XXIX Lipoid Proteinosis (Urbach-Wiethe)

Lipoid proteinosis of larynx: review of four cases

Lipoid proteinosis is a rare autosomal recessive disorder characterized by intercellular deposition of an amorphous hyaline material. It mainly involves skin and mucosal membranes of upper aerodigestive tract as well as central nervous system, lung, lymph nodes and striated muscles. Etiology and pathogenesis are unknown. Infantile hoarseness is a common presenting feature of the disease due to infiltration of larynx. In two-thirds of the cases, voice changes are present at birth or in early infancy as the first manifestation. We present four patients with lipoid proteinosis involving skin, oropharynx and larynx.

Lipoid proteinosis of the larynx: a cause of voice change in the infant and young child

Lipoid proteinosis is an autosomal recessive disorder that may display multiple systemic manifestations involving mucosal deposition of hyalin material. Skin and upper aerodigestive tract mucosal involvement predominate. In approximately two thirds of cases, voice change secondary to laryngeal involvement occurring at birth or early in infancy is the first manifestation of the disease.

Hyalinosis cutis et mucosae

Hyalinosis cutis et mucosae is an uncommon genetic disease characterized by accumulation of glycoproteinaceous material not only at mucocutaneous sites but also in salivary glands, central and peripheral nervous systems, eyes, nd other organs and tissues. The course of the disease is protracted, and it is not likely to regress, either spontaneously or with therapy. Although it does not usually result in decreased longevity, the disorder may produce considerable disfigurement and functional impairment. This article documents the case of a 5-year-old girl who presented with vocal weakness, misarticulations, and hoarseness; hypopigmented scarring of the arms and pubis; fibrotic thickenings of the oral and laryngeal mucosa; and serous otitis media. A tongue biopsy revealed diffuse hyaline deposits throughout the connective tissue and in a lamellar pattern about blood vessels. A diagnosis of hyalinosis cutis et mucosae was made.