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Keith Choate, MD, PhD

Aaron B. and Marguerite Lerner Professor and Chair of Dermatology. Professor of Genetics and Pathology. Associate Dean for Physician-Scientist Development

Contact Information

Keith Choate, MD, PhD

Research Summary

We employ a comprehensive approach human genetic disorders, attempting to understand their clinical presenations by studying their genetics and pathobiology. Using genetic tools, we have identified new genetic causes of inherited disorders and we are actively studying how these genes function in health and disease.

Extensive Research Description

Genetics has informed our understanding of normal skin development and differentiation, largely due to the fact that mutations affecting the skin result in easily observed phenotypes. Genetic investigation has permitted us to identify a priori pathways previously unrecognized to be relevant to skin biology. These insights have been relevant to diagnosis, disease prevention, and development of novel therapeutics.

We have three ongoing projects in the lab:

1. Identification of novel genetic causes of inherited skin disorders including ichthyosis, inflammatory disorders and alopecia. We have developed one of the largest registries of kindreds with ichthyosis and have identified over 10 new genetic cause of this group of disorders – we employ cell, murine, and engineered tissue models to understand that biological basis of disease and the role of novel genes in disease pathobiology.

2. Identification of novel genetic causes of mosaic skin disorders including childhood malformations, vascular tumors, and linear presentations of inflammatory disorders. Mosaic disorders are the result of embryonic somatic mutation, with timing of mutation determining the extent of disease. Among other discoveries, we have systematically dissected pathways leading to development of aggressive infantile vascular tumors, identified novel causes of acne pathogenesis and hair follicle differentiation, and have identified Ras as a regulator of phosphate homeostasis. A new project is focused on linear manifestation of common inflammatory disorders such as lupus, psoriasis, and lichen planus with the expectation that investigation will identify novel pathways in cutaneous innate immunity.

3. Elucidation of mechanisms of revertant mosaicism in ichthyosis with confetti to enable therapeutic recombination in the skin. We have found that specific mutations in KRT1 and KRT10 cause ichthyosis with confetti which undergoes spontaneous self-correction via revertant mosaicism, resulting in hundreds to thousands of patches of normal skin. All spots arise from mitotic recombination, and have found that keratin mutations directly influence DNA damage and repair and that cellular competition favors reversion. We are employing forward genetics to identify the pathways relevant to recombination and competition.

Coauthors

Research Interests

Cell Biology; Genetics, Medical; Musculoskeletal Diseases; Human Genome Project; Skin and Connective Tissue Diseases

Public Health Interests

Cancer; Genetics, Genomics, Epigenetics; Child/Adolescent Health

Selected Publications

  • 502 The genomic and phenotypic landscape of ichthyosis: An analysis of 1000 kindredsSun Q, Marukian N, Cheraghlou S, Paller A, Larralde M, Bercovitch L, Levinsohn J, Ren I, Hu R, Zhou J, Zaki T, Fan R, Tian C, Saraceni C, Nelson-Williams C, Loring E, Craiglow B, Milstone L, Lifton R, Boyden L, Choate K. 502 The genomic and phenotypic landscape of ichthyosis: An analysis of 1000 kindreds Journal Of Investigative Dermatology 2022, 142: s85. DOI: 10.1016/j.jid.2022.05.511.
  • Acral Hemorrhagic Darier’s Disease: a case report of a rare presentation and literature reviewHong E, Hu R, Posligua A, Choate K, Durkin J. Acral Hemorrhagic Darier’s Disease: a case report of a rare presentation and literature review JAAD Case Reports 2022 DOI: 10.1016/j.jdcr.2022.05.030.
  • LB731 GJA4 somatic mutations drive venous malformation in the skin and liver and reveal a novel pathway for therapeutic interventionUgwu N, Atzmony L, Ellis K, Panse G, Jain D, Ko C, Nassiri N, Choate K. LB731 GJA4 somatic mutations drive venous malformation in the skin and liver and reveal a novel pathway for therapeutic intervention Journal Of Investigative Dermatology 2021, 141: b8. DOI: 10.1016/j.jid.2021.07.021.
  • 25905 The Ichthyosis Scoring System (ISS): Development and validation of a novel ichthyosis severity assessment instrumentSun Q, Paller A, Choate K. 25905 The Ichthyosis Scoring System (ISS): Development and validation of a novel ichthyosis severity assessment instrument Journal Of The American Academy Of Dermatology 2021, 85: ab12. DOI: 10.1016/j.jaad.2021.06.073.
  • 180 ASPRV1 mutations cause dominantly inherited ichthyosisBoyden L, Zhou J, Hu R, Zaki T, Loring E, Scott J, Traupe H, Paller A, Lifton R, Choate K. 180 ASPRV1 mutations cause dominantly inherited ichthyosis Journal Of Investigative Dermatology 2021, 141: s32. DOI: 10.1016/j.jid.2021.02.200.
  • 186 Kindler epidermolysis bullosa-like skin phenotype and downregulated basement membrane zone gene expression in poikiloderma with neutropenia and a homozygous USB1 mutationVahidnezhad H, Youssefian L, Touati A, Saeidian A, Harvey N, Zabihi M, Barzegar M, Sotoudeh S, Liu L, Guy A, Kariminejad A, Zeinali S, Boyden L, Choate K, McGrath J, Uitto J. 186 Kindler epidermolysis bullosa-like skin phenotype and downregulated basement membrane zone gene expression in poikiloderma with neutropenia and a homozygous USB1 mutation Journal Of Investigative Dermatology 2021, 141: s33. DOI: 10.1016/j.jid.2021.02.206.
  • 422 The Ichthyosis Scoring System (ISS): Development and validation of a novel ichthyosis severity assessment instrumentSun Q, Paller A, Choate K. 422 The Ichthyosis Scoring System (ISS): Development and validation of a novel ichthyosis severity assessment instrument Journal Of Investigative Dermatology 2021, 141: s73. DOI: 10.1016/j.jid.2021.02.445.
  • 428 Randomized, double-blind, placebo-controlled study of efficacy and safety of secukinumab to treat adults with ichthyosesLefferdink R, Chima M, Ibler E, Pavel A, Kim H, Wu B, Abu-Zayed H, Rangel S, Wu J, Zumpf K, Jackson K, Choate K, Guttman-Yassky E, Paller A. 428 Randomized, double-blind, placebo-controlled study of efficacy and safety of secukinumab to treat adults with ichthyoses Journal Of Investigative Dermatology 2021, 141: s74. DOI: 10.1016/j.jid.2021.02.451.
  • 294 Recessive mutations in AP1B1 cause ichthyosis, deafness, and blindnessBoyden L, Atzmony L, Zhou J, Lim Y, Hu R, Lifton R, Choate K. 294 Recessive mutations in AP1B1 cause ichthyosis, deafness, and blindness Journal Of Investigative Dermatology 2020, 140: s36. DOI: 10.1016/j.jid.2020.03.300.
  • 432 Ichthyosis affects mental health in adults and children: A cross-sectional studySun Q, Ren I, Zaki T, Maciejewski K, Choate K. 432 Ichthyosis affects mental health in adults and children: A cross-sectional study Journal Of Investigative Dermatology 2020, 140: s57. DOI: 10.1016/j.jid.2020.03.440.
  • 579 Rationale and design for the Kallikrein Inhibitor in Netherton Syndrome (KINS) pivotal clinical trialJohnson K, Hovnanian A, Teng J, Paller A, Choate K, Elias P, Laura Z, Nguyen T, Smith D, Hsu A, Alani L, Lai C, Hsu L. 579 Rationale and design for the Kallikrein Inhibitor in Netherton Syndrome (KINS) pivotal clinical trial Journal Of Investigative Dermatology 2020, 140: s79. DOI: 10.1016/j.jid.2020.03.589.
  • 868 Pathogenesis based therapy improves cutaneous abnormalities in porokeratosis- A pilot studyAzmony L, Sun Q, Hamilton C, Lim Y, Leventhal J, Paller A, Choate K. 868 Pathogenesis based therapy improves cutaneous abnormalities in porokeratosis- A pilot study Journal Of Investigative Dermatology 2020, 140: s113. DOI: 10.1016/j.jid.2020.03.884.
  • 390 Second-hit, post-zygotic PMVKand MVD mutations cause linear porokeratosisAtzmony L, Khan H, Lim Y, Paller A, Levinsohn J, Holland K, Mirza F, Yin E, Ko C, Leventhal J, Choate K. 390 Second-hit, post-zygotic PMVKand MVD mutations cause linear porokeratosis Journal Of Investigative Dermatology 2019, 139: s67. DOI: 10.1016/j.jid.2019.03.466.
  • 799 Exome, genome, and cDNA sequencing reveal KDSR mutations cause two forms of ichthyosis and identify retinoids as pathogenesis-directed therapyBoyden L, Vincent N, Zhou J, Hu R, Paller A, Lifton R, Baserga S, Choate K. 799 Exome, genome, and cDNA sequencing reveal KDSR mutations cause two forms of ichthyosis and identify retinoids as pathogenesis-directed therapy Journal Of Investigative Dermatology 2018, 138: s136. DOI: 10.1016/j.jid.2018.03.809.
  • 832 Mechanisms of spontaneous genetic reversion in ichthyosis with confettiLim Y, Lu Y, Mirza H, Zhou J, Hu R, Choate K. 832 Mechanisms of spontaneous genetic reversion in ichthyosis with confetti Journal Of Investigative Dermatology 2018, 138: s141. DOI: 10.1016/j.jid.2018.03.842.
  • 380 Ichthyosis has a moderate impact on quality of life in adultsRen I, Ren I, Olamiju B, Li L, Li L, Deng Y, Deng Y, Marukian N, Marukian N, Zaki T, Zhou J, Hu R, Milstone L, Choate K. 380 Ichthyosis has a moderate impact on quality of life in adults Journal Of Investigative Dermatology 2018, 138: s64. DOI: 10.1016/j.jid.2018.03.386.
  • 379 Quality of life in children with ichthyosisOlamiju B, Ren I, Ren I, Li L, Li L, Deng Y, Deng Y, Marukian N, Marukian N, Zhou J, Hu R, Zaki T, Craiglow B, Choate K. 379 Quality of life in children with ichthyosis Journal Of Investigative Dermatology 2018, 138: s64. DOI: 10.1016/j.jid.2018.03.385.
  • 655 Origin and functions of the corneocyte lipid envelopeCrumrine D, Khnykin D, Krieg P, Man M, Celli A, Mauro T, Menon G, Mauldin E, Miner J, Brash A, Sprecher E, Radner F, Choate K, Roop D, Uchida Y, Gruber R, Schmuth M, Elias P. 655 Origin and functions of the corneocyte lipid envelope Journal Of Investigative Dermatology 2018, 138: s111. DOI: 10.1016/j.jid.2018.03.664.
  • 1338 Dermal Wnt/β-catenin activation tunably controls hair follicle initiationGupta K, Chen D, Levinsohn J, Choate K, Taketo M, Myung P. 1338 Dermal Wnt/β-catenin activation tunably controls hair follicle initiation Journal Of Investigative Dermatology 2018, 138: s227. DOI: 10.1016/j.jid.2018.03.1355.
  • 513 GNA14 somatic mutation causes congenital and sporadic vascular tumors by MAPK activationLim Y, Bacchiocchi A, Qiu J, Bruckner A, Bercovitch L, Narayan D, McNiff J, Ko C, Robinson-Bostom L, Antaya R, Halaban R, Choate K. 513 GNA14 somatic mutation causes congenital and sporadic vascular tumors by MAPK activation Journal Of Investigative Dermatology 2017, 137: s88. DOI: 10.1016/j.jid.2017.02.533.
  • 291 Establishing and validating an ichthyosis severity indexMarukian N, Deng Y, Gan G, Ren I, Thermidor W, Craiglow B, Milstone L, Choate K. 291 Establishing and validating an ichthyosis severity index Journal Of Investigative Dermatology 2017, 137: s50. DOI: 10.1016/j.jid.2017.02.307.
  • 497 Genetic investigation of linear inflammatory disordersTheodosakis N, Levinsohn J, Lim Y, Paller A, Sugarman J, Choate K. 497 Genetic investigation of linear inflammatory disorders Journal Of Investigative Dermatology 2017, 137: s85. DOI: 10.1016/j.jid.2017.02.517.
  • 458 Cellular and metabolic basis for the ichthyotic phenotype in ichthyin deficiencyMauldin E, Cassal M, Jeong S, Vavrova K, Uchida Y, Park K, Craiglow B, Choate K, Shin K, Lee Y, Khnykin D, Grove G, Elias P. 458 Cellular and metabolic basis for the ichthyotic phenotype in ichthyin deficiency Journal Of Investigative Dermatology 2017, 137: s79. DOI: 10.1016/j.jid.2017.02.477.
  • 514 Somatic mutations in nevus comedonicus identify nek9 as a determinant of follicular keratinocyte cell fateLevinsohn J, Sugarman J, McNiff J, Freiden I, Antaya R, Choate K. 514 Somatic mutations in nevus comedonicus identify nek9 as a determinant of follicular keratinocyte cell fate Journal Of Investigative Dermatology 2017, 137: s88. DOI: 10.1016/j.jid.2017.02.534.
  • 463 GJA1 mutations causing erythrokeratodermia variabilis et progressiva display increased connexin hemichannel activityKhan H, Boyden L, Tomita S, Choate K. 463 GJA1 mutations causing erythrokeratodermia variabilis et progressiva display increased connexin hemichannel activity Journal Of Investigative Dermatology 2017, 137: s80. DOI: 10.1016/j.jid.2017.02.482.
  • 351 Epidermal fragility in Keratin 10 ichthyosis with confetti mutation results from loss of keratin 1-desmoplakin interactionLu Y, Mirza H, Hu R, Zhou J, Crumrine D, Elias P, Lifton R, Choate K. 351 Epidermal fragility in Keratin 10 ichthyosis with confetti mutation results from loss of keratin 1-desmoplakin interaction Journal Of Investigative Dermatology 2016, 136: s62. DOI: 10.1016/j.jid.2016.02.383.
  • 366 Bathing suit ichthyosis: Novel mutations and clues to pathogenesisMarukian N, Zhou J, Hu R, Theos A, Kaymakcalan H, Bayliss S, Paller A, Boyden L, Choate K. 366 Bathing suit ichthyosis: Novel mutations and clues to pathogenesis Journal Of Investigative Dermatology 2016, 136: s65. DOI: 10.1016/j.jid.2016.02.399.
  • 373 Keratin network is regulated by nonsense mediated decay and ubiquitin-proteosome in epidermolyic ichthyosisMirza H, Lian R, Hu R, Zhou J, Choate K. 373 Keratin network is regulated by nonsense mediated decay and ubiquitin-proteosome in epidermolyic ichthyosis Journal Of Investigative Dermatology 2016, 136: s66. DOI: 10.1016/j.jid.2016.02.406.
  • 383 A novel erythrokeratodermia-cardiomyopathy syndrome is caused by dominant, clustered mutations in desmoplakinBoyden L, Kam C, Hernández-Martín A, Zhou J, Craiglow B, Milstone L, Hu R, Elias P, Green K, Choate K. 383 A novel erythrokeratodermia-cardiomyopathy syndrome is caused by dominant, clustered mutations in desmoplakin Journal Of Investigative Dermatology 2016, 136: s68. DOI: 10.1016/j.jid.2016.02.416.
  • 395 Disease severity and cutaneous inflammation in ichthyosis are linked to Th17 pathway activationPaller A, Suarez-Farinas M, Renert-Yuval Y, Oliva M, Huynh T, Esaki H, Suprun M, Friedland R, Wanderman R, Krueger J, Choate K, Guttman-Yassky E. 395 Disease severity and cutaneous inflammation in ichthyosis are linked to Th17 pathway activation Journal Of Investigative Dermatology 2016, 136: s70. DOI: 10.1016/j.jid.2016.02.429.
  • 392 A novel polyalanine frameshift mutation in KRT10 causes ichthyosis with confettiLim Y, Saraceni C, Choate K. 392 A novel polyalanine frameshift mutation in KRT10 causes ichthyosis with confetti Journal Of Investigative Dermatology 2016, 136: s69. DOI: 10.1016/j.jid.2016.02.426.
  • Claudins Mediate Specific Paracellular Fluxes in VivoChoate K, Lu Y, Lifton R. Claudins Mediate Specific Paracellular Fluxes in Vivo 2001 DOI: 10.1201/9781420038538.ch22.

Clinical Trials

ConditionsStudy Title
Diseases of the Integumentary System; Genetics - Adult; Genetics - PediatricDoes Ichthyosis Affect Growth Among Children?