eMedicine Specialties > Dermatology > Papulosquamous Diseases

Vohwinkel Syndrome: Follow-up

Author: Zoltan Trizna, MD, PhD, Private Practice
Coauthor(s): Renée R Snyder, MD, Dermatologist, Private Practice; Dayna Diven, MD, Clinical Professor, Clinical Professor, Department of Dermatology, University of Texas Medical Branch at Galveston
Contributor Information and Disclosures

Updated: Feb 19, 2009

Follow-up

Further Inpatient Care

  • Regular follow-up by a dermatologist is recommended.
  • Refer patient to a surgeon if pseudo-ainhum develops.
  • Further care and laboratory testing or radiography depend on the treatment selected, course, and complications.
  • Audiologists and speech therapists may be referred on an individual basis.

Complications

  • Loss of digit(s) with functional impairment of the limb
  • Hearing loss

Prognosis

  • The prognosis is good as long as medications are used.

Patient Education

  • Tailor patient education to the course and complications.

Miscellaneous

Medicolegal Pitfalls

  • Medical pitfalls
    • Failure to offer symptomatic treatment
    • Failure to discuss the adverse effects of treatment
    • Failure to offer surgical interventions and evaluation by specialists
    • Failure to detect the potential adverse effects of retinoids
  • Legal pitfalls (No specific legal actions are known.)
    • Failure to discuss adverse effects of treatment options
    • Disregarding contraindications
    • Possibly not offering genetic counseling to affected family members

Special Concerns

  • Pregnancy
    • Genetic counseling is advisable to discuss risk of the offspring being affected by the syndrome
    • If topical retinoids are used in women with childbearing potential, inform patients about teratogenicity and apply current guidelines
 


More on Vohwinkel Syndrome

Overview: Vohwinkel Syndrome
Differential Diagnoses & Workup: Vohwinkel Syndrome
Treatment & Medication: Vohwinkel Syndrome
Follow-up: Vohwinkel Syndrome
Multimedia: Vohwinkel Syndrome
References

References

  1. Lucker GP, Van de Kerkhof PC, Steijlen PM. The hereditary palmoplantar keratoses: an updated review and classification. Br J Dermatol. Jul 1994;131(1):1-14. [Medline].

  2. Bondeson ML, Nyström AM, Gunnarsson U, Vahlquist A. Connexin 26 (GJB2) mutations in two Swedish patients with atypical Vohwinkel (mutilating keratoderma plus deafness) and KID syndrome both extensively treated with acitretin. Acta Derm Venereol. 2006;86(6):503-8. [Medline].

  3. Kelsell DP, Wilgoss AL, Richard G, Stevens HP, Munro CS, Leigh IM. Connexin mutations associated with palmoplantar keratoderma and profound deafness in a single family. Eur J Hum Genet. Jun 2000;8(6):469-72. [Medline].

  4. Solis RR, Diven DG, Trizna Z. Vohwinkel's syndrome in three generations. J Am Acad Dermatol. Feb 2001;44(2 Suppl):376-8. [Medline].

  5. Drera B, Tadini G, Balbo F, Marchese L, Barlati S, Colombi M. De novo occurrence of the 730insG recurrent mutation in an Italian family with the ichthyotic variant of Vohwinkel syndrome, loricrin keratoderma. Clin Genet. Jan 2008;73(1):85-8. [Medline].

  6. White TW. Functional analysis of human Cx26 mutations associated with deafness. Brain Res Brain Res Rev. Apr 2000;32(1):181-3. [Medline].

  7. Camisa C, Rossana C. Variant of keratoderma hereditaria mutilans (Vohwinkel's syndrome). Treatment with orally administered isotretinoin. Arch Dermatol. Oct 1984;120(10):1323-8. [Medline].

  8. Spitz JL. Genodermatoses: A Clinical Guide to Genetic Skin Disorders. 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2004.

Further Reading

Keywords

Vohwinkel syndrome, keratoderma hereditaria mutilans, palmoplantar keratoderma mutilans, autoamputation, palmar keratosis, plantar keratosis, pseudo-ainhum, hearing loss

Contributor Information and Disclosures

Author

Zoltan Trizna, MD, PhD, Private Practice
Zoltan Trizna, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Renée R Snyder, MD, Dermatologist, Private Practice
Renée R Snyder, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Dayna Diven, MD, Clinical Professor, Clinical Professor, Department of Dermatology, University of Texas Medical Branch at Galveston
Dayna Diven, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Idaho Medical Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Abby S Van Voorhees, MD, Assistant Professor, Director of Psoriasis Services and Phototherapy Units, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania
Abby S Van Voorhees, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, National Psoriasis Foundation, Phi Beta Kappa, Sigma Xi, and Women's Dermatologic Society
Disclosure: Amgen Honoraria Consulting; Astellas Grant/research funds Other; Abbott Honoraria Consulting; Genentech Honoraria Consulting; Incyte Grant/research funds Other; Centocor Honoraria Consulting; Warner Chilcott  Consulting; Merck Salary Review panel membership

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Mary Farley, MD, Dermatologic Surgeon/Mohs Surgeon, Anne Arundel Surgery Center
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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