showed a severe TC-NER defect and reduced GG-NER, with very low XPA protein levels despite a conservative amino acid change; clinically, the 69-year-old developed progressive neurologic degeneration in his 40s, while the 32-year-old has no neurologic abnormalities to date.

Study limitations

Only two cases from a single ancestry are reported, limiting generalizability; the abstract provides no quantitative repair metrics and appears truncated, leaving mechanistic details incomplete.

Clinical implications

XP-A due to c.389G>A (p.R130K) can present with mild cutaneous disease yet later neurologic decline; functional testing can reveal marked NER defects even when the variant appears conservative, and adult patients may warrant ongoing neurologic surveillance.