Acrogeria | |
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Other names | Acrogeria, Gottron type, Gottron's syndrome [1] |
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Fibers of Collagen Type I - TEM | |
Specialty | Dermatology |
Usual onset | Childhood |
Duration | Lifelong |
Causes | Genetic |
Differential diagnosis | Werner's syndrome |
Prognosis | Normal life expectancy |
Acrogeria (Gottron's syndrome) is a skin condition characterized by premature aging, typically in the form of unusually fragile, thin skin on the hands and feet (distal extremities). [1]
This is one of the classic congenital premature aging syndromes, occurring early in life, others being pangeria (Werner's syndrome) and progeria (Hutchinson–Gilford's syndrome), and was characterized in 1940. [2] Acrogeria was originally described by Gottron in 1941, when he noticed premature cutaneous aging localized on the hands and feet in two brothers. The problem had been present since birth. [2]
Onset is often in early childhood, it progresses over the next few years and then remains stable over time with morphology, colour and site remaining constant. A bruising tendency has been observed. [3] Mutations in the COL3A1 gene, located at chromosome 2q31–q32, have been reported in varied phenotypes, including acrogeria and vascular rupture in Ehlers-Danlos' syndrome (more especially type IV). [4]
The most characteristic symptom of acrogeria is thin, atrophic skin with mottled pigmentation and telangiectasia, most severe in the limbs and extremities. [5] This is accompanied by easy bruising, hyperkeratosis, and a loss of subcutaneous fat, [6] which is replaced by connective tissue. [7] Patients have a facies with a pinched face, hollow cheeks, prominent eyes without exophthalmos, a beak-like nose and thin lips. [8] Though the hair and nails are normal in many cases, [9] alopecia and nail dystrophies, such as onychogryphosis and koilonychia, have been reported. [10] Stature is short in some patients [11] and normal in others. [10] The general skeletal structure is unremarkable, [10] but acrogeria results in delayed closure of the cranial sutures, notching of the mandible, and micrognathia; [11] and may also coincide with spina bifida, clubfoot and congenital dislocation of the hips. [7] Sexual development, including the development of secondary sex characteristics, is normal, and so is intelligence. [10] There is no correlation of acrogeria with metabolic, opthamological or cardiovascular disorders, and patients have a normal life expectancy. [10] Similarities between the clinical features of acrogeria and Werner's syndrome have been observed. [12]