Meynadier J, Guillot B, Barnéon G, Djian B, Lévy A
Service de Dermatologie, Hôpital Saint-Charles, Montpellier.
Ann Dermatol Venereol. 1987;114(12):1529-36.
Trichothiodystrophy is a congenital dysplasia of hairs characterized by: a pathognomonic image of the hair shaft under polarized light (the hair is plaited with alternately dark and light oblique bands) and trichoschisis with a clear-cut break; a deficiency of sulphurated aminoacids in the hair. We report a case where trichothiodystrophy was associated with abnormalities of the nails, teeth and eyes, growth and mental retardation, neurological syndrome and hypogonadism. From this case and a review of the cases published so far the following points emerge: 1. Congenital abnormalities of the neuroectodermal system are frequent. They include: skin lesions, such as ichthyosis, photosensitivity and atopic eczema; ungueal dysplasia; dysmorphic syndrome; growth and mental retardation; hypogonadism; neurological and ophthalmic abnormalities. 2. The condition seems to be transmitted as an autosomal recessive trait. A common element, dysplasia, enables us to include in the same nosological group as trichothiodystrophy a number of other pathological conditions, viz.: syndromes hitherto described under various names but almost identical, such as Brown's syndrome and BIDS syndrome (brittle hair, intellectual deficit, decreased fertility, small stature); IBIDS and PIBIDS syndromes which, in addition to the former, comprise ichthyosis and photosensitivity, as well as Tay's syndrome (characterized by the presence in all cases of ichthyosis associated with hair dysplasia); and perhaps some anecdotic cases with either a pathognomonic image under polarized light or a suggestive biochemical profile. Finally, since typical trichothiodystrophy has been reported in patients with Siemens' syndrome or with Marviesco-Sjögren syndrome, these two syndromes may perhaps also be classified in the same category, as borderline forms of the disease.
毛发硫营养不良是一种先天性毛发发育异常,其特征为:偏振光下毛干呈现特征性图像(毛发呈交替的深色和浅色斜带编织状)以及毛发裂隙并有明显的断裂;毛发中含硫氨基酸缺乏。我们报告了一例毛发硫营养不良合并指甲、牙齿和眼部异常、生长和智力发育迟缓、神经综合征及性腺功能减退的病例。从该病例以及对迄今已发表病例的回顾中可得出以下要点:1. 神经外胚层系统的先天性异常很常见。包括:皮肤病变,如鱼鳞病、光敏性和特应性湿疹;指甲发育异常;畸形综合征;生长和智力发育迟缓;性腺功能减退;神经和眼部异常。2. 该病似乎以常染色体隐性性状遗传。一个共同要素——发育异常,使我们能够将一些其他病理状况归入与毛发硫营养不良相同的疾病分类组,即:迄今以各种名称描述但几乎相同的综合征,如布朗综合征和BIDS综合征(脆发、智力缺陷、生育力下降、身材矮小);IBIDS和PIBIDS综合征,除前者外还包括鱼鳞病和光敏性,以及泰氏综合征(其特征为所有病例均存在鱼鳞病并伴有毛发发育异常);或许还有一些在偏振光下有特征性图像或有提示性生化特征的罕见病例。最后,由于在西门子综合征或马尔维斯科 - 舍格伦综合征患者中报告了典型的毛发硫营养不良,这两种综合征或许也可归为同一类别,作为该疾病的边缘形式。