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$Unique_ID{BRK03866}
$Pretitle{}
$Title{Ichthyosis, Erythrokeratodermia Variabilis}
$Subject{Ichthyosis, Erythrokeratodermia Variabilis Disorder of Cornification
18 (Erythrokeratodermia Variabilis Type) DOC 18 (Erythrokeratodermia
Variabilis Type) EKV Keratosis Rubra Figurata Mendes Da Costa Syndrome
Ichthyosis Ichthyosis Congenita (Collodion Baby; Congenital Ichthyosiform
Erythroderma; Xeroderma; Desquamation of Newborn) X-Linked Ichthyosis }
$Volume{}
$Log{}
Copyright (C) 1988, 1989, 1990, 1992, 1993 National Organization for Rare
Disorders, Inc.
559:
Ichthyosis, Erythrokeratodermia Variabilis
** IMPORTANT **
It is possible that the main title of this article (Erythrokeratodermia
Variabilis) is not the name you expected. Please check the SYNONYM list to
find the alternate names and disorder subdivisions covered by this article.
Synonyms
Disorder of Cornification 18 (Erythrokeratodermia Variabilis Type)
DOC 18 (Erythrokeratodermia Variabilis Type)
EKV
Keratosis Rubra Figurata
Mendes Da Costa Syndrome
Information on the following disorders can be found in the Related
Disorders section of this report:
Ichthyosis
Ichthyosis Congenita (Collodion Baby; Congenital Ichthyosiform
Erythroderma; Xeroderma; Desquamation of Newborn)
X-Linked Ichthyosis
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 physician and/or the agencies listed in the "Resources" section
of this report.
Erythrokeratodermia Variabilis is a form of Ichthyosis, a group of
hereditary skin disorders characterized by scaly patches on the skin. In
this type of Ichthyosis, sharply defined red areas (erythemas) resemble a
geographic map with a shifting configuration. Fixed hardened (keratotic)
skin plaques independent of the red areas usually also develop. Skin lesions
are localized in most cases, but may spread over the entire body surface.
Symptoms
Erythrokeratodermia Variabilis is characterized by red skin areas with sharp
borderlines that tend to shift positions. Fixed plaques of hardened skin
also develop independent from the red areas. The reddened skin areas may
develop after exposure to heat, cold, wind, or emotional upset, and they may
rapidly change shape or position. In most cases, hardened skin plaques are
limited to small areas. However, they may appear over the entire body
surface in some cases, including the palms of the hands and the soles of the
feet.
Causes
Erythrokeratodermia Variabilis is a hereditary disorder transmitted by
autosomal dominant 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.)
Affected Population
Erythrokeratodermia Variabilis is a rare form of Ichthyosis which is present
at birth. Males and females are affected in equal numbers.
Related Disorders
Symptoms of the following disorders can be similar to those of
Erythrokeratodermia Variabilis. Comparisons may be useful for a differential
diagnosis:
Ichthyosis is a general term describing a group of skin disorders that
are characterized by an excessive accumulation of dead skin cells (squames)
in the top layer of the skin. The conversion of an abnormally large number
of skin 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. In general, all forms of
Ichthyosis cause dry scaly skin.
Ichthyosis Congenita (Collodion Baby; Congenital Ichthyosiform
Erythroderma; Xeroderma; Desquamation of Newborn) is characterized by
generalized, abnormally red, dry and rough skin, with large, coarse scales.
Itchiness (pruritus) usually also develops. Skin on the palms of the hands
and soles of the feet is abnormally thick. (For more information, choose
"Ichthyosis Congenita" as your search term in the Rare Disease Database.)
X-Linked Ichthyosis is an inherited skin disorder that affects males. It
is caused by a deficiency of the enzyme steroid sulfatase. This enzyme
deficiency leads to biochemical alterations in steroid hormone metabolism.
Cholesterol sulfate may accumulate in the blood and skin. (For more
information, choose "X-Linked Ichthyosis" as your search term in the Rare
Disease Database.)
Other forms of Ichthyosis include: Ichthyosis Vulgaris; Epidermolytic
Hyperkeratosis; Lamellar Recessive Ichthyosis; Lamellar Dominant Ichthyosis;
Harlequin Type Ichthyosis; Ichthyosis Hystrix, Curth-Macklin Type; Netherton
Syndrome; Sjogren-Larsson Syndrome; Refsum Syndrome; Chanarin-Dorfman
Syndrome; Multiple Sulfatase Deficiency; Tay Syndrome; Keratitis Ichthyosis
Deafness Syndrome (KID Syndrome); CHILD Syndrome; Conradi-Hunermann
Syndrome; Erythrokeratodermia Variabilis; Erythrokeratolysis Hiemalis;
Erythrokeratodermia Progressiva Symmetrica; Peeling Skin Syndrome; Darier
Disease (Keratosis Follicularis); Giroux-Barbeau Syndrome; Keratosis
Follicularis Spinulosa Decalvans. (Search under each name for more
information on that disorder in the Rare Disease Database.)
Therapies: Standard
The scaly skin symptoms of Erythrokeratodermia Variabilis are treated by
applying skin softening (emollient) ointments, preferably plain petroleum
jelly. This can be especially effective after bathing while the skin is
still moist. Salicylic acid gel is another particularly effective ointment.
The skin should be covered at night with an airtight, waterproof dressing
when this ointment is used. Lactate lotion can also be an effective
treatment for this disorder.
Therapies: Investigational
Drugs derived from Vitamin A (retinoids) such as tretinoin, motretinide, and
etretinate can be effective against symptoms of Erythrokeratodermia
Variabilis, 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.
The National Institute of Arthritis, Musculoskeletal and Skin Diseases is
looking for patients with various kinds of Ichthyosis willing to participate
in research aimed at mapping the genes responsible for their disorder.
Interested persons may contact:
Dr. Sherri Bale
National Institute of Arthritis, Musculoskeletal and Skin Diseases
9000 Rockville Pike
Bethesda, MD 20892
(301) 402-2679
The orphan product Monolaurin (Glylorin) is being tested for the
treatment of Erythrokeratodermia Variabilis. 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 Erythrokeratodermia Variabilis, 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, Inc. (F.I.R.S.T.)
P.O. Box 20921
Raleigh, NC 27619-0921
(919) 782-5728
(800) 545-3286
The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 495-4484
For information on genetics 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
MENDELIAN INHERITANCE IN MAN, 7th ed.: Victor A. McKusick; Johns Hopkins
University Press, 1986. P. 238.
ERYTHROKERATODERMIA VARIABILIS TREATED WITH ISOTRETINOIN. A CLINICAL,
HISTOLOGIC, AND ULTRASTRUCTURAL STUDY: I.P. Rappaport, et al.; Arch Dermatol
(April 1986: issue 122(4)). Pp. 441-445.
PROGRESSIVE SYMMETRIC ERYTHROKERATODERMIA. HISTOLOGICAL AND
ULTRASTRUCTURAL STUDY OF PATIENT BEFORE AND AFTER TREATMENT WITH ETRETINATE:
V. Nazzaro, et al.; Arch Dermatol (April 1986: issue 122(4)). Pp. 434-440.
ERYTHROKERATODERMIA VARIABILIS: IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL
STUDIES OF THE EPIDERMIS: N. McFadden, et al.; Acta Derm Venereol
(Stockholm) (1987: issue 67(4)). Pp. 284-288.
GENETICALLY TRANSMITTED, GENERALIZED DISORDERS OF CORNIFICATION. THE
ICHTHYOSES: M.L. Williams, et al.; Dermatol Clin (January 1987: issue 5(1)).
Pp. 155-178.