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- $Unique_ID{BRK03878}
- $Pretitle{}
- $Title{Incontinentia Pigmenti}
- $Subject{Incontinentia Pigmenti IP Bloch-Sulzberger Syndrome
- Bloch-Siemens-Sulzberger Syndrome Incontinentia Pigmenti Achromians
- Franceschetti-Jadassohn Syndrome Caffey Disease }
- $Volume{}
- $Log{}
-
- Copyright (C) 1988, 1990 National Organization for Rare Disorders,
- Inc.
-
- 409:
- Incontinentia Pigmenti
-
- ** IMPORTANT **
- It is possible the main title of the article (Incontinentia Pigmenti) 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
-
- IP
- Bloch-Sulzberger Syndrome
- Bloch-Siemens-Sulzberger Syndrome
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Incontinentia Pigmenti Achromians
- Franceschetti-Jadassohn Syndrome
- Caffey Disease
-
- 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.
-
-
- Incontinentia Pigmenti is a genetic dermatological disorder characterized
- by unusual patterns of discolored skin. These discolorations tend to improve
- with age. Abnormal deposits of normal skin pigment (melanin) cause these
- discolorations. Three stages of progression may overlap or even occur
- simultaneously in some cases. Other oral, visual and/or neurological
- symptoms may also occur.
-
- Symptoms
-
- Incontinentia Pigmenti is divided into three stages of progression. The
- first two stages may overlap or even occur at the same time. Inflammation
- (beginning between birth and six months of age) is accompanied by skin
- redness and spiral lines of small fluid-filled blisters. The number of white
- blood cells in the blood usually associated with inflammation or infection
- may be elevated during infancy. A second stage gradually develops with
- rough, warty skin growths often arranged in the same spiral or linear
- patterns as in the previous stage. Skin growths usually appear on the arms
- or legs and less often on the head or trunk. These lesions usually resolve
- during infancy or early childhood, although persistent growths have been
- reported in patients as late as age sixteen.
-
- The third stage is characterized by discolorations (abnormal deposits of
- skin pigment known as melanin) appearing in unusual patterns. These often
- appear as the first two stages are resolving. This stage usually begins
- between three months and two years of age. Patchy brown or slate gray spots
- develop in spiral and linear patterns on the arms, legs or trunk. These
- spots do not seem to appear in previously affected areas. Additionally, they
- do not follow the lines of nerves, vessels, or cleavage areas. Skin
- discolorations gradually resolve during late childhood or adolescence, but
- occasionally they may persist into adulthood.
-
- All three stages may frequently overlap or even appear together. A
- fourth stage may appear consisting of diminished pigmentation or atrophy in
- areas of previous discolorations. Hair loss with scarring may also occur in
- rare cases.
-
- Other non-dermatological symptoms may occur in approximately fifty
- percent of affected individuals. Possible dental symptoms include delayed
- tooth growth or decay, missing or malformed teeth. Diminished vision may
- develop in approximately one-third of patients. Seizures, muscle spasms or
- slight paralysis may also occur in rare cases.
-
- Deterioration of finger or toe nails is very rare in Incontinentia
- Pigmenti (IP). Developmental abnormalities may sometimes appear in this
- disorder but are not considered characteristic. These may include dwarfism
- or short stature, clubfoot, spina bifida, skull and ear deformities, cleft
- lip or palate, atrophy of one side of the body (hemiatrophy), abnormal
- development of cartilage (chondrodystrophy), congenital dislocation of the
- hip, incomplete development of one side of the spinal bones (hemivertebrae),
- extra ribs or webbed fingers (syndactyly). Extremely kinky or wooly hair
- (Wooly hair nevus) and an immune system dysfunction have also been reported
- in a small number of patients with IP.
-
- Causes
-
- Incontinentia Pigmenti is thought to be inherited as an X-linked dominant
- trait. (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 X-linked dominant disorders the female
- with only one X chromosome affected will develop the disease. However the
- affected male always has a more severe condition. Sometimes affected males
- die before birth so that only female patients survive.)
-
- Affected Population
-
- Incontinentia Pigmenti (IP) is an extremely rare disorder with approximately
- six hundred cases reported in medical literature in this century. It can
- occur world wide and affects females almost exclusively.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to Incontinentia Pigmenti
- (IP). Comparisons may be useful for a differential diagnosis:
-
- Incontinentia Pigmenti Achromians is characterized by diminished skin
- pigmentations similar only in pattern to discolorations of Incontinentia
- Pigmenti (IP). The lack of skin coloration is easily contrasted with the
- excess discoloration characteristic of IP although diminished skin
- pigmentations can appear late in the course of some cases of IP. This
- disorder is inherited as an autosomal dominant trait. A variety of other
- developmental abnormalities and/or conditions may also occur in conjunction
- with this illness. Skin color tends to normalize with aging.
-
- Franceschetti-Jadassohn Syndrome is marked by skin pigmentation changes
- similar to those of Incontinentia Pigmenti (IP), but symptoms begin during
- adolescence and does not follow inflammatory skin changes. Additionally,
- skin may thicken on the hands and/or feet, ability to sweat may become
- impaired and yellow mottling of the teeth may occur. This disorder appears
- to be inherited as an autosomal dominant trait.
-
- Caffey Disease is characterized by discolorations accompanied by soft
- tissue swellings over benign bone growths typically capped by cartilage.
- Fever and irritability may also occur. Symptoms tend to fluctuate in
- severity. This disorder, also known as Infantile Cortical Hyperostosis,
- primarily affects infants under six months of age and often resolves with
- age. The exact cause is unknown although it is assumed to be genetic.
-
- Therapies: Standard
-
- Skin abnormalities characteristic of Incontinentia Pigmenti (IP) usually
- disappear by adolescence or adulthood without any treatment. Diminished
- vision may be treated using corrective lenses, medication or in severe cases,
- surgery. Dental abnormalities can often be treated effectively by a dentist.
- Hair problems may require the attention of a dermatologist in some cases,
- although they are usually not severe. Neurological symptoms such as
- seizures, muscle spasms or mild paralysis may be controlled with various
- drugs and/or medical devices. Since these symptoms are not typical, a
- neurologist should be consulted. Additionally, skeletal anomalies occurring
- in conjunction with some cases of IP should be dealt with on an individual
- basis. Genetic counseling may be of benefit for patients and their families.
- Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Researchers are trying to locate the gene that causes Incontinenti Pigmenti.
- Families with this disorder having two generations of affected individuals
- should contact:
-
- Dr. Richard A. Lewis, Associate Professor
- Depts. of Ophthalmology, Medicine, Pediatrics, and the Institute for
- Molecular Genetics
- Baylor College of Medicine
- 6501 Fanin, NC 206
- Houston, TX 77030
- (713) 798-3030
-
- This disease entry is based upon medical information available through
- January 1990. 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 Incontinentia Pigmenti, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- The National Arthritis and Musculoskeletal and Skin Diseases Information
- Clearinghouse
- Box AMS
- Bethesda, MD 20892
- (301) 495-4484
-
- For genetic information and genetic counseling referral, 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
-
- INCONTINENTIA PIGMENTI. STUDY OF 3 FAMILIES: B. Garcia-Bravo, et al.; Ann
- Dermatol Venereol (1986, issue 113(4)). Pp. 301-308.
-
- DOMINANT DISORDERS WITH MULTIPLE ORGAN INVOLVEMENT: Mary F. Kegel, M.D.;
- Dermatologic Clinics (January 1987, issue 5 (1)). Pp. 210-214.
-
-