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Harlequin ichthyosis: a review of clinical and molecular findings in 45 cases.
[lamellar ichthyosis]
To
assess
the
clinical
outcomes
of
45
cases
of
harlequin
ichthyosis
and
review
the
underlying
ABCA
12
gene
mutations
in
these
patients
.
Multicenter
,
retrospective
,
questionnaire-based
survey
.
Dermatology
research
institute
.
Patients
with
harlequin
ichthyosis
for
whom
we
had
performed
ABCA
12
mutation
analysis
.
Referring
physicians
were
asked
to
complete
a
questionnaire
using
the
patients
'
notes
,
detailing
the
clinical
outcome
of
the
affected
child
.
In
each
case
,
the
causative
ABCA
12
mutation
was
identified
using
standard
polymerase
chain
reaction
and
sequencing
techniques
.
Of
the
45
cases
,
the
ages
of
the
survivors
ranged
from
10
months
to
25
years
,
with
an
overall
survival
rate
of
56
%
.
Death
usually
occurred
in
the
first
3
months
and
was
attributed
to
sepsis
and
/
or
respiratory
failure
in
75
%
of
cases
.
The
early
introduction
of
oral
retinoids
may
improve
survival
,
since
83
%
of
those
treated
survived
,
whereas
76
%
who
were
not
given
retinoids
died
.
Recurrent
skin
infections
in
infancy
affected
one
-
third
of
patients
.
Problems
maintaining
weight
affected
44
%
.
Three
children
developed
an
inflammatory
arthritis
,
and
developmental
delay
was
reported
in
32
%
.
Mutation
analysis
revealed
that
52
%
of
survivors
had
compound
heterozygous
mutations
,
whereas
all
deaths
were
associated
with
homozygous
mutations
.
Harlequin
ichthyosis
should
be
regarded
as
a
severe
chronic
disease
that
is
not
invariably
fatal
.
With
improved
neonatal
care
and
probably
the
early
introduction
of
oral
retinoids
,
the
number
of
survivors
is
increasing
.
Compound
heterozygotes
appear
to
have
a
survival
advantage
.
Diseases
Validation
Diseases presenting
"improved neonatal care and probably the early introduction"
symptom
harlequin ichthyosis
lamellar ichthyosis
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