Stiff-skin syndrome R23.4

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Congenital fascial dystrophy; Congenital pseudoscleroderma; Easterly-McKusick syndrome; OMIM 228020; Stiff-man syndrome; Stiff-people syndrome

History
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Pichler, 1968; Esterly and McKusick, 1971

Definition
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Autosomal-dominantly inherited, very rare hereditary connective tissue disease, which leads to extensive skin hardening, especially over the joints. The progressive skin hardening leads to stiffness of the extremities and trunk. The syndrome is caused by a mutation in the FBN1 gene (15q21.1), which codes for the protein Fbrillin 1.

Manifestation
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Congenital or occurring in the first years of life.

Localization
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Mainly the trunk and extremities are affected.

Clinical features
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Scleroderma-like, rock-hard, cutaneous induration and caking of the skin with underlying layers of connective tissue, especially in regions with large fasciae Restriction of movement, especially of the knee joints or hip joints. Attacks of tetaniform, very painful muscle cramps.

Histology
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Non-inflammatory proliferation of collagen fibres with massively spread dermis and fascia.

Diagnosis
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No immunological abnormalities. Diagnosis according to clinic, histology and medical history.

Differential diagnosis
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Complication(s)
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As a result of muscle spasms: fractures, dislocations, contractures.

Therapy
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Trial with systemic glucocorticoids and intensive physiotherapy for joint mobilization.

Progression/forecast
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Rare developmental delay, due to the restriction of the lung in thoracic infestation. Mostly only mild progression.

Literature
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  1. Esterly NB, McKusick VA (1971) Stiff skin syndrome. Pediatrics. 47: 360-369
  2. Fidzianska A, Jablonska S (2000) Congenital fascial dystrophy: abnormal composition of the fascia. J Am Acad Dermatol 43(5 Pt 1): 797-802
  3. Gilaberte Y et al (1995) Stiff skin syndrome: a case report and review of the literature. Dermatology 190: 148-151
  4. Helmet TN, Wirth PB, Helmet KF (1997) Congenital fascial dystrophy: the stiff skin syndrome. Cutis 60: 153-154
  5. Jablonska S, Blaszczyk M (2000) Scleroderma-like indurations involving fascias: an abortive form of congenital fascial dystrophy (Stiff skin syndrome). Pediatric dermatol 17: 105-110
  6. Mat C et al (2003) Stiff skin syndrome: a case report. Pediatric dermatol 20: 339-341
  7. Morrell DS et al (2003) Two cases for diagnosis: asymmetric childhood scleredema or stiff skin syndrome? Pediatric Dermatol 20: 350-355
  8. Pichler E (1968) Hereditary contractures with scleroderma-like skin changes. Journal for Pediatrics (Berlin) 104: 349-361

Outgoing links (1)

Scleroderma systemic;

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020