Ichthyin

Alternative Names

  • Congenital Ichthyosis, Autosomal Recessive
  • ARCI
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OMIM Number

609383

Gene Map Locus
5q33

Description

Autosomal recessive Congenital Ichthyosis (ARCI) is a rare inherited skin disorder that is characterized by dry, desquamated, FISH-like scaling of the skin usually with erythema. The disease is named ichthyosis as the Greece word "Ichthy" means FISH. Most infants are born as collodion babies (infants born with bright red, shiny, translucent, and drawn tight skin, resulting in immobilization). Patients develop redness, blistering and peeling of the skin since birth or by 6 months of age. Fluid-filled blisters can become infected and cause foul skin odor. Losing water through the skin leads to dehydration of the neonates. Because the skin is not properly functions, bacteria can enter the blood through this insufficient barrier. Few days after the initial blistering, scaling develops.

Clinical presentation and severity of ARCI may vary widely ranging from Harlequin ichthyosis (the most severe and often fatal), to lamellar ichthyosis (LI) and non-bullous congenital ichthyosiform erythroderma (NCIE). LI differs from NCIE in the scales properties. In LI, the scales are large, adherent, dark, and pigmented with no erythroderma. The NCIE form has fine and white scales on an erythematous background, although the scales are larger and grayish on the limbs. The incidence rate is estimated to be between 1:300,000 and 1:500,000 for the different forms of the disease. Boys and girls of all races and ethnicities are equally affected.

Molecular Genetics

Mutation in the ichthyin gene is associated with autosomal recessive congenital ichthyosis. The gene is localized on chromosome 5q33 and codes for a protein with several transmembrane domains and it belongs to a new protein family of unknown function localized in the plasma membrane. Six different homozygous mutations in 14 consanguineous families have been identified to date; including one nonsense mutation and five missense mutations.

Epidemiology in the Arab World

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Other Reports

Algeria

Lefevre et al. (2004) identified a gene for a new form of non-syndromic autosomal recessive congenital ichthyosis (ARCI) and studied its genomic localization by homozygosity mapping. The study included 11 patients (six males and five females) with ARCI from eight consanguineous Algerian families. Some patients were born as collodion babies. Seven patients presented the nonbullous congenital ichthyosiform erythroderma (NCIE) phenotype. Those patients had generalized ichthyosis with erythema, fine whitish scaling on the face and trunk, and larger brownish scaling on the neck, buttocks and legs. All patients had palmoplanter keratoderma, often yellowish with fissures, and some had clubbing of nails. Lefevre et al. (2004) identified a new gene in those patients (ichthyin). Sequencing of ichthyin gene showed four different homozygous mutations in the patients. One of these mutations was a nonsense mutation presented in three families (247C->T). The other three were missense mutations (341C->A, 437C->T, 239G->T). The product of ichthyin is predicted to be a 404-amino acid protein with several transmembrane domains localizing in the plasma membrane. The RT-PCR demonstrated a high expression of ichthyin in brain, lung, stomach, skin, and leukocytes. Lefevre et al. (2004) proposed that ichthyin protein was a membrane receptor for a ligand, probably trioxilin A3, from the hepoxilin pathway.

Syria

Lefevre et al. (2004) identified a gene for a new form of non-syndromic autosomal recessive congenital ichthyosis (ARCI) and studied its genomic localization by homozygosity mapping. The study included two sisters with ARCI from a consanguineous Syrian family. They were born as collodion babies. Both sisters had palmoplanter keratoderma, often yellowish with fissures. Lefevre et al. (2004) identified a new gene in those patients (ichthyin). Sequencing of ichthyin gene showed the presence of a missense mutation in exon 5 (523C-to-G).

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