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PubMed2003

EEC syndrome--a case report.

EEC syndrome is a multiple congenital anomaly syndrome characterized by ectodermal dysplasia, distal limb anomaly, cleft lip and palate and ocular adnexia anomalies. A case report of a 10 year old female patient with EEC is presented and it is emphasised that management of these cases requires a multidisciplinary approach. Early diagnosis will allow parents to get accurate counseling and in particular obtain reassurance regarding the low risk of mental handicap.

Child↗

PubMed1999

EEM syndrome: report of a family and results of a ten-year follow-up.

We report on a Brazilian kindred in which two sibs presented with the complete form of EEM (ectodermal dysplasia, ectrodactyly, and macular dystrophy) syndrome with hypotrichosis, dental anomalies, syndactyly, and retinal changes with prominent pigmentation in the posterior pole of the retina. In this family, we also observed another sib with syndactyly, as well as a first cousin with ectrodactyly. A 10-year follow-up demonstrated gradually decreasing visual acuity and progression of retinal degenerative anomalies.

Adult↗

PubMed2003

[Rapp-Hodgkin's syndrome: two cases].

INTRODUCTION: In 1968, Rapp and Hodgkin described a family (a mother and her son and daughter) with a combination of dysplasic hair, nails, hypodontia and hypohidrosis associated with oral clefting and hypoplasia of the maxillary. Forty other cases of this congenital disorder have since been reported, and provide better knowledge of this predominantly hereditary disease. CASE REPORT: We examined a 4 year-old boy for who had suffered since birth from a crusting and inflammatory scalp dermatitis which evolved periodically. He also had a coarse, wiry, light colored and slow growing hair, onychodysplasia, skin atrophy areas on the trunk, and distinctive craniofacial anomalies including a bifid uvula. He had never been seen to sweat. His father presented similar features, but less pronounced, and with a segmentary distribution. DISCUSSION: We report two new cases of Rapp-Hodgkin's ectodermal dysplasia. We suspect a mosaicism in the father who may be the first and sporadic case of the family. These discret forms are frequently misdiagnosed and we hope we have provided some new elements which will help in the description of this rare disease. Early diagnosis permits an early follow-up and avoids numerous complications.

Adult↗

PubMed2006

Alternative oral rehabilitation of children with hypodontia and conical tooth shape: a clinical report.

This case report outlines an alternative oral rehabilitation treatment of a 4-year-old boy with hypodontia and conical tooth shape, which along with other characteristics led to a suspicious ectodermal dysplasia diagnosis. Diagnostic waxup and a silicone matrix formed the basis to the successful reconstruction of the anterior teeth with resin composite. Additionally, removable partial dentures were fabricated to improve esthetics and chewing ability. Positive psychologic influence of this alternative treatment on this patient is also discussed.

Anodontia↗

PubMed1987

[Christ-Siemens-Touraine syndrome. Therapeutic case review].

The Christ-Siemens-Touraine syndrome, or anhidrotic ectodermal dysplasia, presents three principal signs: anhidrosis or hypohidrosis, hypotrichosis and anodontia or hypodontia. This syndrome is of particular interest to stomatologists and orthodontists because of the particular therapeutic problems raised by the anodontia and associated skeletal anomalies. A case is reported in which the principal clinical sign was anodontia, and the various therapeutic options currently available are discussed.

Anodontia↗

PubMed2006

EDA signaling and skin appendage development.

The same morphogenetic signals are often involved in the development of different organs. For developing skin appendages, a model for tissue-specific regulation of signaling is provided by the EDA pathway, which accesses the otherwise ubiquitous NFkappaB transcription factors. EDA signaling is mediated by ectodysplasin, EDAR and EDARADD, which form a new TNF ligand-receptor-adaptor family that is restricted to skin appendages in vertebrates from fish to human. The critical function of the pathway was demonstrated in the hereditary genetic disorder Anhidrotic Ectodermal Dysplasia (EDA), which is characterized by defective formation of hair follicles, sweat glands and teeth. The pathway does not appear to initiate the development of the appendages, but is regulated by and regulates the course of further morphogenesis. In mice, transgenic and knockout strains have increasingly revealed features of the mechanism, and suggest possible non-invasive interventions to alleviate EDA deficiency, especially in sweat glands and eyes.

Amino Acid Sequence↗

PubMed1997

Schöpf-Schulz-Passarge syndrome with an unusual pattern of inheritance.

Schöpf-Schulz-Passarge syndrome is a rare form of ectodermal dysplasia comprising hypotrichosis, hypodontia, unusual eyelid cysts, palmar-plantar keratosis, and nail dystrophy. To date, ten cases have been reported; all except one are compatible with autosomal recessive inheritance. We report on a family in which three full sibs and one half-sib have Schopf-Schulz-Passarge syndrome, yet there is no other evidence of dominant transmission in prior or subsequent generations. Possible explanations are discussed.

Anodontia↗

PubMed2001

Alopecia areata universalis in an infant.

BACKGROUND: Alopecia areata (AA) is common during childhood and rarely reported in infants. The four reported cases of AA in infants all exhibited circumscribed patches of alopecia that appeared at birth or shortly thereafter. OBJECTIVE: We report a case of alopecia areata universalis that developed after birth along with fingernail changes of shortening (onychomadesis) and onycholysis. Scalp biopsy at 2 years of age revealed rare, intermediate, terminal follicles in catagen associated with sparse peribulbar lymphocytic infiltrates. RESULTS: This constellation of clinicopathologic features was interpreted as AA. We discuss the differential diagnosis of generalized alopecia in healthy infants, in particular, Clouston's syndrome, a hair-nail (hidrotic) ectodermal dysplasia found in this region. Genetic testing for linked polymorphisms to the Clouston gene locus were negative in this child and his parents. CONCLUSIONS: Alopecia areata should be included in the differential diagnosis of generalized alopecia presenting at or shortly after birth. For purposes of genetic counseling and prognosis, it is crucial that a correct diagnosis be made.

Alopecia Areata↗

PubMed1978

[Rudiger (E. E. C.) syndrome: report of a case associated with atopic dermatitis (author's transl)].

The syndrome of ectrodactyly, ectodermal dysplasia and cleft lip-palate is described in a boy aged 3; although inherited in most cases as an autosomal dominant trait, it seems here to be sporadic. An atopic dermatitis clinically evident and particularly resistant to treatment is present, but IgE level is not raised. Ophthalmologic changes are prominent. Systematic intravenous pyelogram showed urinary tract strictures.

Child, Preschool↗

PubMed1997

The Marshall syndrome: report of a new family and review of the literature.

The Marshall syndrome is an autosomal dominant trait comprising ocular abnormalities, sensorineural hearing loss, craniofacial anomalies, and anhidrotic ectodermal dysplasia. To our knowledge, only seven additional multigenerational families have been reported since the initial description of the disorder by Marshall in 1958. We present a family in which six members in four generations are affected with apparent Marshall syndrome. We also review and compare similar disorders, such as Stickler, Weissenbacher-Zweimüller, and Wagner syndromes, and conclude that Marshall syndrome is a distinct entity.

Abnormalities, Multiple↗

PubMed2006

Keratin 17 mutation in pachyonychia congenita type 2 patient with early onset steatocystoma multiplex and Hutchinson-like tooth deformity.

Pachyonychia congenita type 2 (PC-2) is an autosomal dominant disorder characterized by hypertrophic nail dystrophy, focal keratoderma, multiple pilosebaceous cysts, and other features of ectodermal dysplasia. It has been demonstrated that PC-2 is caused by mutations in the keratin 17 and keratin 6b genes. In this report, we describe a missense mutation in the keratin 17 gene, M88T, in a Korean patient whose phenotype included early onset steatocystoma multiplex and Hutchinson-like tooth deformities along with other typical features of PC-2 such as hypertrophic nails, natal teeth and follicular hyperkeratosis.

Child↗

PubMed1995

Sonographic depiction of fetal tooth germs.

Recently, sonography of the fetal face has gained increasing importance in prenatal diagnosis. It is not yet clear whether sonographic depiction of fetal tooth germs would have an influence on the prenatal diagnosis of ectodermal dysplasia syndromes. During routine malformation screening, horizontal sections of fetal jaws were visualized and examined for tooth germs in 124 pregnant women following sonographic 'facing'. Histological jaw sections of fetuses that had died in utero at various gestational ages were produced in order to examine the degree of correspondence between the sonographic and histological findings. At least four tooth germs were found in the jaws of all fetuses between 19 and 34 gestational weeks (n = 104). Although jaw visualization was possible between 14 and 18 gestational weeks (n = 20), the exact number and location of the tooth germs could not be determined. Assessment of tooth germs may become increasingly important, as aplasia of the tooth germs is one of the principal signs of various hereditary ectodermal diseases.

Anodontia↗

PubMed1986

A simple technique for recording and counting sweat pores on the dermal ridges.

A simple method was devised for recording dermatoglyphics in a form suitable for sweat pore counting. Fifteen members of a family with a hypohidrotic X-linked ectodermal dysplasia made their own hand prints using our method and mailed the results to us for interpretation. The simplicity of the technique also makes it practical to use on new-born males at risk for the condition, or where dermatoglyphic records are required for other purposes. Preliminary data suggest that patchiness of sweat pore distribution on the fingers and palms may be useful in the discrimination of heterozygotes.

Adolescent↗

PubMed1993

Severe skin erosions and scalp infections in AEC syndrome.

Hay-Wells syndrome is an autosomal dominant condition characterized by ankyloblepharon filiforme adnatum, ectodermal dysplasia, and cleft palate with or without associated cleft lip (AEC syndrome). Although several reported patients had eroded skin at birth and recurrent scalp infections, these are not generally regarded as major features of the disorder. In our experience, denuded skin at birth and chronic scalp erosions complicated by infection are common features of this syndrome. Aggressive wound care in conjunction with early administration of topical or systemic antibiotics is suggested.

Abnormalities, Multiple↗

PubMed1997

Human genes for dental anomalies.

The development of the tooth at gene level is beginning to be understood. This paper reviews current knowledge and the advances in research on human genes whose defect leads to dental anomalies. Amelogenesis imperfecta (AI) is a diverse group of hereditary disorders characterized by a variety of developmental enamel defects including hypoplasia and hypomineralization, some of which have been revealed to be associated with defective amelogenin genes. The human amelogenin genes on X and Y chromosomes have been cloned and investigated extensively. Although autosomally inherited forms of AI are more common than the X-linked forms, most studies on the genes causing AI have been performed on the genes of X-linked forms. Recently, the gene for the human tuftelin protein (an enamelin) has been cloned as a candidate gene for the autosomal forms of AI with another gene on chromosome 4 involved in some families. Dentinogenesis imperfecta (DI) may be associated with osteogenesis imperfecta (OI), which is an autosomal dominant bone disease. Most patients with OI have mutations in either the COLIA1 or COLIA2 genes, which encode the alpha 1(I) or alpha 2(I) subunits of type I collagen, the major organic component of bone and dentin. Gene defects causing isolated DI have not been identified. Recently, it was demonstrated that a missense mutation of MSXI, a human homeobox gene, causes autosomal dominant agenesis of second premolars and third molars. Data indicating an important function for MSXI, the mouse counterpart of the human MSXI gene, in mouse tooth development have been accumulating since 1991. Knockout mice lacking this gene exhibited multiple craniofacial anomalies including complete tooth agenesis. X-linked anhidrotic ectodermal dysplasia (EDA), characterized by abnormal hair, teeth, and sweat glands, was demonstrated to be caused by a mutation in a novel transmembrane protein gene that is expressed in epithelial cells and in other adult and fetal tissues. The predicted EDA protein may belong to a novel class of proteins with a role in epithelial-mesenchymal signaling. Several mutations have been reported in genes causing hypophosphatasia, which is characterized by defective mineralization of the skeletal and dental structures.

Adult↗

PubMed2002

The p63 gene in EEC and other syndromes.

Several autosomal dominantly inherited human syndromes have recently been shown to result from mutations in the p63 gene. These syndromes have various combinations of limb malformations fitting the split hand-split foot spectrum, orofacial clefting, and ectodermal dysplasia. The p63 syndrome family includes the EEC syndrome, AEC syndrome, ADULT syndrome, limb-mammary syndrome, and non-syndromic split hand/foot malformation. The pattern of heterozygous mutations is distinct for each of these syndromes. The functional effects on the p63 proteins also vary between syndromes. In all of these syndromes, the mutation appears to have both dominant negative and gain of function effects rather than causing a simple loss of function.

Congenital Abnormalities↗

PubMed2004

Plakophilin 1: an important stabilizer of desmosomes.

Desmosomes are cell-cell junctions found primarily in epithelial tissues and particularly in those that frequently undergo mechanical stress. Desmosomal cadherins provide the adhesion for opposing cell membranes and desmosomal plaque proteins link cytoskeletal intermediate filaments to these cadherins. Plakophilin 1 is a desmosomal plaque protein and a member of the armadillo family of structural and signalling proteins. Expressed primarily in the suprabasal layers of stratifying epithelia, plakophilin 1 is absent in patients with the rare autosomal recessive disorder, ectodermal-dysplasia skin-fragility syndrome (OMIM 604536). These patients exhibit skin fragility with trauma induced blistering, especially on the weight-bearing parts of the soles, and thus provide a vivid illustration of the clinical importance of PKP1 in skin physiology. Recent in vitro data also implicate plakophilin 1 in regulating desmosome integrity in response to low calcium concentrations and in altering the migratory properties of wounded keratinocyte sheets in culture. These findings further underscore the significant role of PKP1 in keratinocyte cell biology.

Calcium↗

PubMed1989

Facial morphology as determined by anthropometry: keeping it simple.

Anthropometry remains an efficient, noninvasive method for describing craniofacial morphology in spite of the appearance of more sophisticated technologies. The major advantage afforded by anthropometry is its technical simplicity, a fact which makes it a readily available tool for evaluating patients, planning facial surgery, or delineating basic features of craniofacial syndromes. Anthropometry lacks the detail of more powerful technologies, but it is better suited for populational studies because of the availability of comparative, normal databases. The standard z-scores produced by such comparisons lend themselves to multivariate analysis. This type of comparative analysis is not yet possible for computerized tomography, three-dimensional imaging, or photogrammetry. To illustrate the utility of this technique an example is cited from an ongoing study of hypohidrotic ectodermal dysplasia (HED) in which anthropometry reveals details of facial morphology overlooked in previous studies. These include the presence of reduced facial height and a striking reduction in the size of the facial features in spite of the fact that facial widths are comparatively normal. Gene carriers show a similar though nonidentical pattern of defects. Like all morphometric approaches, anthropometry has its limitations. Well-designed protocols minimize these limitations by incorporating multiple facial dimensions in the analysis and by emphasizing careful collection of data with standard instruments and methodology.

Cephalometry↗