Hypohidrotic Ectodermal Dysplasia: A Rare Disorder With Bilateral Infantile Glaucoma.

Ectodermal dysplasia (ED) is a disorder that occurs due to abnormalities of ectodermal structures such as skin, teeth, hair, nails, and eccrine glands. Approximately 200 different conditions have been identified as ED, the most common being hypohidrotic ED. It is characterized by hypotrichosis (sparse scalp or body hair), hypodontia (absent or malformed teeth), and hypohidrosis (reduced ability to sweat). It is also associated with distinctive facial features, such as the prominent forehead, thick lips, flattened nasal bridge, and thin wrinkled skin. Ocular anomalies are less frequently observed, the most common ones being dysplasia of the lacrimal gland or meibomian gland that leads to dry eye and variable corneal involvement. We report a case of a 9-year-old child of hypohidrotic ED presenting with bilateral infantile glaucoma managed by the implantation of glaucoma drainage devices (GDDs) after a failed trabeculotomy and trabeculectomy in both eyes.

Displasia ectodérmica hipohidrótica: reporte de casos / Hypohydrotic ectodermal dysplasia: Report of case

La Displasia Ectodérmica Hipohidrótica (DEH) es una genodermatosis que se caracteriza por presentar alteraciones en las estructuras deri-vadas del ectodermo, frecuentemente se da la triada: hipohidrosis, hipotricosis e hipodoncia. El síndrome puede manifestarse como heren-cia autosómica dominante o recesiva y tam-bién como herencia ligada al sexo, la forma más frecuente es la de herencia recesiva relacionada al cromosoma X con sujetos de sexo masculino afectados y de sexo femenino portadores. Puede ocurrir a través de mutacio-nes autosómicas, de las cuales las del gen EDA1 son responsables del 58% de los casos. La DEH presenta tasa de mortalidad infantil entre 2% y 20%, dependiendo de la precocidad del diag-nóstico y de los protocolos de tratamiento. Este artículo presenta un paciente de 23 meses de edad quien había sido hospitalizado por otra-patología y se re rió al Instituto Hondureño de Seguridad Social (IHSS), por observar cabello hipopigmentado, escaso, no, ausencia de pestañas y cejas, dientes cónicos e hipohidro-sis: por lo que se diagnostica displasia ectodér-mica hipohidrótica, quedando pendiente la realización de biopsia de piel y exámenes genéticos debido a que no se cuenta con el equipo médico necesario. Por tal motivo, no se conoció el patrón de segregación...(AU)

Early respiratory and ocular involvement in X-linked hypohidrotic ectodermal dysplasia.

UNLABELLED: X-linked hypohidrotic ectodermal dysplasia (XLHED; ectodysplasin deficiency) has been classically described as affecting hair, sweat glands, and dentition. What may be underappreciated is the effect ectodysplasin deficiency has on glands surrounding the airways and eyes and the resulting chronic health issues. In this study, 12 male children (age range 6-13 years) and 14 male adults with XLHED (18-58 years of age) were investigated by pulmonary function tests, measurement of fractional exhaled nitric oxide, and by ophthalmologic assessments. Twelve healthy individuals (six children, six adults) served as controls. Signs of airway constriction and inflammation were detected in eight children with XLHED, including the youngest subject, and in ten adult XLHED patients. Increased tear osmolarity, reduced tear film break-up time, and other ocular abnormalities were also present at an early age. Five of 12 XLHED subjects not reporting a history of asthma and 7 of the 12 patients not reporting a history of dry eye issues showed at least two abnormal test results in the respective organ system. The presence of residual sweat ducts, suggestive of partial ectodysplasin gene expression, correlated with milder disease in two XLHED subjects with mutations affecting the collagen-like domain of ectodysplasin. CONCLUSION: The high prevalence of asthma-like symptoms in XLHED patients as young as 6 years and a similar prevalence of dry eye problems indicate that screening evaluation, regular monitoring, and consideration of therapeutic intervention should begin in early childhood.

Overdenture restoration in a growing patient with hypohidrotic ectodermal dysplasia: a clinical report.

Ectodermal dysplasia is a hereditary disorder of ectodermal origin. A 12-year-old boy was referred for management of the oral manifestations of his ectodermal dysplasia. An overdenture retained by natural teeth for the maxilla and a double-crown-retained denture for the mandible were made. Double-crown-retained dentures may be modified into complete dentures if the abutment teeth are lost. The patient was instructed to maintain oral hygiene and return periodically for follow-up visits. This report describes a potential routine approach to restoring the appearance, function, and psyche of a growing boy with ectodermal dysplasia.

Oral rehabilitation with endosseous implants in a child with ectodermal dysplasia: a case report.

AIM: The purpose of this article is to report the clinical course of a 12-year-old child with ectodermal dysplasia who was treated with an implant-supported overdenture for the mandible and an overdenture for the maxilla. CASE REPORT: Two dental implants were placed in the canine regions of the mandible. The maxillary teeth were prepared for the milled copings. Because the preparation of parallel walls was difficult, near-parallelism with an angle of convergence or taper of approximately 5 degrees was achieved. The cervical third of the teeth was prepared to be as parallel as possible to one another. In addition, the occlusal surfaces were reduced 1.5 mm, and the axial surfaces were reduced 1 mm. Occlusal reduction was performed to provide adequate thickness for the overlying denture base material. A chamfer finish line was prepared. The copings were cast with a Cr-Ni-based metal alloy and luted, bilateral balanced occlusion was developed using anatomic acrylic teeth. An impression was taken with an individual tray for impressions of overdentures. In response to the patient's dry mucosa, the impressions were taken using rapid-setting silicone impression material with high elasticity. Bilateral balanced occlusion was achieved using anatomic acrylic teeth for overdentures. The maxillary overdenture and implant-supported mandibular overdenture were prepared by conventional methods using thermal-curing acrylic resin. The patient was seen 48 hours later for adjustment, then after 1 and 2 weeks, 1, 3, and 6 months, and 1 year and he is still satisfied with his prosthesis both aesthetically and functionally. CONCLUSION: The use of endosseous implants in the prosthetic rehabilitation of children with ectodermal dysplasia may provide a considerable improvement in comparison with traditional prosthetic methods.

A Mongolian patient with hypohidrotic ectodermal dysplasia with a novel P121S variant in EDARADD.

INTRODUCTION: Hypohidrotic ectodermal dysplasia is a genetic disorder characterized by diminished or a lack of sweating, congenital missing teeth, and sparse or absent hair. Three genes, EDA, EDAR, and EDARADD, all related to tumor necrosis factor signaling, have been reported as responsible genes for this disorder. Among them, the largest numbers of mutations have been identified in EDA, and only two mutations identified in EDARADD. MATERIALS AND METHODS: DNA analysis of EDA, EDAR, and EDARADD was performed on a Mongolian patient by polymerase chain reaction-direct sequencing. RESULTS: The 5-year-old Mongolian individual had no erupted deciduous or permanent teeth. A panoramic radiograph showed only one tooth in the right mandible. His hair and eyebrows were sparse, but he did not have a short stature. He showed diminished sweating. The nails of his fingers and toes were normal. Based on these conditions, he was diagnosed with hypohidrotic ectodermal dysplasia. There was no gene mutation of EDA or EDAR. A novel heterozygous variant (P121S; c.361C>T) was identified in the death domain of EDARADD (NM_080738). No other member of his family was affected, and this variant was not identified in his parents or maternal grandparents. CONCLUSION: This study reports an individual affected with hypohidrotic ectodermal dysplasia with a novel heterozygous P121S variant in the death domain of EDARADD.

Quantification of taurodontism: interests in the early diagnosis of hypohidrotic ectodermal dysplasia.

OBJECTIVE: The aim of this study was to provide a quantification of taurodontism in Hypohidrotic Ectodermal Dysplasia (HED) and to report its occurrence in a cohort of HED patients to assess phenotypic-genotypic correlations. PATIENTS AND METHODS: Of 68 HED patients retrospectively reviewed, 16 patients aged 7-51 years were selected and compared with a control sample (n = 351). The pulp surface index of the first lower permanent molar was calculated from the panoramic radiograph of each individual, and statistical comparisons between the HED patients and the control sample were performed. RESULTS: Whatever the genetic disorder, 81.25% of the HED patients exhibited a relative enlargement (>or=1 s.d.) of the pulp. Major deviations (>5 s.d.) were respectively related to men affected by large deletion of the EDA gene or missense mutation. The autosomal recessive form was linked to a relative moderate pulp enlargement (3.44 s.d.). In NEMO forms, the increase of pulp size in men appeared to be less marked than in EDA mutations. CONCLUSION: This study provides for the first time an objective assessment of pulp enlargement in HED patients, and the various degrees of taurodontism depicted could be interesting dental phenotypic markers of HED forms.