Presentation
We present four patients with lipoid proteinosis involving skin, oropharynx and larynx. [ncbi.nlm.nih.gov]
Entire Body System
- Developmental Disorder
Crispian Scully, Stephen Flint, Stephen Porter and Khursheed Moos, Congenital and Developmental Disorders, Oral and Maxillofacial Diseases, 10.3109/9780203508954-29, (491-548), (2013). Noritaka Oyama, Ien Chan, Sallie M. Neill, Andrew P. [dx.doi.org]
Respiratoric
- Pharyngitis
Biopsies from the eyelid, pharyngeal mucosa, and elbow lesions revealed diffuse amorphous deposits of hyaline material within the dermis and around blood vessels, which stained positively for periodic acid-Schiff, was diastase resistant and stained negatively [ncbi.nlm.nih.gov]
Biopsies from the eyelid, pharyngeal mucosa, and elbow lesions revealed diffuse amorphous deposits of hyaline material within the dermis and around blood vessels, which stained positively for periodic acid–Schiff, was diastase resistant and stained negatively [journals.lww.com]
Oral, pharyngeal and laryngeal manifestations in Urbach-Wiethe disease. Ann Clin Res 1977;9:1-7. 5. Al-Bitar Y, Samdani AJ. Lipoid proteinosis in two brothers with multiple organ involvement from Saudi Arabia. Int J Dermatol 2004;43:360-1. 6. [ijdvl.com]
Jaw & Teeth
- Macroglossia
Additional symptoms included beaded eyelid papules, macroglossia with yellowish papules, yellowish deposits of soft palate, papular eruption in the axillary area and tuberous nodules on the elbows. [histopathology-india.net]
[…] and inner canthus 1,3 alopecia may also eventually develop 1,3 head and neck initially, a hoarse cry in infancy due to vocal cord stiffening, this is often the first clinical feature of the disease 1,3 over time thickened white oral mucosa (causing macroglossia [radiopaedia.org]
[…] amyloidosis +Hyperpigmented papulonodular eruptions occur, especially on the shins and upper limbs that may coalesce into thickened plaques +A skin biopsy with Congo red stain helps in making the diagnosis Xanthomatosis Myxoedema hoarseness of voice, macroglossia [slideshare.net]
Physical examination revealed an otherwise healthy man with macroglossia, yellowish deposits on the tongue and soft palate, beaded papules on the thickened margins of the eyelids, yellowish papules in the axillae and nodules of variable sizes on both [medicaljournals.se]
Lateral surface of his tongue showed clear indentations of the dentition, indicating macroglossia. The tongue was firm and woody in consistency, with no fibrotic bands on palpation. [jdrntruhs.org]
Skin
- Skin Thickening
The typical cutaneous manifestations of LP include waxy yellow papules with generalized skin thickening on the face, extremities, and trunk. Here we report a case with significant mucosal involvement but less skin involvement. [ncbi.nlm.nih.gov]
Waxy yellow skin thickening Beaded eyelid papules (moniliform blepharosis) Generalized skin thickening, most obvious on face, axilla and scrotum Warty papules and plaques at sites of friction (eg elbows and extensor forearms) Other common cutaneous features [dermnetnz.org]
Common clinical features include: skin initially, increased susceptibility to trauma, recurrent impetigo that is often bullous 1,3 over time skin thickening develops, most evident on the face and in skin folds 1,3 this progresses to development of multiple [radiopaedia.org]
The basic pathology is the deposition of periodic acid-Schiff-positive hyaline-like material in the dermis, around blood vessels and adnexae with resultant skin thickening, abnormal scarring, abnormal wound healing and premature aging. [ijdvl.com]
Eyes
- Thickened Eyelids
Patients with this genodermatosis can usually be recognized instantly because of husky voice, inability to protrude tongue and thickened eyelids. [indianpediatrics.net]
- Angioid Streaks of the Retina
Individuals most commonly present with yellowish papules in the skin and/or with angioid streaks of the retina found on routine eye examination or associated with retinal hemorrhage. [ncbi.nlm.nih.gov]
Workup
Microbiology
- Human Papillomavirus
Epidermodysplasia verruciformis (EV) is also a rare autosomal recessive genodermatosis involving susceptibility to human papillomavirus (HPV) infections and squamous cell carcinoma, caused in most cases by homozygous mutations in EVER1 or EVER2. [ncbi.nlm.nih.gov]
Treatment
Previous research on treatment of lipoid proteinosis has focused on genetic etiology and clinical diagnosis of this rare laryngeal disorder. However, few studies on this disorder have examined treatment methods directed at improving voice qualities. [ncbi.nlm.nih.gov]
Prognosis
Prognosis is variable depending on the level of CNS dysfunction and involvement of other organs but can be normal. [radiopaedia.org]
The prognosis of lipoid proteinosis is generally good although, the disease is progressive until early adult life. [6] Almost every organ of the body is involved. [e-ijd.org]
Prognosis of LP is, nonetheless, relatively good quoad vitam, if not quoad valetudinem. [ncbi.nlm.nih.gov]
Prognosis •Lipoid proteinosis has a stable or slowly progressive course •The presence of this disease is compatible with a normal life span unless altered by airway obstruction or fatal seizure activity •Mortality rates in infants and adults are slightly [slideshare.net]
The overall prognosis is good. There is no definitive treatment. [idoj.in]
Etiology
Etiology and pathogenesis are unknown. Infantile hoarseness is a common presenting feature of the disease due to infiltration of larynx. In two-thirds of the cases, voice changes are present at birth or in early infancy as the first manifestation. [ncbi.nlm.nih.gov]
[…] founder mutation, Mol Syndromol 2016;7:26 ) Pathophysiology Uncertain ECM1 (extracellular matrix protein 1) is a component of the extracellular matrix and patients with LP lack functional ECM1 - this leads to hyaline deposits through an unknown mechanism Etiology [pathologyoutlines.com]
Etiology and Pathogenesis The molecular basis for hypermobility EDS is largely unclear. [plasticsurgerykey.com]
Epidemiology
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
Miller is responsible for the strategic development and execution of research and testing in the areas of dermatotoxicology, clinical safety and efficacy studies, post-market surveillance studies, epidemiology studies, environmental studies (biodegradation [books.google.com]
[…] and lamina propria corresponding clinically to waxy yellowish white lesions Variable clinical presentation ( see clinical features below ) Autosomal recessive inheritance Terminology Also known as hyalinosis cutis et mucosae or Urbach-Wiethe disease Epidemiology [pathologyoutlines.com]
Self-skin examination New smartphone apps to check your skin Learn more (Sponsored content) Related information References Lipoid Proteinosis: Background, Pathophysiology, Epidemiology. 2015 Jun 20 [cited 2015 Jul 26] Krafchik B, Lara-Corrales I. [dermnetnz.org]
Epidemiology Frequency More than 300 cases have been reported worldwide. [5] Incidence and prevalence figures are not available. [emedicine.medscape.com]
Pathophysiology
Patient details Age Adult Location Egypt Localisation Head / face / eyelid Description Beaded papules along the eyelid margin presenting with hoarseness, characteristic of lipoid proteinosis Primary Lesions papules beaded papules along the eyelid margins Pathophysiology [dermquest.com]
Loss of key protein-protein interactions may underscore some of the disease pathophysiology. There is currently no effective treatment for lipoid proteinosis and clinical care is largely supportive. © 2015 Elsevier B.V. All rights reserved. [ncbi.nlm.nih.gov]
Loss of key protein-protein interactions may underscore some of the disease pathophysiology. There is currently no effective treatment for lipoid proteinosis and clinical care is largely supportive. [kclpure.kcl.ac.uk]
Prevention
Journal of Indian Society of Pedodontics and Preventive Dentistry, Jan-Mar, 2011, 29(1). Van Hougenhouck-Tulleken W, Chan I, Hamada T, Thronton H, Jenkins T, McLean WHI, et al. [revista.acorl.org]
Rare Brain Disorder Prevents All Fear 20. Curvilinear hyperattenuated horn-shaped lesions are well depicted by CT in the amygdaloid bodies On MR imaging, such lesions are hypointense in all pulse sequences, especially in GRE T2* weighted images 21. [slideshare.net]
Avoiding and preventing injuries is of great importance. Assessment of the home environment with modifications to make homes “EDS safe,” such as avoiding hard, sharp edges on furniture and arrangement to prevent or minimize falls, can be helpful. [plasticsurgerykey.com]
The 2 most reliable signs of lipoid proteinosis are [3]: Hoarse voice, classically presenting as an infant with a faint or hoarse cry Thickened sublingual frenulum (a band of tissue), which prevents patients from protruding the tongue Further testing [dermnetnz.org]
Despite many therapeutic trials for LiP, treatment of this condition remains unsatisfactory and mainly aims at reducing morbidity and preventing complications. [jiaomr.in]