Recent Advances in the Genetics and Management of Harlequin Ichthyosis
Article first published online: 12 JUN 2014
© 2014 Wiley Periodicals, Inc.
Volume 31, Issue 5, pages 539–546, September/October 2014
How to Cite
Ahmed, H. and O'Toole, E. A. (2014), Recent Advances in the Genetics and Management of Harlequin Ichthyosis. Pediatric Dermatology, 31: 539–546. doi: 10.1111/pde.12383
- Issue published online: 4 SEP 2014
- Article first published online: 12 JUN 2014
Harlequin ichthyosis (HI) is the most severe and devastating form of the autosomal recessive congenital ichthyoses (ARCIs). Mutations in the ABCA12 gene result in disruption of intercellular lipid deposition in the stratum corneum and a major skin barrier defect. Patients present at birth, often premature, with cutaneous thick, yellow, hyperkeratotic plates with deep erythematous fissures, causing a typical facial appearance. Harlequin ichthyosis has often been considered to be fatal, and management tends to be palliative, but follow-up of 45 affected infants has shown that with good neonatal care and early introduction of oral retinoids, survival rates are improving. Because ABCA12 mutations have been identified, known carriers are able to undergo preventative preimplantation and prenatal genetic testing. Experimental studies have shown recovery of lipid secretion in lamellar granules using corrective gene therapy. Further research is needed to develop alternative therapies to retinoids in HI.