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$Unique_ID{BRK03867}
$Pretitle{}
$Title{Ichthyosis, Erythrokeratolysis Hiemalis}
$Subject{Ichthyosis, Erythrokeratolysis Hiemalis Disorder of Cornification 19
(Erythrokeratolysis Hiemalis) DOC 19 (Erythrokeratolysis Hiemalis) Keratolytic
Winter Erythema Oudtshoorn Skin Ichthyosis Ichthyosis Congenita X-Linked
Ichthyosis }
$Volume{}
$Log{}
Copyright (C) 1988, 1989, 1991, 1992, 1993 National Organization for Rare
Disorders, Inc.
558:
Ichthyosis, Erythrokeratolysis Hiemalis
** IMPORTANT **
It is possible that the main title of this article (Erythrokeratolysis
Hiemalis) 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 19 (Erythrokeratolysis Hiemalis)
DOC 19 (Erythrokeratolysis Hiemalis)
Keratolytic Winter Erythema
Oudtshoorn Skin
Information on the following disorders can be found in the Related
Disorders section of this report:
Ichthyosis
Ichthyosis Congenita
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.
Erythrokeratolysis Hiemalis is a form of Ichthyosis which is a group of
hereditary skin disorders. This condition is characterized by periodic
attacks of red (erythematous) plaques that are distributed equally on both
sides of the body. A layer of skin can be peeled from these plaques.
Symptoms usually improve with age.
Symptoms
Erythrokeratolysis Hiemalis is characterized by periodic attacks of red skin
plaques. A thick layer of skin can be peeled off these plaques from the
center outward. As new skin forms, the plaques are pushed outward. Symptoms
may start during infancy or adolescence, and the disorder usually improves
with age. Only the palms of the hands and the soles of the feet are involved
in most cases. However, the disorder may spread to the skin of the back or
elsewhere on the body surface. Appearance of new plaques may be precipitated
by fever or surgery.
Causes
Erythrokeratolysis Hiemalis is a hereditary disorder transmitted through
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 other 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
Erythrokeratolysis Hiemalis primarily affects descendants of farmers from the
Oudtshoorn district in South Africa. This disorder starts during infancy or
adolescence and usually improves with age. It affects males and females in
equal numbers. One in every 100,000 persons will be affected, that is, ten
per million for a total of 2,500 persons in the United States with thirty-
seven babies born with this disorder every year.
Related Disorders
Symptoms of the following disorders may be similar to those of
Erythrokeratolysis Hiemalis. Comparisons can be useful for a differential
diagnosis:
"Ichthyosis" 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 dead skin 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 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 affecting 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 Sjogren-Larsson Syndrome, Netherton
Syndrome, Ichthyosis Hystrix, Lamellar Ichthyosis, Refsum Syndrome, Darier
Disease, Conradi-Hunermann Syndrome, Chanarin-Dorfman Syndrome, and
Epidermolytic Hyperkeratosis. (Choose the appropriate name as your search
term for more information on that disorder in the Rare Disease Database.)
Therapies: Standard
Erythrokeratolysis Hiemalis is 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
can be 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 may be effective against symptoms of Erythrokeratolysis Hiemalis,
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 treatment of
Erythrokeratolysis Hiemalis. 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 Erythrokeratolysis Hiemalis, 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:
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
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. Pp. 1027-1039.