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Chopra A, Mitra D, Kandpal R, Agarwal R. Rare Variant of Ankyloblepharon-ectodermal Defect-cleft Lip/Cleft Palate Syndrome: Curly Hair-ankyloblepharon-nail Disease Syndrome. Int J Trichology 2018; 10:17-20. [PMID: 29440852 PMCID: PMC5803846 DOI: 10.4103/ijt.ijt_55_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ankyloblepharon-ectodermal defect-cleft lip/cleft palate (AEC) syndrome is one of the variants of ectodermal dysplasia. It is an autosomal dominant disorder comprising of ankyloblepharon, ectodermal dysplasia, and cleft palate or cleft lip. In 1976, it wasfirst described by Hay and Wells, therefore also known as Hay–Wells syndrome. The characteristic feature of this syndrome is “ankyloblepharon filiforme adnatum”, which refers to the partial thickness fusion of the eyelid margins. The “curly hair-ankyloblepharon-nail disease (CHAND) syndrome” is a clinical variant of AEC syndrome. We report a rare case of a 7-year-old girl child who presented with history of abnormal dentition, 20 nail dystrophy, and light-colored, sparse curly hairs since birth. Parents gave history that at the time of birth, her both eyelids were fused partially, which was surgically corrected by an ophthalmologist at 1 month of age. There was no history of hypohidrosis or anhidrosis, heat intolerance, cleft lip or cleft palate. Microscopy of the hair shaft found “bubbly hair” morphology. This case is unique as it is a rare presentation, and awareness should be there for this constellation of findings so that the systemic associations can be investigated. “Bubble hair” morphology on microscopy is a unique feature in this rare autosomal recessive condition.
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Affiliation(s)
- Ajay Chopra
- Department of Dermatology, Base Hospital Delhi Cantt, New Delhi, India
| | - Debdeep Mitra
- Department of Dermatology, Base Hospital Delhi Cantt, New Delhi, India
| | - Renu Kandpal
- Department of Dermatology, Base Hospital Delhi Cantt, New Delhi, India
| | - Reetu Agarwal
- Department of Dermatology, Base Hospital Delhi Cantt, New Delhi, India
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Busa T, Jeraiby M, Clémenson A, Manouvrier S, Granados V, Philip N, Touraine R. Confirmation that RIPK4
mutations cause not only Bartsocas-Papas syndrome but also CHAND syndrome. Am J Med Genet A 2017; 173:3114-3117. [DOI: 10.1002/ajmg.a.38475] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/03/2017] [Accepted: 08/21/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Tiffany Busa
- Unité de génétique clinique, APHM; CHU Timone-Enfants; Marseille France
| | - Mohammed Jeraiby
- Service de Génétique Clinique, Chromosomique et Moléculaire; CHU-Hôpital Nord; Saint Etienne France
| | - Alix Clémenson
- Service d'Anatomie et Cytologie Pathologiques; CHU-Hôpital Nord; Saint Etienne France
| | - Sylvie Manouvrier
- Service de Génétique médicale; Hôpital Jeanne de Flandre; CHRU de Lille; Lille France
| | - Viviana Granados
- Service de Génétique Clinique, Chromosomique et Moléculaire; CHU-Hôpital Nord; Saint Etienne France
| | - Nicole Philip
- Unité de génétique clinique, APHM; CHU Timone-Enfants; Marseille France
| | - Renaud Touraine
- Service de Génétique Clinique, Chromosomique et Moléculaire; CHU-Hôpital Nord; Saint Etienne France
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Lima LB, Barbosa de Paulo LF, Silva CJ, Mendes VC, Simamoto-Júnior PC, Durighetto AF. Congenital oral synechia and ankyloblepharon filiforme adnatum: Case report and literature review. Int J Pediatr Otorhinolaryngol 2016; 90:196-199. [PMID: 27729131 DOI: 10.1016/j.ijporl.2016.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/16/2016] [Accepted: 09/18/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Congenital intraoral synechias are adhesions of intraoral structures involving soft tissue. These conditions and another anomaly called ankyloblepharon filiforme adnatum, which is partial fusion of the eyelid margins by bands of tissue, are rarely reported in the literature. The association of both anomalies of the craniomaxillofacial region is an even more unusual finding. PURPOSE This article adds more information to the literature by reporting a case of a neonate with a rare association of bilateral synechia between the jaws, fusion of buccal mucosa to the ridges and between the tongue and palate, and ankyloblepharon filiforme adnatum in both eyes, without any other facial or systemic malformation. METHODS A literature review of similar cases published in PUBMED/MEDLINE was conducted followed by a discussion and comparison to the new case. CONCLUSION The rare association of these congenital defects, without the presence of syndromic symptoms, could be diagnosed and treated easily with good prognostic evolution.
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Affiliation(s)
| | - Luiz Fernando Barbosa de Paulo
- Program of Specific Care in Oral Disease (PROCEDE), School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Cláudia Jordão Silva
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | | | - Paulo Cézar Simamoto-Júnior
- Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Donepudi SK, Stocks RMS, Pivnick EK, Mineck C, Thompson JW. Cleft palate lateral synechia syndrome: an opportunity for unique surgical closure. Int J Pediatr Otorhinolaryngol 2009; 73:861-6. [PMID: 19368978 DOI: 10.1016/j.ijporl.2009.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Revised: 03/09/2009] [Accepted: 03/11/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To report two cases of cleft palate lateral synechia (CPLS) syndrome in a single family and describe surgical closure using the synechia. STUDY DESIGN Case report and literature review. METHODS A case report is presented with a review of the literature of cleft palate in conjunction with lateral synechia. Clinical presentation with photographic images of surgical repair is presented as well as a genetic workup with pedigree. RESULTS A 6-week-old male presented for evaluation of a cleft palate. Mucosa-lined, fibromuscular tissue bands were noted connecting the floor of mouth and the free edges of a bilateral complete secondary cleft palate. No other craniofacial, digital, genital or limb defects were noted. The patient's 13-month-old sister had similar synechial bands and cleft palate at birth. Another older sibling had cleft palate without synechia. The patient's mother and maternal great grandmother had cleft palates at birth without synechia. The three children share a common mother but have three different fathers. Genetic analysis failed to reveal chromosomal defects or a mutation in the interferon regulatory factor 6 (IRF6) gene, a locus linked to Van der Woude syndrome. At 2 years of age, the index patient was growing and feeding well. His intra-oral bands remained intact and were incorporated in the surgical repair using a novel approach. CONCLUSIONS Since more otolaryngologists are performing cleft surgeries, the awareness of the differential diagnoses associated with a cleft palate is important. CPLS is an extremely rare condition. The report of this family supports the suspected pattern of autosomal dominant inheritance with variable expressivity. The unusual surgical approach will be discussed.
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Affiliation(s)
- Sreekrishna Kanth Donepudi
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Room 428, Memphis, TN 38163, USA
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Cabiling DS, Yan AC, McDonald-McGinn DM, Zackai EH, Kirschner RE. Cleft lip and palate repair in Hay-Wells/ankyloblepharon-ectodermal dysplasia-clefting syndrome. Cleft Palate Craniofac J 2007; 44:335-9. [PMID: 17477760 DOI: 10.1597/06-065] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hay-Wells/ankyloblepharon-ectodermal dysplasia-clefting syndrome is a rare autosomal dominant disorder characterized by ankyloblepharon, ectodermal dysplasia, and cleft lip and/or cleft palate. Mutations in the p63 gene recently have been shown to be etiologic in the majority of cases of ankyloblepharon-ectodermal dysplasia-clefting syndrome. To date, there have been no reports to document wound healing after cleft lip and/or palate repair in ankyloblepharon-ectodermal dysplasia-clefting patients. We describe two patients with ankyloblepharon-ectodermal dysplasia-clefting syndrome and provide a review of the literature. There have been no reported instances of wound healing complications in affected patients. Seventeen percent (3/18) of reported patients required revisions or repair of oronasal fistulae. Cleft lip and palate repair can be performed safely in patients with Hay-Wells syndrome.
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Affiliation(s)
- David S Cabiling
- Department of Surgery and Division of Plastic Surgery at The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4318, USA
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Abstract
We present 2 contrasting cases of congenital interalveolar synechiae. The first occurred in the setting of Van der Woude syndrome and was associated with a cleft palate. In the second case, it was an isolated abnormality and there was no contributory family history or syndromic associations. We review the literature on interalveolar synechiae and discuss its management, implications, and genetics. Interalveolar synechiae is a condition with an excellent prognosis; its presence necessitates careful examination for associated abnormalities and syndromes.
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Sahin MT, Türel-Ermertcan A, Chan I, McGrath JA, Oztürkcan S. Ectodermal dysplasia showing clinical overlap between AEC, Rapp-Hodgkin and CHAND syndromes. Clin Exp Dermatol 2004; 29:486-8. [PMID: 15347331 DOI: 10.1111/j.1365-2230.2004.01584.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The ectodermal dysplasias represent a complex collection of congenital abnormalities of skin, hair, teeth, nail, and sweat gland development, many of which have overlapping clinical features. In this report, we describe a 7-year-old girl, born to clinically normal parents, with ankyloblepharon, cleft lip/palate and hair abnormalities, features resembling the autosomal dominant disorder, ankyloblepharon-ectodermal dysplasia-clefting (AEC) syndrome, which results from mutations in the sterile-alpha motif domain of the gene encoding the transcription factor, p63. However, direct sequencing of the p63 gene in this individual did not reveal any pathogenic sequence variants. Moreover, two of her paternal cousins were discovered to have similar congenital ectodermal anomalies, raising the alternative possibility of an autosomal recessive pattern of inheritance. Furthermore, all affected individuals lacked a history of erosive scalp dermatitis that is usually characteristic of AEC syndrome. Instead, the scalp hair was coarse and wiry. In addition, another atypical feature, hypohidrosis, was present. Collectively, the clinical features also resembled Rapp-Hodgkin syndrome, Bowen-Armstrong syndrome and CHAND syndrome, but did not appear to fit neatly with any one particular disorder. This case highlights the difficulties in trying to classify the ectodermal dysplasia syndromes on clinical features alone.
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Affiliation(s)
- M T Sahin
- Department of Dermatology, Celal Bayar University, Medical Faculty, Manisa, Turkey.
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Bertola DR, Kim CA, Sugayama SM, Albano LM, Utagawa CY, Gonzalez CH. AEC syndrome and CHAND syndrome: further evidence of clinical overlapping in the ectodermal dysplasias. Pediatr Dermatol 2000; 17:218-21. [PMID: 10886756 DOI: 10.1046/j.1525-1470.2000.01756.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Among the ectodermal dysplasias, there are several examples of overlapping phenotypes in disorders that are considered distinct. We report a 5-year-old boy born to nonconsanguineous parents and presenting with ectodermal dysplasia, ankyloblepharon filiforme adnatum, and bilateral choanal atresia consistent with the diagnosis of AEC syndrome. We compare the findings in our patient with the previous reported cases and discuss the overlapping phenotype of this disorder with CHAND syndrome.
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Affiliation(s)
- D R Bertola
- Department of Pediatrics, Instituto da Criança do Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
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Zenteno JC, Venegas C, Kofman-Alfaro S. Evidence that AEC syndrome and Bowen--Armstrong syndrome are variable expressions of the same disease. Pediatr Dermatol 1999; 16:103-7. [PMID: 10337671 DOI: 10.1046/j.1525-1470.1999.99009.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Several clinical disorders combine ectodermal dysplasia (ED) and cleft lip and/or palate (CL/P). These conditions have been recognized as a group of diseases with a narrow phenotypic spectrum and multiple points of overlap. We report a patient with a clinical diagnosis of AEC syndrome (ankyloblepharon, ectodermal defects, and CL/P) who additionally has some features observed in a different ED-CL/P disorder, Bowen-Armstrong syndrome. Because of this clinical overlap, we suggest that AEC syndrome and Bowen-Armstrong syndrome may be variable manifestations of the same pathologic entity.
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Affiliation(s)
- J C Zenteno
- Servicio de Genética, Hospital General de México-Facultad de Medicina UNAM, Mexico City, México
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