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Compound heterozygous ABCA12 mutations including a novel nonsense mutation underlie harlequin ichthyosis.
[harlequin ichthyosis]
Recently
,
it
has
been
reported
that
several
harlequin
ichthyosis
(
HI
)
patients
survive
the
neonatal
period
and
their
condition
subsequently
improves
.
Here
we
describe
a
2
-
year
-old
Japanese
boy
who
exhibited
typical
clinical
features
of
HI
at
birth
.
He
survived
beyond
the
neonatal
period
after
oral
retinoid
treatment
and
,
at
the
age
of
2
years
,
showed
moderately
thick
,
lamellar
scales
and
erythroderma
over
his
whole
body
.
The
patient
is
a
compound
heterozygote
for
2
ABCA
12
mutations
,
a
paternal
deletion
mutation
c
.
2021
_
2022
del
(
p
.
Lys
674
ArgfsX
63
)
and
a
novel
maternal
nonsense
mutation
c
.
7444
C
-
-
>
T
(
p
.
Arg
2482
X
)
.
Electron
microscopic
observation
of
a
skin
biopsy
specimen
from
the
perinatal
period
revealed
epidermal
ultrastructural
features
consistent
with
HI
.
Immunofluorescence
labeling
using
antiserum
against
a
C-
terminal
ABCA
12
epitope
showed
loss
of
expression
in
the
patient
's
epidermis
.
The
present
patient
demonstrates
that
rapid
diagnosis
of
HI
by
ABCA
12
expression
analysis
and
mutation
detection
,
and
early
commencement
of
systemic
retinoid
therapy
are
crucial
to
significantly
improving
an
HI
patient
's
prognosis
.
Diseases
Validation
Diseases presenting
"skin biopsy specimen from the perinatal period"
symptom
harlequin ichthyosis
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