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$Unique_ID{BRK03896}
$Pretitle{}
$Title{Keratitis Ichthyosis Deafness Syndrome}
$Subject{Keratitis Ichthyosis Deafness Syndrome Disorder of Cornification 15
Keratitis Deafness Type DOC 15 Keratitis Deafness Type Ichthyosiform
Erythroderma Corneal Involvement Deafness KID Syndrome Ichthyosis Darier
Disease Keratosis Follicularis Ichthyosis Congenita Ichthyosis X-Linked }
$Volume{}
$Log{}
Copyright (C) 1992, 1993 National Organization for Rare Disorders, Inc.
884:
Keratitis Ichthyosis Deafness Syndrome
** IMPORTANT **
It is possible that the main title of the article (Keratitis Ichthyosis
Deafness Syndrome) is not the name you expected. Please check the SYNONYMS
listing to find the alternate name and disorder subdivision covered by this
article.
Synonyms
Disorder of Cornification 15 (Keratitis Deafness Type)
DOC 15 (Keratitis Deafness Type)
Ichthyosiform Erythroderma, Corneal Involvement, Deafness
KID Syndrome
Information on the following diseases can be found in the Related
Disorders section of this report:
Ichthyosis
Darier Disease (Keratosis Follicularis)
Ichthyosis Congenita
Ichthyosis, X-Linked
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.
Keratitis Ichthyosis Deafness (KID) Syndrome is a very rare disorder,
that occur most often for no apparent reason but has also been linked to an
autosomal recessive trait. It is characterized by inflammation of the eye's
cornea (keratitis), fixed hardened skin scales (plaques) on the extremities
and face, thick hardened skin on the palms of the hands and the soles of the
feet, and deafness.
Symptoms
Keratitis Ichthyosis Deafness Syndrome is present at birth. The cornea of
the eye is usually inflamed. A red, diffusely thickened skin rash is usually
shed during the first week of life. Fixed, hardened (keratotic) skin
plaques, often with a red base, usually occur on the extremities and face,
producing an aged or lion-like appearance. Some patients have thickened and
hardened skin (hyperkeratosis) and prominent hair sacs (follicles) over much
of the body surface. In others, the involvement may be limited to the face
and extremities. Overdevelopment of the outer layer of skin (hyperkeratosis)
around the hair follicles on the scalp may result in significant baldness.
The nails may be abnormal or underdeveloped, and teeth may be small and
susceptible to decay.
Hardening and thickening of the outer skin layer of the palms of the
hands and the soles of the feet (keratoderma palmoplantare) makes them appear
pebbly. Some patients develop recurrent skin infections, including
candidiasis, multiple abscesses and uncommon granulomatous fungus infections.
Squamous cell skin cancers may occur in some cases.
Nerve deafness, which may be severe in some cases, usually occurs. Eye
involvement includes inflammation of the cornea and the membranes of the eye
(conjunctiva), which may progress to abnormal formation of tiny vessels in
the cornea.
Growth may be impaired in patients with KID Syndrome.
Causes
Keratitis Ichthyosis Deafness Syndrome occurs for no apparent reason in the
majority of cases. Several cases of this disorder have been linked to an
autosomal recessive trait. Human traits, including the classic genetic
diseases, are the product of the interaction of two genes, one received from
the father and one from the mother.
In recessive disorders, the condition does not appear unless a person inherits
the same defective gene for the same trait from each parent. If one receives
one normal gene and one gene for the disease, the person will be a carrier for
the disease, but usually will not show symptoms. The risk of transmitting the
disease to the children of a couple, both of whom are carriers for a recessive
disorder, is twenty-five percent. Fifty percent of their children will be
carriers, but healthy as described above. Twenty-five percent of their
children will receive both normal genes, one from each parent, and will be
genetically normal.
Affected Population
Keratitis Ichthyosis Deafness Syndrome appears to affect females slightly more
often then males. This syndrome usually starts during infancy. However,
symptoms may begin as late as the second decade of life.
Related Disorders
Symptoms of the following disorders can be similar to those of Keratitis
Ichthyosis Deafness Syndrome. Comparisons may 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 dead skin cells 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 on this disorder choose
"Ichthyosis" as your search term in the Rare Disease Database).
Darier Disease is a gradually progressive, hereditary skin disorder. It
is characterized by elevated spots (papules) on the scalp, forehead, face,
neck, area behind the ears, and middle of the back. These spots may become
darker and may be covered with grey/brown scales or crusts (ichthyosis).
(For more information on this disorder choose "Darier Disease" as your search
term in the Rare Disease Database).
Ichthyosis Congenita 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
on this disorder 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 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
on this disorder 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 proper name as your search term in
the Rare Disease Database).
Therapies: Standard
Dermatologic symptoms of KID Syndrome 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.
Genetic counseling may be of benefit for patients and their families.
Other treatment is symptomatic and supportive.
Therapies: Investigational
Drugs derived from vitamin A (retinoids) such as tretinoin, motretinide, and
etretinate may also be effective against dermatologic symptoms of KID
Syndrome, 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 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
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
Keratitis Ichthyosis Deafness Syndrome. 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 Keratitis Ichthyosis Deafness Syndrome
National Organization for Rare Disorders
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.)
3640 Grand Avenue, Suite 2
Oakland, CA 94610
(415) 763-9839
The National Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Information Clearinghouse
Box AMS
Bethesda, MD 20892
(301) 495-4484
National Eye Institute (NEI)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5248
Eye Research Institute of Retina Foundation
20 Staniford St.
Boston, MA 02114
(617) 742-3140
For Genetic Information and Genetic Counseling Referrals:
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, 9th Ed.: Victor A. McKusick, Editor: Johns
Hopkins University Press, 1990. Pp. 1272.
BIRTH DEFECTS ENCYCLOPEDIA, Mary Louise Buyse, M.D., Editor-In-Chief;
Blackwell Scientific Publications, 1990. Pp. 935-6.
GENETICALLY TRANSMITTED, GENERALIZATION 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.
1253-58.
KID SYNDROME (KERATITIS, ICHTHYOSIS, AND DEAFNESS) AND CHRONIC
MUCOCUTANEOUS CANDIDIASIS: CASE REPORT AND REVIEW OF THE LITERATURE: M.
Harms, et al,; Pediatr Dermatol (July 1984, issue 2(1)). Pp. 1-7.