ABSTRACT
ABSTRACT Hypohydrotic ectodermal dysplasia (HED) is a genetic disorder that affects the development of ectodermal tissues. This study reports a case of a 5-year-old male patient, with clinical extra and intraoral characteristics of HED. The intraoral clinical examination revealed a generalized absence of teeth, panoramic radiograph revealed the presence of permanent first molars with taurodontism, and confirm the oligodontia. Cephalometric analysis revealed a class III skeletal relationship, due to deficiency in the sagittal development of the maxilla and an anti-clockwise growth tendency. Alterations in craniofacial development require multidisciplinary treatment and long-term follow-up to monitor craniofacial growth.
RESUMEN La displasia ectodérmica hipohidrótica (DEH) es un trastorno genético que afecta el desarrollo de los tejidos ectodérmicos. Se realiza el reporte de caso de un paciente masculino de 5 años, con características clínicas extra e intraorales de DEH. El examen clínico intraoral reveló una ausencia generalizada de dientes, la radiografía panorámica reveló la presencia de primeros molares permanentes con taurodontismo y confirmó la oligodoncia. El análisis cefalométrico reveló una relación esquelética de clase III, debido a la deficiencia en el desarrollo sagital del maxilar y una tendencia de crecimiento en sentido antihorario. Las alteraciones en el desarrollo craneofacial requieren un tratamiento multidisciplinario y un seguimiento a largo plazo para controlar el crecimiento craneofacial.
ABSTRACT
Resumen Introducción: Las displasias ectodérmicas son un grupo de genodermatosis que se caracterizan por distrofia de las estructuras derivadas del ectodermo. De ellas, la variedad más común es la hipohidrótica, con una incidencia de 7/100,000 nacidos vivos observada en todos los grupos étnicos. La displasia ectodérmica hipohidrótica tiene distintas etiologías. La presentación más frecuente es la asociada a un patrón de herencia ligado al cromosoma X, causada por variantes patogénicas del gen EDA en Xq13.1. EDA codifica a la ectodisplasina A, una molécula de señalización que participa en la comunicación epitelio-mesénquima durante el desarrollo de la piel y los anexos. Caso clínico: Varón de 6 años con las características clínicas cardinales de la displasia ectodérmica hipohidrótica ligada al cromosoma X (DEHLX), que incluyen hipotricosis, oligodoncia e hipohidrosis. El análisis del gen EDA por secuenciación directa mostró la presencia de la variante patogénica c.466C>T, p.Arg156Cys, rs132630313 con presentación de novo en el paciente. Esta variante ya ha sido reportada en diferentes poblaciones, incluyendo familias mexicanas, y constituye un punto caliente para mutación en EDA. Se analizaron los hallazgos clínicos, la etiología y el manejo de la DEHLX, en la que de manera reciente se ha planteado la posibilidad de otorgar tratamiento prenatal para prevenir sus manifestaciones clínicas. Conclusiones: Se pone de relevancia que el análisis molecular en pacientes con DEHLX corrobora el diagnóstico clínico y permite brindar asesoramiento genético con bases moleculares.
Abstract Background: Ectodermal dysplasias are a group of genodermatoses characterized by dystrophy of ectodermal derived structures. The most frequent presentation of the ectodermal dysplasias is the hypohidrotic type, which has an incidence of 7/100,000 newborns and has been described in all ethnic groups. The hypohidrotic ectodermal dysplasia (HED) has different etiologies, and it is more frequently associated with an X-linked pattern of inheritance caused by pathogenic variants of the EDA gene in Xq13.1. EDA encodes the protein ectodisplasin A, a signal molecule which participates in epithelium and mesenchymal development of the skin. Case report: A 6 year-old male patient with the main clinical characteristics of the X-linked HED including hypotrichosis, hypodontia and hypohidrosis. The direct sequencing analysis of EDA in our patient detected a de novo pathogenic variant, c.466C>T, p.Arg156Cys, rs132630313. This variant has been previously described in different ethnic groups, including Mexican families, and is considered a mutational hotspot. The clinical characteristics, etiology and management of the X-linked HED, including the possibility of prenatal therapy in order to avoid the clinical manifestations are discussed. Conclusions: The molecular analysis in patients with X-linked HED is of relevance, as it enables to confirm the clinical diagnosis and also, it allows a genetic assessment with molecular bases.
Subject(s)
Child , Humans , Male , Ectodermal Dysplasia 1, Anhidrotic/genetics , Ectodysplasins/genetics , Pedigree , Phenotype , Recurrence , Point Mutation , Ectodermal Dysplasia 1, Anhidrotic/diagnosis , MexicoABSTRACT
OBJECTIVE@#To detect the ectodysplasin A (EDA) gene mutation in patients with hypohidro-tic ectodermal dysplasia (HED), and to analyze the distribution pattern of missing permanent teeth and the systemic manifestation of HED patients with EDA gene mutation.@*METHODS@#Twelve HED families were enrolled from clinic for genetic history collection, systemic physical examination and oral examination. Peripheral blood or saliva samples were collected from the probands and the family members to extract genomic DNA. PCR amplification and Sanger sequencing were utilized to detect the EDA gene variations, which were compared with the normal sequence (NM_001399.5). The functional impact of EDA gene variants was then evaluated by functional prediction of mutation, conservation analysis and protein structure prediction. The pathogenicity of each EDA gene variation was assessed according to the stan-dards and guidelines of the American College of Medical Genetics and Genomics (ACMG). The systemic phenotype and missing permanent tooth sites of HED patients with EDA gene mutations were summarized, and the missing rate of each tooth position was analyzed and compared.@*RESULTS@#Eight out of twelve HED families were identified to carry EDA gene mutations, including: c.164T>C(p.Leu55Pro); c.457C>T (p.Arg153Cys); c.466C>T(p.Arg156Cys); c. 584G>A(p.Gly195Glu); c.619delG(p.Gly207Profs*73); c.673C>T(p.Pro225Ser); c.676C>T(p.Gln226*) and c.905T>G(p.Phe302Cys). Among them, c.164T>C(p.Leu55Pro); c.619delG(p.Gly207Profs*73); c.673C>T(p.Pro225Ser); c.676C>T(p.Gln226*) and c.905T>G(p.Phe302Cys) were novel mutations. The HED patients with EDA gene mutations in this study were all male. Our results showed that the average number of missing permanent teeth was 13.86±4.49, the average number of missing permanent teeth in the upper jaw was 13.14±5.76, the missing rate was 73.02%. And in the lower jaw, the average number of missing permanent teeth was 14.57±3.05, the missing rate was 80.95%. There was no significant difference in the number of missing teeth between the left and right sides of the permanent dentition (P>0.05). Specifi-cally, the maxillary lateral incisors, the maxillary second premolars and the mandibular lateral incisors were more likely to be missing, while the maxillary central incisors, the maxillary and mandibular first molars had higher possibility of persistence.@*CONCLUSION@#This study detected novel EDA gene pathogenic variants and summarized the distribution pattern of missing permanent teeth of HED patients, thus enriched the variation and phenotype spectrum of EDA gene, and provided new clinical evidence for genetic diagnosis and prenatal consultation.
Subject(s)
Humans , Male , Ectodermal Dysplasia , Ectodermal Dysplasia 1, Anhidrotic/genetics , Ectodysplasins/genetics , Mutation , Pedigree , PhenotypeABSTRACT
RESUMEN Las displasias ectodérmicas constituyen alteraciones de los derivados embriológicos del ectodermo. Paciente adulta, con hipoparatiroidismo, llamó la atención por su fenotipo y fue remitida de la consulta de Neurología a la consulta Genética. Se diagnosticó una displasia ectodérmica hipohidrótica, de origen genético con herencia autosómica dominante, poco común para esta entidad. Se presenta este caso con el objetivo de describir las manifestaciones clínicas de esta alteración genética, las cuales nunca fueron objeto de interés médico resultando inadvertidas para su estudio y diagnóstico. Esta alteración se asocia a una condición patológica como el hipoparatiroidismo, en la literatura revisada no se encontraron reportes de la misma. La evaluación clínica de la paciente permitió hacer el diagnóstico y explicar muchos de los problemas para los cuales no existían respuestas, así como ofrecer un asesoramiento genético adecuado para ella y para sus familiares con riesgo de padecer una condición genética similar.
ABSTRACT Ectodermic dysplasias are alterations of the ectoderm embryologic derivatives. This is a case of an adult female patient with hypoparathyroidism, drawing attention due to her phenotype; she was remitted by the consultation of Neurology to the Genetic one. She was diagnosed a hypohidrotic ectodermal dysplasia, of genetic origin with autosomal dominant inheritance, what is very rare for this entity. The case is presented with the aim of describing the clinical manifestation of this genetic alteration that never drew medical interest and nobody diagnosed or studied. It is associated to a pathologic condition like hypothyroidism and was not reported in medical literature before. The clinical evaluation of the patient allowed arriving to the diagnostic and explaining many problems that were unexplained, and also offering the adequate genetic advice to her and her relatives likewise at risk of suffering a similar genetic condition.
Subject(s)
Humans , Female , Adult , Ectodermal Dysplasia/diagnosis , Ectodermal Dysplasia/etiology , Ectodermal Dysplasia/genetics , Ectodermal Dysplasia/drug therapy , Ectodermal Dysplasia/epidemiology , Genetic Counseling , Hypoparathyroidism/diagnosis , Hypoparathyroidism/etiology , Quality of Life , Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/etiologyABSTRACT
Here we report two cases of anhidrotic ectodermal dysplasia in a family presented to us with intermittent fever, developmental delay, frontal bossing, hypohydrosis, sparse hair and oligodontia. Ectodermal dysplasias are a large hereditary group of disorders which are usually manifested as X-linked recessive hypohidrotic ectodermal dysplasia (HED) and has a full expression in males, whereas females show little to no signs of the disorder. Ectodermal dysplasia are group of rare genetic disorders characterized by faulty development of ectodermal structures and thought to be due to embryonic defect in ectodermal development. Patients frequently consult dentists for delay in tooth eruption so the appropriate awareness of the disease among dentists is essential for early diagnosis.
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Displasia ectodérmica hipohidrótica (DEH) es una enfermedad genética rara de carácter autosómico recesivo ligado al cromosoma X; abarca un conjunto de desórdenes que envuelven tejidos derivados del ectodermo, siendo afectados el sexo masculino y portadores el sexo femenino. Presentan una tríada típica: hipohidrosis, oligodoncia e hipotricosis. Se reporta el caso clínico de un paciente con signos característicos de DEH: piel reseca, cabellos, cejas y pestañas escasos; arrugas e hiperpigmentación perioral y periorbitales; labios y puente nasal prominentes y disminución de secreción lagrimal. En el examen intraoral se observaron ausencias múltiples de piezas dentarias, con presentación de sólo ocho dientes superiores y dos inferiores, todos ellos con alteración de forma y presencia de diastemas. El reconocimiento y tratamiento odontológico precoz de los individuos portadores de DEH, referidos a alteraciones bucales, es de vital importancia no solamente por ofrecer un aspecto funcional y estético favorables sino también porque permite en corto plazo reducir alteraciones en el crecimiento facial.
Hypohidrotic ectodermal dysplasia (HED) is a rare genetic condition. It is of recessive autosomic character and linked to the X chromosome, encompassing a heterogeneous group of disorders involving ectoderm-derived tissues. Males are affected by the disease and females play the role of carriers. This disease presents a typical triad: hypohidrosis, oligodontia and hypotrichosis. This article examines the clinical case of a patient who exhibited characteristic signs of HED: dry skin, scarce hair eyebrows and eyelashes, wrinkles and peri-oral and peri-orbital hyperpigmentation, prominent lips and nasal bridge and decreased lachrymal secretion. Intra-oral examination revealed multiple tooth absences, presence of only eight teeth in the upper jaw and two teeth in the lower jaw, all with shape alterations and presence of diastemata. Early recognition and dental treatment of HED carrier individuals referred to oral alterations is of the utmost importance, not only to achieve favorable esthetics and functionality but also to allow the decrease facial growth alterations in a short time.
ABSTRACT
Las displasias ectodérmicas comprenden más de 200 entidades clínicamente distintivas, las cuales afectan, al menos, dos estructuras derivadas del ectodermo, que incluyen la piel, el pelo, las unas, los dientes, las glándulas sudoríparas y sebáceas. La displasia ectodérmica hipohidrótica ligada al X es el tipo más frecuente y es causada por mutación del gen EDA, que codifica la ectodisplasina-A. Su frecuencia es menor de 1 en 100000 individuos y se caracteriza clínicamente por presentar hipodoncia, hipohidrosis, hipotricosis y alteraciones oculares. Se expone el caso de un escolar evaluado de forma multidisciplinaria con diagnóstico clínico y molecular de displasia ectodérmica hipohidrótica ligada al X con mutación tipo cambio de sentido c.1133C>,T, p.T378M, en el gen EDA.
Ectodermal dysplasia encompasses more than 200 clinically distinct entities, which affect at least two structures derived from the ectoderm, including the skin, hair, nails, teeth, sweat glands, and sebaceous glands. X-linked hypohidrotic ectodermal dysplasia is the most common type and is caused by mutation of the EDA gene that encodes Ectodysplasin-A. It occurs in less than 1 in 100 000 individuals and is clinically characterized by hypodontia, hypohidrosis, hypotrichosis, and eye dis orders. We present a child evaluated in a multidisciplinary manner with clinical and molecular diagnosis of X-linked hypohidrotic ectodermal dysplasia with type missense mutation c.1133C> T; p.T378M in EDA gene.
Subject(s)
Humans , Male , Child , Ectodermal Dysplasia 1, Anhidrotic/diagnosis , Ectodermal Dysplasia 1, Anhidrotic/genetics , Ectodysplasins/genetics , MutationABSTRACT
Objective To explore the mutations of EDA gene in 2 X - linked hypohidrotic ectodermal dyspla-sia(XLHED)pedigrees,and provide clues for the XLHED diagnosis,genetic counseling and treatment. Methods Polymerase chain reaction and direct sequencing were used to analyze the coding sequences and their flanking sequences of the EDA gene in the patients,suspicious carriers,normal family members in 2 families and non - relative control sam-ples. Results In family 1,mutation c. 659 676del18,namely p. 220 225del(Gly - X - Y)6 which was located in (Gly - X - Y)19 collagen - like repeat domain,was found in the proband and other patient's EDA gene. In family 2,an insertion c. 118 - 119insT was found in the intracellular domain,which induces reading frame alteration from the 40th a-mino acid. The mutations found in the 2 families were consistent with the principle of mutation and phenotype co - sepa-ration,but these mutations were not found in the normal control samples. EDA gene analysis of fetal amniotic fluid sam-ple from Ⅲ - 1 in the family 1 was not found to have the same mutation as the proband,and the follow - up after birth proved normal for the baby. Conclusions EDA gene c. 118 - 119insT mutation found in the research is a novel muta-tion. Sequence analysis of EDA gene is an efficient method in XLHED diagnosis,and is beneficial for the genetic coun-seling and the genetic intervention of the disease in the affected families.
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La displasia ectodérmica hipohidrótica es un síndrome congénito, caracterizado por la tríada hipohidrosis, hipotricosis e hipodoncia no progresivas. La forma más común es lade herencia recesiva ligada al cromosoma X, aunque también existe una autosómica recesiva y otra dominante. Su tratamiento incluye un manejo interdisciplinario, con medidas de soporte para las manifestaciones clínicas del trastorno y el asesoramiento genético familiar.
Hypohidrotic ectodermal dysplasia is a congenital syndrome characterized by the triad of hypohidrosis, hypotrichosis and non-progressivehypodontia. The most common form is the one inherited in a recessive X-linked way, although there is also an autosomal recessive and a dominant ones. Treatment includes the interdisciplinary management, supportive for the clinical manifestations of the disorder and family genetic counseling.
Subject(s)
Humans , Female , Child , Ectodermal Dysplasia , Ectodermal Dysplasia, Hypohidrotic, Autosomal Recessive , Anodontia , Hypohidrosis , HypotrichosisABSTRACT
Objective To evaluate exertional overheating and endurance during and after physical exercise on individuals with hypohidrotic ectodermal dysplasia(HED) ,to assess protective effects of skin cooling device ,and to provide theoretical basis for ex-ternal cooling devices .Methods 12 HED patients and 12 age-matched healthy controls were studied during standardized exercise on a treadmill at ambient temperatures of 25 ℃ and 30 ℃ .Body core temperature ,performance ,heart rate ,respiratory rate ,blood pres-sure and serum lactate were investigated during and after exercise .Results HED subjects experienced a significantly greater rise in body temperature after cycling than healthy controls ,and their body temperature remained elevated longer(P<0 .05) .HED subjects had a lower endurance time(F=9 .985 ,P=0 .005) and increasing speed value(F=7 .158 ,P=0 .014) .However ,serum lactate value of the HED subjects found to be higher than the controls (F=5 .204 ,P=0 .033) .Maximum heart rates ,respiratory rate and blood pressure did not differ significantly between HED and the control groups .However ,compared with controls ,body temperature and endurance time of HED patients equipped with skin cooling device had no statistical significance .Conclusion HED subjects showed a significantly greater rise of body temperature during exercise than the control groups ,and their body temperature remained elevat-ed longer than in healthy subjects ,and had a lower performance .External evaporative skin cooling attenuates exertional overheating in HED patients and may facilitate their participation in athletic activities and professional life .
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La displasia ectodérmica hipohidrótica es una enfermedad hereditaria, infrecuente en la población general, caracterizada clínicamente por la tríada de hipohidrosis, deficiencias dentarias y falta de crecimiento de cabello. Además, se afectan otros anexos cutaneos como folículos pilosos, uñas y dientes e incluso estructuras como las glándulas mucosas del tracto aerodigestivo superior lo que puede ocasionar signos, síntomas y patologías de interés para el otorrinolaringólogo. Se presentan dos casos clínicos, un adulto y un niño, y se revisa la literatura respecto de las manifestaciones de la displasia ectodérmica hipohidrótica en cabeza y cuello.
Hypohidrotic ectodermal dysplasia is an uncommon, hereditary disease, clinically characterized by the triad of hypohidrosis, dental deficiencies and lack of hair growth. In addition, it affects other skin appendages such as hair follicles, nails and teeth and even structures such as the mucous glands of the upper aerodigestive tract causing signs and also symptoms and pathologies of interest for the otolaryngologist. Two cases are presented, an adult and a child one,an in addition to literature review regarding the manifestations of hypohidrotic ectodermal dysplasia in head and neck.
Subject(s)
Humans , Male , Child, Preschool , Middle Aged , Epistaxis/etiology , Ectodermal Dysplasia 1, Anhidrotic/complications , Otorhinolaryngologic Diseases/etiology , Tomography, X-Ray Computed , Ectodermal Dysplasia 1, Anhidrotic/diagnostic imagingABSTRACT
INTRODUCCIÓN: La displasia ectodérmica hipohidrótica es una enfermedad genética caracterizada por hipotricosis, hipohidrosis e hipodoncia, las cuales se vuelven evidentes durante la niñez. Su forma más común es aquella con herencia recesiva ligada al cromosoma X; si bien existe una forma autosómica recesiva y otra dominante. Es más común en varones, y entre sus manifestaciones se incluye cabello fino, dientes en forma de cono, piel hipoplásica e intolerancia al calor. El tratamiento incluye medidas de soporte para las distintas manifestaciones de la enfermedad, además del consejo genético para las familias. PRESENTACIÓN DEL CASO: Presentamos el caso de un niño de8 años, con antecedentes de cariotipo XYY, síndrome progeria no especificado y con diagnóstico de displasia ectodérmica hipohidrótica, además su madre presenta el diagnóstico de displasia ectodérmica. Al examen físico destaca pelo lanoso en cantidad normal, cejas y pestañas ralas, dientes escasos y terminados en punta. DISCUSIÓN: El diagnóstico de esta enfermedad es fundamentalmente clínico, en base a la tríada característica, pudiendo complementarse con estudio histológico, tomando biopsia de la frente o de las palmas de las manos y plantas de los pies. En nuestro caso éste fue realizado fundado sólo en la clínica, manteniéndose en tratamiento para la xerosis con buenos resultados.
INTRODUCTION: Hypohidrotic ectodermal dysplasia is a genetic disease characterized by hypotrichosis, hypohidrosis and hypodontia, which become evident during childhood. Its most common presentation is recessive sex-linked X chromosome disorder, although there are recessive and dominant autosomal disorders. It is more common in men, and its manifestations include thinning hair, cone-shaped teeth, hypoplastic skin and heat intolerance. Treatment includes supportive measures for the different manifestations of the disease and genetic counseling for relatives. CASE REPORT: We report the case of an eight-year old male, with XYY karyotype, unspecified progeria syndrome and hypohidrotic ectodermal dysplasia diagnosis, furthermore his mother has ectodermal dysplasia diagnosis. Normal quantity woolly hair, sparse eyebrows and eyelashes, teeth few and pointed toes are the highlights of the physical examination. DISCUSSION: The diagnosis of this disease is mainly clinical, based on the characteristic triad, and can be supplemented by histological study, with biopsy of the forehead or the palms and soles. In our case this was done based only on the clinical manifestation, actually in treatment for xerosis with good results.
Subject(s)
Humans , Male , Child , Ectodermal Dysplasia/diagnosis , Hypohidrosis/diagnosisABSTRACT
La displasia ectodérmica hipohidrótica (DEH) es una enfermedad rara de etiología genética. La forma más frecuente es la de herencia recesiva relacionada al cromosomo X con sujetos de sexo masculino afectados y de sexo femenino portadores. Pueden ocurrir a través de mutaciones autosómicas, y en estas, las del gene EDA1 son responsables por la mayoría de los casos. Se caracteriza por la tríada: hipohidrosis, oligodoncia e hipotricosis. Presentamos dos casos de pacientes con DEH en los cuales se observaron signos característicos del síndrome: piel delicada; cabellos, cejas y pestañas escasos; arrugas periorbitales; hiperpigmentación perioral y periorbital; labios prominentes y además de eso el paciente del caso 2 presentaba depresión del puente nasal. Se constató aún disminución de la secreción salival y lagrimal y hipoplasia de maxila en los dos casos. Al examen oral estaban presentes en el caso 1 los caninos superiores derecho e izquierdo temporales y el canino inferior derecho temporal y en el caso 2 los caninos superiores e inferiores (derechos e izquierdos) temporales y dos incisivos superiores (uno derecho y otro izquierdo) permanentes con morfología alterada, siendo todos los elementos dentarios íntegros. El tratamiento odontológico precoz de los portadores de DEH, principalmente en la presencia de oligodoncia, como la que se observa en los casos aquí reportados, es importante no solamente para ofrecer mejor calidad de vida para estos pacientes en corto plazo, sino también en el intento de mitigar las alteraciones en el crecimiento facial a que estos pacientes están sometidos.
Hypohidrotic ectodermal dysplasia (HED) is a rare disease of genetic etiology. The most frequent form is of recessive linked to X-chromosome inheritance with affected male and female carriers. It can occur through autosomal mutations, of the gene EDA1 gene being responsible for the majority of the cases. It is characterized by the triad: hypohidrosis, oligodontia and hypotrichosis. We present two cases of patients with HED in which we observed characteristic signs of this syndrome: delicate skin, sparce hair, eyebrows and eyelashes, periorbital wrinkles, perioral and periorbital hyperpigmentation, prominent lips, in addition the patient in case 2 also present the depressed nasal bridge. We also found decreased salivary and lacrimal secretion and maxillary hypoplasia in both cases. At the oral examination in case 1 the upper right and left deciduous canines and lower right deciduous canine were present, and in case 2 the upper and lower (right and left) deciduous canines and two upper (one right and other left) permanent incisors were present with altered morphology, all of these dental elements were healthy. The early dental treatment of patients with HED, especially in the presence of oligodontia, as observed in our cases, is important not only to provide a better quality of life for these patients in the short term, but also an attempt to minimize the changes in facial growth to which these patients are subject.
Subject(s)
Child , Anodontia/pathology , Anodontia , Ectodermal Dysplasia/pathology , Ectodermal Dysplasia , Cone-Beam Computed Tomography , Ectodermal Dysplasia 1, Anhidrotic/pathology , Ectodermal Dysplasia 1, AnhidroticABSTRACT
Introducción: el objetivo de esta investigación fue describir las características faciales, cefalométricas y determinar cuáles dientes estaban presentes o ausentes tanto clínica como radiográficamente en dieciséis pacientes con displasia ectodérmica hipohidrótica (DEH) de la Facultad de Odontología de la Universidad de Antioquia, en edades entre cinco y diecinueve años. La displasia ectodérmica hipohidrótica (DEH) es un síndrome de tipo hereditario que afecta principalmente los tejidos de origen ectodérmico, se manifiesta como una tríada que incluye: hipotricosis, hipohidrosis e hipodoncia; se presenta en uno de cada cien mil nacidos vivos. Intraoralmente se observa retraso en la erupción, dientes con formas conoides, afectando ambos maxilares. Otras características son: frente, labios prominentes, puente nasal hundido, retrusión del maxilar superior y protrusión mandibular. Métodos: se realizó un análisis descriptivo univariado, utilizando tablas de frecuencia, medidas descriptivas, promedio, gráficos de barras y pastel para las variables cualitativas, e histogramas de frecuencia o polígonos para las variables cuantitativas. El análisis estadístico se realizó con la base de datos SPSS versión 15.0. Resultados y conclusiones: las medidas antropométricas disminuidas fueron: ancho facial (85,5%), alturas mandibular, cutánea del labio superior (75%) y total del labio superior (56,3%). Las medidas que se encontraron aumentadas fueron: altura facial superior (81,3%), distancia intercantal externa (68,8%) yancho de la frente (50%). En el esqueleto las medidas cefalométricas mostraron en general maloclusiones clase III con maxilares hipoplásicos (62,5%), retrusivos (81,3%), mandíbulas de tamaño y posición adecuada, con perfiles cóncavos (75%). Los dientes que más tuvieron ausencias fueron: laterales superiores e inferiores, primeros premolares superiores y centrales inferiores.
Introduction: the objective of this study was to describe the facial and cephalometric characteristics of 16 patients with hypohidrotic ectodermal dysplasia (HED) being treated at the College of Dentistry of the University of Antioquia and to clinically and radiographically determine which teeth were present or absent; the age of the patients ranged between 5 and 19 years. Hypohidrotic ectodermal dysplasia is a genetic syndrome that mainly affects the embryonic ectodermal originated tissues, it is manifested as a triad which includes: hypotricosis, hypohidrosis and hypodontia; it is present in one of every one hundred thousand born alive. Intraorally, a delay in tooth eruption and conoid shaped teeth are observed, affecting both jaws. Other characteristics are: prominent front and, sunken nasal bridge, retrusion of the maxilla and, protrusion of the mandible. Methods: an univariate descriptive analysis was done using frequency tables, descriptive measurements, average, bar and piegraphs for the qualitative variables and frequency histograms for the quantitative variables. The statistical analysis was done with the SPSS data base, version 15.0. Results and conclusions: the decreased anthropometric measurements were: facial width (85.5%), cutaneous mandibular height for the upper lip (75%) and total upper lip height (56.3%). The increased measurements were: upper face height (81.3%), external inter canthal distance (68.8%) and forehead width (50%). At the skeletal level the cephalometric measurements showed Class III malocclusions with hypoplastic maxillas (62.5%), retrusion (81.3%), mandibles with adequate size and position and concave profiles (75%). The most commonly absent teeth were: upper and lower lateral incisors, upper first bicuspids and lower central incisors.
Subject(s)
Humans , Anodontia , Cephalometry , Ectodermal DysplasiaABSTRACT
Ectodermal dysplasia is a rare hereditary disorder. Its Hypohidrotic (HED) variant is also known as Chirst- Siemens-Touraine syndrome. It is inherited as an X- linked trait. Such Patients are characterized by the clinical manifestations of Hypodontia, Hypotrichosis, Hypohidrosis and a highly characteristic facial physiognomy. This article, reports a typical case of Hypohidrotic Ectodermal Dysplasia (HED) and management.
ABSTRACT
Hypohidrotic ectodermal dysplasia is a rare X-linked recessive disorder. It is characterized by the absence or hypoplasia of hair, teeth and sweat glands and by the characteristic facial features. A 20-year-old man presented with hypohidrosis and dry skin since birth. The skin was dry and his face had the characteristic appearance with prominent supraorbital ridges, a wide nasal bridge, thick everted lips and bat-like ears. His scalp and pubic hairs were sparse and eyebrows were absent. His family showed a typical pedigree of X-linked recessive trait. A skin biopsy from the left palm revealed no eccrine gland structures. Herein we report a typical case of hypohidrotic ectodermal dysplasia with a brief review.
Subject(s)
Humans , Young Adult , Biopsy , Ear , Eccrine Glands , Ectodermal Dysplasia 1, Anhidrotic , Eyebrows , Hair , Hypohidrosis , Lip , Parturition , Pedigree , Scalp , Skin , Sweat Glands , ToothABSTRACT
Objetive:To detect the gene mutation of a patient with anhidrotic ectodermal dysplasia. Methods: Genomic DNA was extracted from the peripheral blood of the patient and all the exon fragments were obtained by PCR. These fragments were sequenced directly. Results: In EDA gene a novel base transition was detected: -48A→G. Conclusion: There is a new base transition in EDA gene in this patient
ABSTRACT
Congenital hypohidrotic ectodermal dysplasia is a rare genodermatosis. It is characterized by hypohidrosis hypotrichosis, dental hypoplasia and characterstic facial features, which reflect a wide constellation of developmental defec of tissue from the ectoderm. We have encountered three cases of congenital hypohidrotic ectodermal dysplasia in a 28-year-old female, her new-born baby, and a 10-month-old boy with a family history. All of the three patients had hypohidrosis, hypotrichosis, defective dentition, and characterstic facial features, which were characterstic features of this disorder. In addition, they showed dry skin, sparse and thin hairs. Histopathologic findings of previous cases revealed no eccrine gland structure in the dermis with routine and immunohistochemical stainning such cytokeratin and filaggrin. We report three typical cases of hypohidrotic ectodermal dysplasia with the review of literature.