Ichthyosis, Sjögren Larsson Syndrome
NORD is very grateful to the members of the Medical and Scientific Advisory Board of the Foundation for Ichthyosis & Related Skin Types for assistance in the preparation of this report.
Synonyms of Ichthyosis, Sjögren Larsson Syndrome
- Ichthyosis, Spastic Neurologic Disorder, Mental Retardation
- No subdivisions found.
Sjögren-Larsson syndrome is an inherited disorder characterized by scaling skin (ichthyosis), mental retardation, speech abnormalities, and spasticity. Affected infants develop various degrees of reddened skin with fine scales soon after birth. After infancy, the skin loses its redness and dark scales often appear on the neck and under the arms. Additionally, larger plate-like thick scales may develop on the lower legs. Developmental delay, speech abnormalities and seizures may accompany skin symptoms. Spasticity in the legs typically impairs motor ability and walking. Many children with this disorder have glistening white dots or degeneration of the pigment in the retina of the eye.
Symptoms of Sjögren-Larsson syndrome are usually evident at birth or during early infancy. This disorder is characterized by thickening of the skin (hyperkeratosis) with fine dry scales on most of the body associated with varying degrees of redness. After infancy, the flexural side of the arms and legs are affected by dark, scaly areas without redness.
In time, larger plate-like scales may appear on the skin's surface, particularly on the legs. The skin has an itchy characteristic. Speech abnormalities, mental retardation and seizures usually occur during the first 2 or 3 years of life. Glistening white dots in the back portion of the inside of the eyeball (retina) may be a specific sign of the disorder.
Patients with Sjögren-Larsson syndrome typically develop some degree of leg spasticity, resulting in difficulty walking or an inability to walk. Less commonly, patients have short stature, and curvature of the spine.
Patients with Sjögren-Larsson syndrome have a deficient activity of fatty aldehyde dehydrogenase (FALDH) and are unable to metabolize a certain type of fat called "fatty alcohol." Normally, fatty alcohol metabolism is important in the skin and brain, where it is used for the synthesis of membrane components.
Sjögren-Larsson syndrome is caused by mutations in the FALDH gene on the short arm of chromosome 17 (17p11.2). It is an inherited disorder transmitted in an autosomal recessive manner.
Chromosomes, which are present in the nucleus of human cells, carry the genetic information for each individual. Human body cells normally have 46 chromosomes. Pairs of human chromosomes are numbered from 1 through 22 and the sex chromosomes are designated X and Y. Males have one X and one Y chromosome and females have two X chromosomes. Each chromosome has a short arm designated "p" and a long arm designated "q". Chromosomes are further sub-divided into many bands that are numbered. For example, "chromosome 17p11.2" refers to a location on band 11 on the short arm of chromosome 17. The numbered bands specify the location of the thousands of genes that are present on each chromosome.
In recessive disorders the condition appears when the person inherits the same defective gene for the same trait from each parent. If the individual receives one normal gene and one gene for the disease, the person will be a carrier for the disease but will not show the condition. The risk of transmitting the disease to the children of a couple, both of whom are carriers for the recessive disorder, is approximately 25 percent per pregnancy.
Sjögren-Larsson syndrome is a rare inherited disorder occurring in approximately 8.3 out of 100,000 persons in northern Sweden. It is less prevalent in the U.S. The disorder affects males and females in equal numbers.
Symptoms of the following disorders may be similar to those of Sjögren-Larsson syndrome. Comparisons can be useful for a differential diagnosis.
Ichthyoses or "disorders of cornification" are general terms describing a group of scaly skin disorders. They are characterized by an abnormal accumulation of large amounts of dead skin cells (squames) in the top layer of the skin. The conversion of an abnormally large number of epidermal cells into squamous cells is thought to be caused by a defect in the metabolism of the skin cells known as "corneocytes" or the fat-rich matrix around these cells. These cells can be thought of as bricks, while the matrix would be the mortar holding these cells together. (See "Ichthyosis" in the Rare Disease Database.)
Ichthyosis congenita (collodion baby; congenital ichthyosiform erythroderma; xeroderma; desquamation of the newborn) is an inherited skin disorder. It is characterized by generalized, abnormally red, dry, and rough skin with large coarse and fine white scales. Itchiness (pruritus) usually also develops. Skin on the palms of the hands and soles of the feet can be abnormally thick. (For more information, choose "Ichthyosis Congenita" as your search term in the Rare Disease Database.)
The skin symptoms of Sjögren-Larsson syndrome can be treated by applying skin softening emollients. This can be especially effective after bathing while the skin is still moist. Lotions containing alpha-hydroxy acids can also be an effective treatment for the skin symptoms of this disorder. Anti-convulsant medication may control seizures. Physical therapy, speech therapy and special education services may be helpful.
Dietary restriction of fat (long chain fatty acids) and supplementation of medium chain fatty acids (triglycerides) has been associated with marked improvement in the skin symptoms in a few patients. In other patients, however, there has been no clinical response to dietary treatment.
Other treatment is symptomatic and supportive.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
For information about clinical trials sponsored by private sources, contact:
Ichthyosis, Sjögren Larsson Syndrome Resources
NORD Member Organizations:
(To become a member of NORD, an organization must meet established criteria and be approved by the NORD Board of Directors. If you're interested in becoming a member, please contact Susan Olivo, Membership Manager, at email@example.com.)
Rizzo, W.B.: Sjögren-Larsson Syndrome: Fatty Aldehyde Dehydrogenase Deficiency. In The Metabolic and Molecular Bases of Inherited Disease. 8th Ed. Edited by Scriver, C.R., Beaudet, A.L., Valle, D., Sly, W.S., McGraw-Hill, New York, pp. 2239/2259, 2001.
Rizzo, WB, Carney, G, and Lin, Z. The molecular basis of Sjögren-Larsson Syndrome: Mutation analysis of the fatty aldehyde dehydrogenase gene. Am J Hum Genet. 1999; 65: 1547- 1560.
Williams, ML, et al. Genetically Transmitted, Generalized Disorders of Cornification. The Ichthyoses. Dermatol Clin. January 1987; 5(1): 155-78.
The information in NORD’s Rare Disease Database is for educational purposes only. It should never be used for diagnostic or treatment purposes. If you have questions regarding a medical condition, always seek the advice of your physician or other qualified health professional. NORD’s reports provide a brief overview of rare diseases. For more specific information, we encourage you to contact your personal physician or the agencies listed as “Resources” on this report.
The National Organization for Rare Disorders (NORD) web site, its databases, and the contents thereof are copyrighted by NORD. No part of the NORD web site, databases, or the contents may be copied in any way, including but not limited to the following: electronically downloading, storing in a retrieval system, or redistributing for any commercial purposes without the express written permission of NORD. Permission is hereby granted to print one hard copy of the information on an individual disease for your personal use, provided that such content is in no way modified, and the credit for the source (NORD) and NORD’s copyright notice are included on the printed copy. Any other electronic reproduction or other printed versions is strictly prohibited.
Copyright ©1988, 1989, 1992, 1993, 1995, 1997, 1999, 2004
Report last updated: 2008/04/01 00:00:00 GMT+0
NORD's Rare Disease Information Database is copyrighted and may not be published without the written consent of NORD.