Cutis laxa

Cutis laxa
Cutis laxa in an infant
Specialty Medical genetics Edit this on Wikidata

Cutis laxa (also known as chalazoderma, dermatochalasia, dermatolysis, dermatomegaly, generalized elastolysis, generalized elastorrhexis,[1] or pachydermatocele[2]) is a group of rare connective tissue disorders in which the skin becomes inelastic and hangs loosely in folds.[3]

Signs and symptoms

It is characterized by skin that is loose, hanging, wrinkled, and lacking in elasticity. The loose skin is often most noticeable on the face, resulting in a prematurely aged appearance. The affected areas of skin may be thickened and dark. In addition, the joints are loose (hypermobile) because of lax ligaments and tendons. When cutis laxa is severe, it can also affect the internal organs. The lungs, heart (supravalvular pulmonary stenosis), intestines, or arteries may be affected with a variety of severe impairments. In some cases, hernias and outpouching of the bladder can be observed. Patients also present with whites of the eyes that are blue.

Causes

In most cases, cutis laxa is inherited. Autosomal dominant, autosomal recessive, and X-linked recessive forms have been described, but acquired forms also occur.

Cutis laxa is associated with deficient or absent elastin fibers in the extracellular matrix.[4] Various mutations in genes have been identified.

Cutis laxa may be caused by mutations in the genes: ELN,[5] ATP6V0A2,[6] ATP7A,[7] FBLN4,[8] FBLN5,[9] and PYCR1.[10] A related neurocutaneous syndrome may be caused by mutations in the gene ALDH18A1 (P5CS).[11] Cutis laxa may also be seen in association with inherited connective tissue disorders such as Ehlers Danlos syndrome.

Acquired causes of cutis laxa include rheumatoid arthritis, systemic lupus erythematosus, and monoclonal gammopathies.

Treatment

As of 2018, there is no treatment for cutis laxa. Procedures aimed at mitigating symptoms and identifying subsequent conditions are often advised.

See also

References

  1. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
  2. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 515. ISBN 0-7216-2921-0.
  3. Millington, P (2009). Skin. Cambridge University Press. p. 100. ISBN 978-0-521-10681-8.
  4. Plopper G (2007). The extracellular matrix and cell adhesion, in Cells (eds Lewin B, Cassimeris L, Lingappa V, Plopper G). Sudbury, MA: Jones and Bartlett. ISBN 0-7637-3905-7.
  5. Online Mendelian Inheritance in Man (OMIM) Cutis Laxa, Autosomal Dominant -123700
  6. Online Mendelian Inheritance in Man (OMIM) Cutis Laxa, Autosomal Recessive, Type II -219200
  7. Online Mendelian Inheritance in Man (OMIM) Cutis Laxa, X-Linked -304150
  8. Online Mendelian Inheritance in Man (OMIM) Cutis Laxa, Autosomal Recessive, Type I -219100
  9. Online Mendelian Inheritance in Man (OMIM) Fibulin 5; FBLN5 -604580
  10. Online Mendelian Inheritance in Man (OMIM) Pyrroline-5-Carboxylate Reductase 1; PYCR1 -179035
  11. Online Mendelian Inheritance in Man (OMIM) Aldehyde Dehydrogenase 18 Family, Member A1; ALDH18A1 -138250

Further reading

  • Van Maldergem, Lionel; Loeys, Bart (2011-10-13). FBLN5-Related Cutis Laxa. NBK5201. In Pagon RA, Bird TD, Dolan CR, et al., eds. (1993). GeneReviews™ [Internet]. Seattle WA: University of Washington, Seattle.
  • Van Maldergem, Lionel; Dobyns, William; Kornak, Uwe (2011-05-10). ATP6V0A2-Related Cutis Laxa. NBK5200. In GeneReviews
  • Loeys, Bart; De Paepe, Anne; Urban, Zsolt (2011-05-12). EFEMP2-Related Cutis Laxa. NBK54467. In GeneReviews
  • G Kaler, Stephen (2010-10-14). ATP7A-Related Copper Transport Disorders. NBK1413. In GeneReviews
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