Dev Anubha, Malhi Kittu, Mahajan Rahul
Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian Dermatol Online J. 2024 Apr 23;15(3):405-414. doi: 10.4103/idoj.idoj_599_23. eCollection 2024 May-Jun.
Ectodermal dysplasias are a heterogeneous group of disorders that are characterized by abnormal development of ectodermal structures like hair, teeth, nails, and sweat glands. Alhough they were earlier classified according to the structures affected and hence the clinical manifestations, recent developments inch towards a genetic basis for classification. They are currently divided into four groups of disorders based on the pathway involved, which includes the ectodysplasin/nuclear factor-kappa B (NFKB) pathway, wingless-type MMTV integration site family, member 10 ([wingless related integration site] WNT10), tumor protein p63 (TP63), and the structural group. In spite of attempts at the segregation of the various disorders, there is a great degree of overlap in clinical features among the conditions, which makes a thorough history-taking and clinical examination important in helping us arrive at a diagnosis and judge the various systems involved. A multidisciplinary approach forms the crux of the management of patients with ectodermal dysplasias and their families, with a focus on education, counseling, prosthesis, and an overall rehabilitative outlook. Special attention must also be paid to screening family members for varying severities of the disorders, and an attempt must be made at a genetic diagnosis with genetic counseling.
外胚层发育异常是一组异质性疾病,其特征是毛发、牙齿、指甲和汗腺等外胚层结构发育异常。尽管它们早期是根据受影响的结构以及临床表现进行分类的,但最近的进展倾向于基于遗传基础进行分类。目前根据所涉及的途径将它们分为四类疾病,其中包括外胚层发育不良蛋白/核因子-κB(NFKB)途径、无翅型MMTV整合位点家族成员10([无翅相关整合位点]WNT10)、肿瘤蛋白p63(TP63)以及结构组。尽管尝试对各种疾病进行分类,但这些疾病的临床特征存在很大程度的重叠,这使得全面的病史采集和临床检查对于帮助我们做出诊断并判断所涉及的各个系统非常重要。多学科方法是外胚层发育异常患者及其家庭管理的关键,重点在于教育、咨询、假体以及全面的康复前景。还必须特别注意筛查家庭成员中不同严重程度的疾病,并尝试通过遗传咨询进行基因诊断。