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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.