Hereditary childhood hearing loss and integumentary system disease

Retinitis pigmentosa, hearing loss and vitiligo: report of two patients

In this report we describe the association of retinitis pigmentosa, hearing loss and vitiligo in two non-related patients. The second patient developed, in addition, an axonal polyneuritis after the age of 30. Previous reports dealing with this unusual combination of symptoms are discussed.

Linear and whorled nevoid hypermelanosis

Two cases are presented of congenital linear and whorled hypermelanosis. Hyperpigmented macules in streaky configurations along Blaschko's lines appeared gradually after birth. Histologic examination revealed prominent epidermal melanocytes and irregular basal layer hyperpigmentation with normal melanosomes. This condition must be differentiated from incontinentia pigmenti, early systematized epidermal nevus, extensive hypomelanosis of Ito, and chimerism. Other similar case reports from the literature suggest that incidence is sporadic and may be associated with more serious congenital anomalies. The patterning is the inverse to that found in hypomelanosis of Ito. Developmental somatic mosaicism may be responsible for this patterned hypermelanosis.

Björnstad syndrome and pili torti

Two children with pili torti (twisted hairs) are reported, one of whom had sensorineural hearing loss. This combination of pili torti and deafness was described as a new genetic entity by Björnstad in 1965. Although light microscopy demonstrated variable numbers of twists along the shafts of hairs obtained from both patients, scanning electron microscopy in both cases revealed flattening and diagonally arranged scalloped defects on only one side of the involved hair shafts rather than true twists. Early auditory testing should be performed in children with pili torti in order to secure early treatment of possible associated hearing loss.