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Linear skin defects with multiple congenital anomalies 1(LSDMCA1)

MedGen UID:
163210
Concept ID:
C0796070
Disease or Syndrome
Synonyms: LSDMCA1; Microphthalmia Dermal Aplasia and Sclerocornea syndrome; Microphthalmia with Linear Skin Defects Syndrome; MLS syndrome
SNOMED CT: Microphthalmia with linear skin defect syndrome (721879006); Syndromic microphthalmia type 7 (721879006); MIDAS syndrome (microphthalmia, dermal aplasia, sclerocornea) syndrome (721879006); MIDAS syndrome (721879006)
 
Genes (locations): COX7B (Xq21.1); HCCS (Xp22.2); NDUFB11 (Xp11.3)
 
Monarch Initiative: MONDO:0024552
OMIM®: 309801

Disease characteristics

Microphthalmia with linear skin defects (MLS) syndrome is characterized by unilateral or bilateral microphthalmia and/or anophthalmia and linear skin defects, usually involving the face and neck, which are present at birth and heal with age, leaving minimal residual scarring. Other findings can include a wide variety of other ocular abnormalities (e.g., corneal anomalies, orbital cysts, cataracts), central nervous system involvement (e.g., structural anomalies, developmental delay, infantile seizures), cardiac concerns (e.g., hypertrophic or oncocytic cardiomyopathy, atrial or ventricular septal defects, arrhythmias), short stature, diaphragmatic hernia, nail dystrophy, hearing impairment, and genitourinary malformations. Inter- and intrafamilial variability is described. [from GeneReviews]
Authors:
Manuela Morleo  |  Brunella Franco   view full author information

Additional descriptions

From OMIM
The microphthalmia with linear skin defects syndrome (MLS) is an X-linked dominant disorder characterized by unilateral or bilateral microphthalmia and linear skin defects--which are limited to the face and neck, consisting of areas of aplastic skin that heal with age to form hyperpigmented areas--in affected females and in utero lethality for males (Wimplinger et al., 2006). Genetic Heterogeneity of Linear Skin Defects with Multiple Congenital Anomalies Also see LSDMCA2 (300887), caused by mutation in the COX7B gene (300885) on Xq21, and LSDMCA3 (300952), caused by mutation in the NDUFB11 gene (300403) on Xp11.3.  http://www.omim.org/entry/309801
From MedlinePlus Genetics
Microphthalmia with linear skin defects syndrome is a disorder that mainly affects females. In people with this condition, one or both eyes may be very small or poorly developed (microphthalmia). Affected individuals also typically have unusual linear skin markings on the head and neck. These markings follow the paths along which cells migrate as the skin develops before birth (lines of Blaschko). The skin defects generally improve over time and leave variable degrees of scarring.

The signs and symptoms of microphthalmia with linear skin defects syndrome vary widely, even among affected individuals within the same family. In addition to the characteristic eye problems and skin markings, this condition can cause abnormalities in the brain, heart, and genitourinary system. A hole in the muscle that separates the abdomen from the chest cavity (the diaphragm), which is called a diaphragmatic hernia, may occur in people with this disorder. Affected individuals may also have short stature and fingernails and toenails that do not grow normally (nail dystrophy).  https://medlineplus.gov/genetics/condition/microphthalmia-with-linear-skin-defects-syndrome

Clinical features

From HPO
Clitoral hypertrophy
MedGen UID:
57848
Concept ID:
C0156394
Finding
Hypertrophy of the clitoris.
Chordee
MedGen UID:
66363
Concept ID:
C0221182
Congenital Abnormality
Ventral, lateral, or ventrolateral bowing of the shaft and glans penis of more than 30 degrees.
Uterine hypoplasia
MedGen UID:
120575
Concept ID:
C0266399
Congenital Abnormality
Underdevelopment of the uterus.
Hypospadias
MedGen UID:
163083
Concept ID:
C0848558
Congenital Abnormality
Abnormal position of urethral meatus on the ventral penile shaft (underside) characterized by displacement of the urethral meatus from the tip of the glans penis to the ventral surface of the penis, scrotum, or perineum.
Ovotestis
MedGen UID:
1634511
Concept ID:
C4551490
Congenital Abnormality
A gonad that contains both ovarian follicles and testicular tubular elements.
Micropenis
MedGen UID:
1633603
Concept ID:
C4551492
Congenital Abnormality
Abnormally small penis. At birth, the normal penis is about 3 cm (stretched length from pubic tubercle to tip of penis) with micropenis less than 2.0-2.5 cm.
Single transverse palmar crease
MedGen UID:
96108
Concept ID:
C0424731
Finding
The distal and proximal transverse palmar creases are merged into a single transverse palmar crease.
Cardiac arrhythmia
MedGen UID:
2039
Concept ID:
C0003811
Finding
Any cardiac rhythm other than the normal sinus rhythm. Such a rhythm may be either of sinus or ectopic origin and either regular or irregular. An arrhythmia may be due to a disturbance in impulse formation or conduction or both.
Atrial septal defect
MedGen UID:
6753
Concept ID:
C0018817
Congenital Abnormality
Atrial septal defect (ASD) is a congenital abnormality of the interatrial septum that enables blood flow between the left and right atria via the interatrial septum.
Ventricular septal defect
MedGen UID:
42366
Concept ID:
C0018818
Congenital Abnormality
A hole between the two bottom chambers (ventricles) of the heart. The defect is centered around the most superior aspect of the ventricular septum.
Junctional ectopic tachycardia
MedGen UID:
21066
Concept ID:
C0039235
Disease or Syndrome
Junctional ectopic tachycardia (JET) is a unique type of supraventricular arrhythmia defined by narrow QRS complex and atrioventricular (AV) dissociation or retrograde atrial conduction in a 1:1 pattern.
Overriding aorta
MedGen UID:
120559
Concept ID:
C0265886
Congenital Abnormality
An overriding aorta is a congenital heart defect where the aorta is positioned directly over a ventricular septal defect, instead of over the left ventricle. The result is that the aorta receives some blood from the right ventricle, which reduces the amount of oxygen in the blood. It is one of the four conditions of the Tetralogy of Fallot. The aortic root can be displaced toward the front (anteriorly) or directly above the septal defect, but it is always abnormally located to the right of the root of the pulmonary artery. The degree of override is quite variable, with 5-95% of the valve being connected to the right ventricle.
Histiocytoid cardiomyopathy
MedGen UID:
310844
Concept ID:
C1708371
Disease or Syndrome
Histiocytoid cardiomyopathy, which was initially described by Voth (1962), goes by various names, including infantile xanthomatous cardiomyopathy (MacMahon, 1971), focal lipid cardiomyopathy (Bove and Schwartz, 1973), oncocytic cardiomyopathy (Silver et al., 1980), infantile cardiomyopathy with histiocytoid change (Ferrans et al., 1976), and foamy myocardial transformation of infancy (Yatani et al., 1988). The disorder is a rare but distinctive entity of infancy and childhood characterized by the presence of characteristic pale granular foamy histiocyte-like cells within the myocardium. It usually affects children younger than 2 years of age, with a clear predominance of females over males. Infants present with dysrhythmia or cardiac arrest, and the clinical course is usually fulminant, sometimes simulating sudden infant death syndrome (Andreu et al., 2000).
Short stature
MedGen UID:
87607
Concept ID:
C0349588
Finding
A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).
Imperforate anus
MedGen UID:
1997
Concept ID:
C0003466
Congenital Abnormality
Congenital absence of the anus, i.e., the opening at the bottom end of the intestinal tract.
Congenital atresia of colon
MedGen UID:
75605
Concept ID:
C0266190
Congenital Abnormality
A developmental defect resulting in complete obliteration of the lumen of the colon. That is, there is an abnormal closure, or atresia of the tubular structure of the colon.
Anteriorly placed anus
MedGen UID:
333160
Concept ID:
C1838705
Finding
Anterior malposition of the anus.
Hearing impairment
MedGen UID:
235586
Concept ID:
C1384666
Disease or Syndrome
A decreased magnitude of the sensory perception of sound.
Hydrocephalus
MedGen UID:
9335
Concept ID:
C0020255
Disease or Syndrome
Hydrocephalus is an active distension of the ventricular system of the brain resulting from inadequate passage of CSF from its point of production within the cerebral ventricles to its point of absorption into the systemic circulation.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterized by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Corpus callosum, agenesis of
MedGen UID:
104498
Concept ID:
C0175754
Congenital Abnormality
The corpus callosum is the largest fiber tract in the central nervous system and the major interhemispheric fiber bundle in the brain. Formation of the corpus callosum begins as early as 6 weeks' gestation, with the first fibers crossing the midline at 11 to 12 weeks' gestation, and completion of the basic shape by age 18 to 20 weeks (Schell-Apacik et al., 2008). Agenesis of the corpus callosum (ACC) is one of the most frequent malformations in brain with a reported incidence ranging between 0.5 and 70 in 10,000 births. ACC is a clinically and genetically heterogeneous condition, which can be observed either as an isolated condition or as a manifestation in the context of a congenital syndrome (see MOLECULAR GENETICS and Dobyns, 1996). Also see mirror movements-1 and/or agenesis of the corpus callosum (MRMV1; 157600). Schell-Apacik et al. (2008) noted that there is confusion in the literature regarding radiologic terminology concerning partial absence of the corpus callosum, where various designations have been used, including hypogenesis, hypoplasia, partial agenesis, or dysgenesis.
Absent septum pellucidum
MedGen UID:
96561
Concept ID:
C0431371
Congenital Abnormality
Absence of the septum pellucidum (meaning translucent wall in Latin - SP), also known as the ventricle of Sylvius. The septum pellucidum is a thin, triangular double membrane separating the frontal horns of the right and left lateral ventricles of the brain. It extends between the anterior portion of the corpus callosum, and the body of the fornix and its width varies from 1.5 to 3.0 mm.
Colpocephaly
MedGen UID:
98131
Concept ID:
C0431384
Congenital Abnormality
Colpocephaly is an anatomic finding in the brain manifested by occipital horns that are disproportionately enlarged in comparison with other parts of the lateral ventricles.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Intellectual disability
MedGen UID:
811461
Concept ID:
C3714756
Mental or Behavioral Dysfunction
Intellectual disability, previously referred to as mental retardation, is characterized by subnormal intellectual functioning that occurs during the developmental period. It is defined by an IQ score below 70.
Congenital diaphragmatic hernia
MedGen UID:
68625
Concept ID:
C0235833
Congenital Abnormality
The presence of a hernia of the diaphragm present at birth.
Microcephaly
MedGen UID:
1644158
Concept ID:
C4551563
Finding
Head circumference below 2 standard deviations below the mean for age and gender.
Cleft palate
MedGen UID:
756015
Concept ID:
C2981150
Congenital Abnormality
Cleft palate is a developmental defect of the palate resulting from a failure of fusion of the palatine processes and manifesting as a separation of the roof of the mouth (soft and hard palate).
Asymmetric, linear skin defects
MedGen UID:
870442
Concept ID:
C4024888
Finding
Microphthalmia
MedGen UID:
10033
Concept ID:
C0026010
Congenital Abnormality
Microphthalmia is an eye abnormality that arises before birth. In this condition, one or both eyeballs are abnormally small. In some affected individuals, the eyeball may appear to be completely missing; however, even in these cases some remaining eye tissue is generally present. Such severe microphthalmia should be distinguished from another condition called anophthalmia, in which no eyeball forms at all. However, the terms anophthalmia and severe microphthalmia are often used interchangeably. Microphthalmia may or may not result in significant vision loss.\n\nPeople with microphthalmia may also have a condition called coloboma. Colobomas are missing pieces of tissue in structures that form the eye. They may appear as notches or gaps in the colored part of the eye called the iris; the retina, which is the specialized light-sensitive tissue that lines the back of the eye; the blood vessel layer under the retina called the choroid; or in the optic nerves, which carry information from the eyes to the brain. Colobomas may be present in one or both eyes and, depending on their size and location, can affect a person's vision.\n\nPeople with microphthalmia may also have other eye abnormalities, including clouding of the lens of the eye (cataract) and a narrowed opening of the eye (narrowed palpebral fissure). Additionally, affected individuals may have an abnormality called microcornea, in which the clear front covering of the eye (cornea) is small and abnormally curved.\n\nBetween one-third and one-half of affected individuals have microphthalmia as part of a syndrome that affects other organs and tissues in the body. These forms of the condition are described as syndromic. When microphthalmia occurs by itself, it is described as nonsyndromic or isolated.
Cataract
MedGen UID:
39462
Concept ID:
C0086543
Disease or Syndrome
A cataract is an opacity or clouding that develops in the crystalline lens of the eye or in its capsule.
Iris coloboma
MedGen UID:
116097
Concept ID:
C0240063
Anatomical Abnormality
A coloboma of the iris.
High myopia
MedGen UID:
78759
Concept ID:
C0271183
Disease or Syndrome
A severe form of myopia with greater than -6.00 diopters.
Irido-corneo-trabecular dysgenesis
MedGen UID:
91031
Concept ID:
C0344559
Congenital Abnormality
Anterior segment dysgeneses (ASGD or ASMD) are a heterogeneous group of developmental disorders affecting the anterior segment of the eye, including the cornea, iris, lens, trabecular meshwork, and Schlemm canal. The clinical features of ASGD include iris hypoplasia, an enlarged or reduced corneal diameter, corneal vascularization and opacity, posterior embryotoxon, corectopia, polycoria, an abnormal iridocorneal angle, ectopia lentis, and anterior synechiae between the iris and posterior corneal surface (summary by Cheong et al., 2016). Anterior segment dysgenesis is sometimes divided into subtypes including aniridia (see 106210), Axenfeld and Rieger anomalies, iridogoniodysgenesis, Peters anomaly, and posterior embryotoxon (Gould and John, 2002). Patients with ASGD5 have been reported with the Peters anomaly, Axenfeld anomaly, and Rieger anomaly subtypes. Peters anomaly consists of a central corneal leukoma, absence of the posterior corneal stroma and Descemet membrane, and a variable degree of iris and lenticular attachments to the central aspect of the posterior cornea (Peters, 1906). It occurs as an isolated ocular abnormality or in association with other ocular defects. In Axenfeld anomaly, strands of iris tissue attach to the Schwalbe line; in Rieger anomaly, in addition to the attachment of iris tissue to the Schwalbe line, there is clinically evident iris stromal atrophy with hole or pseudo-hole formation and corectopia (summary by Smith and Traboulsi, 2012).
Sclerocornea
MedGen UID:
344000
Concept ID:
C1853235
Disease or Syndrome
A congenital anomaly in which a part or the whole of the cornea acquires the characteristics of sclera, resulting in clouding of the cornea.
Pigmentary retinopathy
MedGen UID:
1643295
Concept ID:
C4551715
Disease or Syndrome
An abnormality of the retina characterized by pigment deposition. It is typically associated with migration and proliferation of macrophages or retinal pigment epithelial cells into the retina; melanin from these cells causes the pigmentary changes. Pigmentary retinopathy is a common final pathway of many retinal conditions and is often associated with visual loss.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
Follow this link to review classifications for Linear skin defects with multiple congenital anomalies 1 in Orphanet.

Recent clinical studies

Etiology

Franco E, Scanga HL, Nischal KK
Am J Med Genet A 2023 Feb;191(2):586-591. Epub 2022 Nov 11 doi: 10.1002/ajmg.a.63043. PMID: 36369709
Kaufmann A, Claus C, Tong D, Hanson C, Carr D, Houseman C, Soo TM
Oper Neurosurg (Hagerstown) 2022 Mar 1;22(3):150-157. doi: 10.1227/ONS.0000000000000076. PMID: 35030140
van Rahden VA, Fernandez-Vizarra E, Alawi M, Brand K, Fellmann F, Horn D, Zeviani M, Kutsche K
Am J Hum Genet 2015 Apr 2;96(4):640-50. Epub 2015 Mar 12 doi: 10.1016/j.ajhg.2015.02.002. PMID: 25772934Free PMC Article

Diagnosis

Franco E, Scanga HL, Nischal KK
Am J Med Genet A 2023 Feb;191(2):586-591. Epub 2022 Nov 11 doi: 10.1002/ajmg.a.63043. PMID: 36369709
Kaufmann A, Claus C, Tong D, Hanson C, Carr D, Houseman C, Soo TM
Oper Neurosurg (Hagerstown) 2022 Mar 1;22(3):150-157. doi: 10.1227/ONS.0000000000000076. PMID: 35030140
Banganho D, Oliveira I, Machado C, Póvoas M
BMJ Case Rep 2019 Apr 23;12(4) doi: 10.1136/bcr-2018-227791. PMID: 31015240Free PMC Article
Durack A, Mehta SG, Allen LE, Ozanic Bulic S, Burrows NP
Clin Exp Dermatol 2018 Oct;43(7):860-862. Epub 2018 Jun 12 doi: 10.1111/ced.13638. PMID: 29896851
Almeida HL Jr, Rossi G, Abreu LB, Bergamaschi C, Silva AB, Kutsche K
An Bras Dermatol 2014 Jan-Feb;89(1):180-1. doi: 10.1590/abd1806-4841.20142240. PMID: 24626674Free PMC Article

Therapy

Banganho D, Oliveira I, Machado C, Póvoas M
BMJ Case Rep 2019 Apr 23;12(4) doi: 10.1136/bcr-2018-227791. PMID: 31015240Free PMC Article
Indrieri A, Grimaldi C, Zucchelli S, Tammaro R, Gustincich S, Franco B
Sci Rep 2016 Jun 6;6:27315. doi: 10.1038/srep27315. PMID: 27265476Free PMC Article

Prognosis

Franco E, Scanga HL, Nischal KK
Am J Med Genet A 2023 Feb;191(2):586-591. Epub 2022 Nov 11 doi: 10.1002/ajmg.a.63043. PMID: 36369709
Alberry MS, Juvanic G, Crolla J, Soothill P, Newbury-Ecob R
Clin Dysmorphol 2011 Apr;20(2):111-113. doi: 10.1097/MCD.0b013e328342eb66. PMID: 21200317

Clinical prediction guides

Kaufmann A, Claus C, Tong D, Hanson C, Carr D, Houseman C, Soo TM
Oper Neurosurg (Hagerstown) 2022 Mar 1;22(3):150-157. doi: 10.1227/ONS.0000000000000076. PMID: 35030140
Indrieri A, Franco B
Genes (Basel) 2021 Feb 11;12(2) doi: 10.3390/genes12020263. PMID: 33670341Free PMC Article
Prepeluh N, Korpar B, Zagorac A, Zagradišnik B, Golub A, Kokalj Vokač N
BMC Pediatr 2018 Aug 1;18(1):254. doi: 10.1186/s12887-018-1234-4. PMID: 30068298Free PMC Article
van Rahden VA, Rau I, Fuchs S, Kosyna FK, de Almeida HL Jr, Fryssira H, Isidor B, Jauch A, Joubert M, Lachmeijer AM, Zweier C, Moog U, Kutsche K
Orphanet J Rare Dis 2014 Apr 15;9:53. doi: 10.1186/1750-1172-9-53. PMID: 24735900Free PMC Article
García-Rabasco A, De-Unamuno B, Martínez F, Febrer-Bosch I, Alegre-de-Miquel V
Pediatr Dermatol 2013 Nov-Dec;30(6):e230-1. Epub 2012 May 21 doi: 10.1111/j.1525-1470.2012.01735.x. PMID: 22612277

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