Netherton syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Netherton syndrome
Synonyms	Comèl–Netherton syndrome
Pronounce
Specialty	Dermatology, Genetics
Symptoms	Ichthyosis, atopic dermatitis, trichorrhexis invaginata
Complications	N/A
Onset	Infancy
Duration	Lifelong
Types	N/A
Causes	Mutations in the SPINK5 gene
Risks
Diagnosis	Genetic testing, clinical evaluation
Differential diagnosis	Ichthyosis vulgaris, atopic dermatitis, seborrheic dermatitis
Prevention
Treatment	Emollients, topical corticosteroids, antibiotics
Medication
Prognosis	Variable, can be severe
Frequency	1 in 200,000 newborns
Deaths

A rare genetic disorder affecting the skin, hair, and immune system

Netherton syndrome is a rare genetic disorder characterized by skin, hair, and immune system abnormalities. It is an autosomal recessive condition, meaning that an individual must inherit two copies of the defective gene, one from each parent, to be affected by the disorder.

Genetics

Netherton syndrome is caused by mutations in the SPINK5 gene, which encodes the protein LEKTI (lympho-epithelial Kazal-type-related inhibitor). This protein plays a crucial role in skin barrier function and immune regulation. The disorder follows an autosomal recessive pattern of inheritance, as illustrated in the diagram.

Clinical Features

The clinical presentation of Netherton syndrome is highly variable but typically includes the following features:

Skin Abnormalities

Patients often present with ichthyosis linearis circumflexa, a condition characterized by red, scaly skin with a distinctive double-edged scale. Atopic dermatitis-like symptoms are also common, leading to chronic skin inflammation and irritation.

Hair Abnormalities

A hallmark of Netherton syndrome is trichorrhexis invaginata, also known as "bamboo hair," where the hair shaft is fragile and prone to breakage. This can lead to sparse and brittle hair.

Immune System Abnormalities

Individuals with Netherton syndrome may experience recurrent infections due to an impaired immune response. They are also at increased risk for atopy, including asthma, allergic rhinitis, and food allergies.

Diagnosis

Diagnosis of Netherton syndrome is based on clinical evaluation, family history, and genetic testing to identify mutations in the SPINK5 gene. Skin biopsy and hair shaft analysis can also aid in diagnosis by revealing characteristic features of the disorder.

Management

There is no cure for Netherton syndrome, and management focuses on alleviating symptoms and preventing complications. Treatment strategies may include:

• Topical and systemic therapies to manage skin inflammation and dryness
• Regular monitoring and treatment of infections
• Nutritional support to address growth and development issues
• Genetic counseling for affected families

Prognosis

The prognosis for individuals with Netherton syndrome varies depending on the severity of symptoms and the effectiveness of management strategies. With appropriate care, many individuals can lead relatively normal lives, although they may require ongoing medical support.

See also

• Ichthyosis
• Atopic dermatitis
• Genetic disorders