Ezzine Sebai Nadia, Khaled Aida, Kharfi Monia, Bouzgarrou Alia, M'halla Hana, Jones Meriem, Fazaa Bécima, Kamoun Mohamed Ridha
Service Dermatologie, Hôpital Charles Nicolle, Tunis, Tunisie.
Tunis Med. 2009 Dec;87(12):805-9.
Ectodermal dysplasias are rare hereditary diseases characterised by congenital absence of ectodermally derived structures and classified according to four symptoms: trichodysplasia, hypodontia, onychodysplasia and hypohidrosis.
The objective of our study is to precise the epidemioclinical characteristics, the diagnostic tools, the evolution and the treatments of this rare disease through a 10-case series of hypohidrotic ectodermal dysplasia (HED).
The present report is a retrospective study of all cases of an/hypohidrotic ectodermal dysplasia collected from 1977 to 2006. We have specified age, sex, parental consanguinity, similar familial cases, clinical and histological features, dental, oto-rhino-laryngologic, ophthalmologic and respiratory examinations.
Ten cases of HED were collected (average age: 14 years, sex ratio 9/1). The mean duration diagnostic period was of 14 years. Parental consanguinity was registered in 3 cases but only one patient had similar familial cases. All patients had facial dysmorphy, hypotrichosis and hypo/anodontia (respectively 8/10 and 2/10). All patients had clinically and histologically documented hypoplastic (6/10) or aplastic sweat glands (4/10). Extra-cutaneous manifestations were noted in 8 patients (recurrent rhinitis 6/10, recurrent pneumopathies 3/10, xerophtalmy 3/10).
Our series deals with 10 cases of HED, consisting in Chris-Siemens Touraine syndrome. It highlights the delayed diagnosis of this disease (mean: 14 years) with a diagnosis made at an adult age in four patients. Our study confirm the X-linked heredity (9/10) with a possible autosomal transmission (one female-case). HED is rarely life-threatening, but early diagnosis allows a better quality of life to patients and genetic counselling to parents. Our series illustrates the rarity of HED which is also probably due to its underestimation by clinicians.
外胚层发育不良是一种罕见的遗传性疾病,其特征为先天性缺乏外胚层衍生结构,并根据四种症状进行分类:毛发发育异常、牙齿发育不全、甲发育异常和少汗症。
我们研究的目的是通过10例少汗型外胚层发育不良(HED)病例系列,明确这种罕见疾病的流行病学临床特征、诊断工具、病情发展及治疗方法。
本报告是一项对1977年至2006年收集的所有少汗/无汗型外胚层发育不良病例的回顾性研究。我们明确了年龄、性别、父母近亲结婚情况、类似家族病例、临床和组织学特征、牙科、耳鼻喉科、眼科和呼吸检查情况。
收集到10例HED病例(平均年龄:14岁,男女比例为9/1)。平均诊断时间为14年。3例有父母近亲结婚情况,但只有1例患者有类似家族病例。所有患者均有面部畸形、毛发稀少和牙齿发育不全/无牙症(分别为8/10和2/10)。所有患者经临床和组织学证实有汗腺发育不全(6/10)或无汗腺(4/10)。8例患者有皮肤外表现(复发性鼻炎6/10、复发性肺病3/10、干眼症3/10)。
我们的系列研究涉及10例HED病例,即克里斯 - 西门子 - 图赖讷综合征。该研究突出了这种疾病的诊断延迟(平均:14年),4例患者在成年期才得以诊断。我们的研究证实了X连锁遗传(9/10),可能存在常染色体显性遗传(1例女性病例)。HED很少危及生命,但早期诊断能让患者有更好的生活质量,并为父母提供遗传咨询。我们的系列研究说明了HED的罕见性,这可能也是由于临床医生对其认识不足所致。