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$Unique_ID{BRK03716}
$Pretitle{}
$Title{Epidermolytic Hyperkeratosis}
$Subject{Epidermolytic Hyperkeratosis Bullous Congenital Ichthyosiform
Erythroderma Disorder of Cornification 3 (Bullous Type) DOC 3 Bullous Type
Ichthyoses Ichthyosis Congenita (Ichthyosis Vulgaris) X-linked Ichthyosis
Epidermolysis Bullosa Epidermolysis Bullosa Acquisita Psoriasis}
$Volume{}
$Log{}
Copyright (C) 1987, 1988, 1990, 1992, 1993 National Organization for Rare
Disorders, Inc.
477:
Epidermolytic Hyperkeratosis
** IMPORTANT **
It is possible the main title of the article (Epidermolytic
Hyperkeratosis) is not the name you expected. Please check the SYNONYMS
listing on the next page to find alternate names, disorder subdivisions, and
related disorders covered by this article.
Synonyms
Bullous Congenital Ichthyosiform Erythroderma
Disorder of Cornification 3 (Bullous Type)
DOC 3 Bullous Type
Information on the following disorders may be found in the Related
Disorders section of this report:
Ichthyoses
Ichthyosis Congenita (Ichthyosis Vulgaris)
X-linked Ichthyosis
Epidermolysis Bullosa
Epidermolysis Bullosa Acquisita
Psoriasis
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Epidermolytic Hyperkeratosis is a hereditary skin disorder that is
characterized by thick, blistery, warty hardening of the skin over most of
the body. This disorder is a form of Ichthyosis which is a group of rare
skin diseases. (For more information, choose "Ichthyosis" as your search
term in the Rare Disease Database.)
Symptoms
Symptoms of Epidermolytic Hyperkeratosis are present at birth. The skin
appears warty, blistery, and thick over most of the body surface. Many warts
may be found in skin creases over joints. Symptoms of the disorder range
from mild to severe.
Causes
Epidermolytic Hyperkeratosis is a hereditary disorder transmitted by
autosomal dominant genes thought by some scientists to be located on
chromosome 12, the keratin K1 gene. Other blistering skin disorders have
also been liked to keratin genes. (Human traits including the classic
genetic diseases, are the product of the interaction of two genes for that
condition, one received from the father and one from the mother. In dominant
disorders, a single copy of the disease gene (received from either the mother
or father) will be expressed "dominating" the normal gene and resulting in
appearance of the disease. The risk of transmitting the disorder from
affected parent to offspring is 50% for each pregnancy regardless of the sex
of the resulting child.)
Researchers have found the genetic defects responsible for Epidermolytic
Hyperkeratosis. Defects or mutations (an unusual change in genetic material
occurring for no apparent reason) in keratin proteins have been shown to
cause EHK. Keratin is a protein that is a primary part of the skin, hair,
nails, and enamel of the teeth. This new information is expected to lead to
prenatal diagnosis and development of new treatments for this disorder.
Affected Population
Epidermolytic Hyperkeratosis is present at birth. It is a very rare disorder
affecting males and females in equal numbers.
Related Disorders
Symptoms of the following disorders may be similar to those of Epidermolytic
Hyperkeratosis. Comparisons can be useful for a differential diagnosis.
"Ichthyoses" or "Disorders of Cornification" are general terms describing
a group of scaly skin disorders. They are characterized by an abnormal
accumulation of large amounts of epidermal cells into squamous cells
(squames) in the top layer of the skin. The conversion of an abnormally
large number of epidermal cells into squamous cells is thought to be caused
by a defect in the metabolism of skin cells known as "corneocytes" or of the
fat-rich matrix around these cells. The cells can be thought of as bricks,
while the matrix would be the mortar holding these cells together. (For more
information, choose "ichthyosis" as your search term in the Rare Disease
Database.)
Ichthyosis Congenita (Collodion Baby; Congenital Ichthyosiform
Erythroderma; Xeroderma; Desquamation of Newborn) is an inherited skin
disorder. It is characterized by an generalized, abnormally red, dry and
rough skin, with large coarse scales. Itchiness (pruritis) usually also
develops. Skin on the palms of the hands and soles of the feet is abnormally
thick. (For more information on this disorder, choose "Ichthyosis Congenita"
as your search term in the Rare Disease Database.)
X-linked Ichthyosis is an inherited skin disorder caused by a deficiency
of the enzyme steroid sulfatase. This enzyme deficiency leads to biochemical
alterations in the steroid sex hormone metabolism, including diminished
estrogen production during fetal development. Cholesterol sulfate
accumulates in blood, skin, and other tissues after birth, causing scaliness
and abnormalities of the eye's cornea. Levels of sex hormones do not appear
to be affected. For more information, choose X-linked Ichthyosis as your
search term in the Rare Disease Database.)
Other forms of Ichthyosis include Sjogren-Larsson Syndrome, Netherton
Syndrome, Ichthyosis Hystrix, Lamellar Ichthyosis, Refsum Syndrome, Darier
Disease, Conradi-Hunerman Syndrome and Chanarin-Dorfman Syndrome. Search
under each name for more information on that disorder in the Rare Disease
Database.)
Psoriasis is a common chronic and recurrent skin disorder characterized
by dry, well-circumscribed silvery-gray scaling spots (papules) or plaques
which usually appear on the scalp, elbows, or knees. (For more information
on this disorder, choose "Psoriasis" as your search term in the Rare Disease
Database.)
X-linked Ichthyosis is an inherited skin disorder that occurs only in
males. Symptoms may appear at birth or during infancy. It is characterized
by large, dark, sometimes fine scales which are prominent on the neck and
trunk. Skin on the palms of the hand and soles of the feet is normal.
Cloudy areas (opacities) in the cornea of the eye may also occur. (For more
information, choose "Ichthyosis" as your search term in the Rare Disease
Database.)
Therapies: Standard
Epidermolytic Hyperkeratosis can be diagnosed before birth by taking a few
cells from the fluid in the water sac that surrounds the fetus, and testing
for abnormalities. This test is called amniocentesis.
Epidermolytic Hyperkeratosis is treated by applying skin softening
(emollient) ointments, such as petroleum jelly, especially after bathing
while the skin is still moist. Salicylic acid in a gel composed of propylene
glycol, ethyl alcohol, hydroxypropylene cellulose, and water is usually
effective. The skin should be covered at night with an airtight and
waterproof dressing when this ointment is used. Lactate lotion can also be
an effective treatment for this disorder.
Drugs derived from Vitamin A (retinoids) such as tretinoin, motretinide,
and etretinate may be effective against symptoms of Epidermolytic
Hyperkeratosis, but can cause toxic effects on the bones in some cases. A
synthetic derivative of Vitamin A, isotretinoin, when taken by pregnant
women, can cause severe birth defects to the fetus. These Vitamin A
compounds have not yet been approved by the Food and Drug Administration
(FDA) for treatment of Ichthyosis.
Long-term treatment with antibiotics such as benzathine penicillin or
oral erythromycin may be required for as long as the thick scaling is
present. This may prevent formation of pustules in Epidermolytic
Hyperkeratosis.
Therapies: Investigational
The orphan product Monolaurin (Glylorin) is being tested for treatment of
Epidermolytic Hyperkeratosis. The product is manufactured by:
Cellegy Pharmaceuticals, Inc.
371 Bel Marin Keys, Suite 210
Novato, CA 94949
This disease entry is based upon medical information available through
May 1993. Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.
Resources
For more information on Epidermolytic Hyperkeratosis, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
Foundation for Ichthyosis and Related Skin Types (F.I.R.S.T.)
P.O. Box 410453
San Francisco, CA 94103
(415) 591-1653
(800) 545-3286
The following doctors are conducting research on Ichthyosis:
Dr. Ervin H. Epstein, Jr.
Dept. Dermatology
University of California, San Francisco
Chicago, IL
(415) 647-3992
Dr. Robert D. Goldman
Dept. of Cell Biology and Anatomy
Northwestern University Medical School
Chicago, IL
(312) 503-4215
Dr. Leonard Milstone
Dept. of Dermatology
Yale University Medical School
New Haven, CT
(203) 937-3833
The National Arthritis and Musculoskeletal and Skin Diseases Information
Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 495-4484
For genetic information and genetic counseling referrals, please contact:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
GENETICALLY TRANSMITTED, GENERALIZED DISORDERS OF CORNIFICATION. THE
ICHTHYOSES: M.L. Williams, et al.; Dermatol Clin (January 1987; issue 5(1).
Pp. 155-178.
THERAPEUTIC ACTIVITY OF LACTATE 12% LOTION IN THE TREATMENT OF
ICHTHYOSIS. ACTIVE VERSUS VEHICLE AND ACTIVE VERSUS A PETROLEUM CREAM: M.
Buxman, et al.; Journal Am Acad Dermatol (December 1986: issue 15(6). Pp.
1253-1258.
THE METABOLIC BASIS OF INHERITED DISEASE, 5th ed.: John B. Stanbury, et
al., eds.; McGraw Hill, 1983. P. 1034.