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Bullous ichthyosiform erythroderma(BCIE; BIE; EI)

MedGen UID:
38179
Concept ID:
C0079153
Disease or Syndrome
Synonyms: Bullous erythroderma ichthyosiformis congenita of Brocq; Bullous ichthyosiform erythroderma congenita; Congenital bullous ichthyosiform erythroderma; Epidermolytic Hyperkeratosis; KRT1-Related Epidermolytic Hyperkeratosis; KRT10-Related Epidermolytic Hyperkeratosis
SNOMED CT: Congenital bullous ichthyosiform erythroderma (254167000); Dominant ichthyosis vulgaris (254167000); Epidermolytic palmoplantar hyperkeratosis (239071005); Bullous ichthyosis (254167000); Bullous ichthyosiform erythroderma (254167000); Epidermolytic hyperkeratosis (254167000); BIE - Bullous ichthyosiform erythroderma (254167000)
Modes of inheritance:
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
 
Related genes: KRT10, KRT1
 
HPO: HP:0007475
Monarch Initiative: MONDO:0007239
OMIM®: 113800
OMIM® Phenotypic series: PS113800
Orphanet: ORPHA312

Definition

Epidermolytic hyperkeratosis is a skin disorder that is present at birth. Affected babies may have very red skin (erythroderma) and severe blisters. Because newborns with this disorder are missing the protection provided by normal skin, they are at risk of becoming dehydrated and developing infections in the skin or throughout the body (sepsis).

As affected individuals get older, blistering is less frequent, erythroderma becomes less evident, and the skin becomes thick (hyperkeratotic), especially over joints, on areas of skin that come into contact with each other, or on the scalp or neck. This thickened skin is usually darker than normal. Bacteria can grow in the thick skin, often causing a distinct odor.

Epidermolytic hyperkeratosis can be categorized into two types. People with PS-type epidermolytic hyperkeratosis have thick skin on the palms of their hands and soles of their feet (palmoplantar or palm/sole hyperkeratosis) in addition to other areas of the body. People with the other type, NPS-type, do not have extensive palmoplantar hyperkeratosis but do have hyperkeratosis on other areas of the body.

Epidermolytic hyperkeratosis is part of a group of conditions called ichthyoses, which refers to the scaly skin seen in individuals with related disorders. However, in epidermolytic hyperkeratosis, the skin is thick but not scaly as in some of the other conditions in the group. [from MedlinePlus Genetics]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
Follow this link to review classifications for Bullous ichthyosiform erythroderma in Orphanet.

Conditions with this feature

Ichthyosis bullosa of Siemens
MedGen UID:
98153
Concept ID:
C0432306
Congenital Abnormality
Ichthyosis bullosa of Siemens (IBS) is an autosomal dominant congenital bullous ichthyosis without erythroderma. Blistering occurs in response to mild physical trauma and results in superficial erosion ('molting') of the outer skin, particularly on flexures, shins, and the periumbilical region. Keratin filament aggregates are seen by electron microscopy in the granular and upper spinous layers of the epidermis (summary by McLean et al., 1994).
Annular epidermolytic ichthyosis
MedGen UID:
334410
Concept ID:
C1843463
Disease or Syndrome
A rare clinical variant of epidermolytic ichthyosis, with manifestations of blistering phenotype at birth and the development from early infancy of annular polycyclic erythematous scales on the trunk and extremities. It has been reported in less than 10 families. The disease is caused by mutations in the KRT1 (12q11-q13) and KRT10 (17q21-q23) genes, encoding keratins 1 and 10 respectively. These mutations impair keratin filament formation and weaken the structural stability of the keratinocyte cytoskeleton. Transmission is autosomal dominant.
Ectodermal dysplasia-cutaneous syndactyly syndrome
MedGen UID:
462159
Concept ID:
C3150809
Disease or Syndrome
Palmoplantar keratoderma, nonepidermolytic, focal 1
MedGen UID:
1644485
Concept ID:
C4552049
Disease or Syndrome
Focal nonepidermolytic palmoplantar keratoderma-1 (FNEPPK1) is an autosomal dominant skin disorder characterized by large, hard, compact, painful masses of keratin that develop at sites of recurrent friction, principally on the feet, though also on the palms and other sites, without evidence of epidermolysis (summary by Kelsell et al., 1995).
Epidermolytic hyperkeratosis 1
MedGen UID:
1826137
Concept ID:
C5781874
Disease or Syndrome
Epidermolytic hyperkeratosis-1 (EHK1) is a rare autosomal dominant disorder of cornification. The disorder usually presents at birth with erythema and blistering and is characterized in adulthood by warty flexural hyperkeratosis with fewer erosions and blisters. Ultrastructural analysis reveals clumping of the intermediate filaments within keratinocytes of the spinous and granular layers (summary by Whittock et al., 2001). A form of epidermolytic hyperkeratosis that is limited to the palms and soles, designated palmoplantar keratoderma (EPPK; 144200), can also be caused by mutation in KRT1, as well KRT9 (607606). Genetic Heterogeneity of Epidermolytic Hyperkeratosis Mutation in the KRT10 gene (148080) results in both autosomal dominant (EHK2A; 620150) and autosomal recessive (EHK2B; 620707) forms of epidermolytic hyperkeratosis.

Professional guidelines

PubMed

Anton-Lamprecht I
J Invest Dermatol 1983 Jul;81(1 Suppl):149s-56s. doi: 10.1111/1523-1747.ep12540961. PMID: 6345689
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Groundwater JR, Maibach HI
Arch Dermatol 1970 May;101(5):528-30. PMID: 5444075

Recent clinical studies

Etiology

Zhang XB, Luo Q, Li CX, He YQ, Xu X
J Dermatolog Treat 2008;19(4):221-8. doi: 10.1080/09546630801955150. PMID: 18608715
Al-Zayir AA, Al-Amro Al-Alakloby OM
Int J Dermatol 2006 Mar;45(3):257-64. doi: 10.1111/j.1365-4632.2006.02042.x. PMID: 16533225
Al-Zayir AA, Al-Amro Alakloby OM
Int J Dermatol 2004 Jun;43(6):415-9. doi: 10.1111/j.1365-4632.2004.01687.x. PMID: 15186221
Lacour M, Mehta-Nikhar B, Atherton DJ, Harper JI
Br J Dermatol 1996 Jun;134(6):1023-9. PMID: 8763418
Anton-Lamprecht I
J Invest Dermatol 1983 Jul;81(1 Suppl):149s-56s. doi: 10.1111/1523-1747.ep12540961. PMID: 6345689

Diagnosis

Tonini G, Trovato E, Pellegrino M, Fimiani M
G Ital Dermatol Venereol 2020 Dec;155(6):783-784. Epub 2018 Jul 10 doi: 10.23736/S0392-0488.18.06058-3. PMID: 29998711
Khullar G, De D, Handa S
Indian J Dermatol Venereol Leprol 2016 Jul-Aug;82(4):462-3. doi: 10.4103/0378-6323.171639. PMID: 27279322
Scheimberg I, Harper JI, Malone M, Lake BD
Pediatr Pathol Lab Med 1996 May-Jun;16(3):359-78. doi: 10.1080/15513819609168677. PMID: 9025839
Anton-Lamprecht I
J Invest Dermatol 1983 Jul;81(1 Suppl):149s-56s. doi: 10.1111/1523-1747.ep12540961. PMID: 6345689
Wells RS
Proc R Soc Med 1972 Jun;65(6):526-7. PMID: 5035904Free PMC Article

Therapy

Tonini G, Trovato E, Pellegrino M, Fimiani M
G Ital Dermatol Venereol 2020 Dec;155(6):783-784. Epub 2018 Jul 10 doi: 10.23736/S0392-0488.18.06058-3. PMID: 29998711
Zhang XB, Luo Q, Li CX, He YQ, Xu X
J Dermatolog Treat 2008;19(4):221-8. doi: 10.1080/09546630801955150. PMID: 18608715
Jonak C, Metze D, Traupe H, Happle R, König A, Trautinger F
Hum Pathol 2005 Jun;36(6):686-93. doi: 10.1016/j.humpath.2005.04.009. PMID: 16021576
Lacour M, Mehta-Nikhar B, Atherton DJ, Harper JI
Br J Dermatol 1996 Jun;134(6):1023-9. PMID: 8763418
Groundwater JR, Maibach HI
Arch Dermatol 1970 May;101(5):528-30. PMID: 5444075

Prognosis

Liang J, Chen P, Chen H, Tian X, Wu Z, Zhang S, Li C, Zhang X
J Dermatol 2018 Aug;45(8):1003-1008. Epub 2018 May 14 doi: 10.1111/1346-8138.14462. PMID: 29756235
Al-Zayir AA, Al-Amro Al-Alakloby OM
Int J Dermatol 2006 Mar;45(3):257-64. doi: 10.1111/j.1365-4632.2006.02042.x. PMID: 16533225
Langtry JA, Carr MM, Ive FA, Gordon P, Hunter JA, Harper JI
Br J Dermatol 1998 Mar;138(3):502-5. doi: 10.1046/j.1365-2133.1998.02133.x. PMID: 9580808
Lacour M, Mehta-Nikhar B, Atherton DJ, Harper JI
Br J Dermatol 1996 Jun;134(6):1023-9. PMID: 8763418
Hopkins EL, Carey J, Moye R
Prog Clin Biol Res 1982;98:27-45. PMID: 7146020

Clinical prediction guides

Ansai S, Mitsuhashi Y, Sasaki K
Br J Dermatol 1999 Dec;141(6):1097-100. doi: 10.1046/j.1365-2133.1999.03211.x. PMID: 10606859
Reynolds NJ, Yi JY, Fisher GJ, Cooper KD, Voorhees JJ, Griffiths CE
Br J Dermatol 1995 Aug;133(2):157-67. doi: 10.1111/j.1365-2133.1995.tb02611.x. PMID: 7547380
Traupe H, Kolde G, Hamm H, Happle R
J Am Acad Dermatol 1986 Jun;14(6):1000-5. doi: 10.1016/s0190-9622(86)70123-0. PMID: 3522665
Hopkins EL, Carey J, Moye R
Prog Clin Biol Res 1982;98:27-45. PMID: 7146020
Cremers CW, Philipsen VM, Mali JW
J Laryngol Otol 1977 Jul;91(7):585-90. doi: 10.1017/s0022215100084085. PMID: 408455

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