Dermatologic Manifestations of Sjogren-Larsson Syndrome Follow-up

  • Author: Anna Zalewska, MD, PhD; Chief Editor: William D James, MD   more...
 
Updated: Aug 17, 2011
 

Further Outpatient Care

  • A multidisciplinary approach to Sjögren-Larsson syndrome (SLS) is mandatory (see Consultations).
  • Sauna treatments (90-100°C) and frequent bathing or showering are beneficial for patients with Sjögren-Larsson syndrome.
  • Orthopedic measures, such as hamstring release and (if kyphosis is present) thoracic braces, can enable patients with Sjögren-Larsson syndrome to walk.
Next

Inpatient & Outpatient Medications

  • Skin emollients and keratolytic agents are necessary for skin care.
Previous
Next

Prognosis

  • After neurologic symptoms appear (age 1-2 y), the developmental milestones are progressively delayed. The initial ability to walk a short distance alone is lost, which is caused by progressive spasticity.
  • No progression of the neurologic findings or mental retardation occurs after puberty.
  • Symptoms tend to appear earlier in patients who will be more severely affected in the future.
Previous
Next

Patient Education

  • Active involvement of a third party (eg, parents, family) is mandatory for the continuous special care of patients with Sjögren-Larsson syndrome.
  • Special schooling is necessary.
  • For excellent patient education resources, visit eMedicine's Arthritis Center. Also, see eMedicine's patient education article Sjögren Syndrome.
Previous
 
Contributor Information and Disclosures
Author

Anna Zalewska, MD, PhD  Professor of Dermatology and Venereology, Psychodermatology Department, Chair of Clinical Immunology and Microbiology, Medical University of Lodz, Poland

Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Jacek C Szepietowski, MD, PhD  Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Stiefel GSK Company Salary Employment; Orfagen Consulting fee Consulting; Maruho Consulting fee Consulting; Astellas Consulting fee Consulting; Abbott Consulting fee Consulting; Leo Pharma Consulting fee Consulting

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Consulting fee Consulting; Celgene Honoraria Safety Monitoring Committee; GSK - Glaxo Smith Kline Consulting fee Consulting; TenXBioPharma Consulting fee Safety Monitoring Committee

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References
  1. Aoki N, Suzuki H, Ito K, Ito M. A novel point mutation of the FALDH gene in a Japanese family with Sjögren-Larsson syndrome. J Invest Dermatol. May 2000;114(5):1065-6. [Medline].

  2. Carney G, Wei S, Rizzo WB. Sjogren-Larsson syndrome: seven novel mutations in the fatty aldehyde dehydrogenase gene ALDH3A2. Hum Mutat. Aug 2004;24(2):186. [Medline].

  3. De Laurenzi V, Rogers GR, Hamrock DJ, et al. Sjogren-Larsson syndrome is caused by mutations in the fatty aldehyde dehydrogenase gene. Nat Genet. Jan 1996;12(1):52-7. [Medline].

  4. Kraus C, Braun-Quentin C, Ballhausen WG, Pfeiffer RA. RNA-based mutation screening in German families with Sjogren-Larsson syndrome. Eur J Hum Genet. Apr 2000;8(4):299-306. [Medline].

  5. Lossos A, Khoury M, Rizzo WB, et al. Phenotypic variability among adult siblings with Sjogren-Larsson syndrome. Arch Neurol. Feb 2006;63(2):278-80. [Medline].

  6. Rizzo WB. Sjogren-Larsson syndrome: molecular genetics and biochemical pathogenesis of fatty aldehyde dehydrogenase deficiency. Mol Genet Metab. Jan 2007;90(1):1-9. [Medline].

  7. Rizzo WB, Carney G, Lin Z. The molecular basis of Sjogren-Larsson syndrome: mutation analysis of the fatty aldehyde dehydrogenase gene. Am J Hum Genet. Dec 1999;65(6):1547-60. [Medline].

  8. Rizzo WB, Craft DA, Somer T, Carney G, Trafrova J, Simon M. Abnormal fatty alcohol metabolism in cultured keratinocytes from patients with Sjogren-Larsson syndrome. J Lipid Res. Feb 2008;49(2):410-9. [Medline].

  9. Rizzo WB, Lin Z, Carney G. Fatty aldehyde dehydrogenase: genomic structure, expression and mutation analysis in Sjogren-Larsson syndrome. Chem Biol Interact. Jan 30 2001;130-132(1-3):297-307. [Medline].

  10. Sillen A, Anton-Lamprecht I, Braun-Quentin C, et al. Spectrum of mutations and sequence variants in the FALDH gene in patients with Sjogren-Larsson syndrome. Hum Mutat. 1998;12(6):377-84. [Medline].

  11. Engelstad H, Carney G, S'aulis D, Rise J, Sanger WG, Rudd MK, et al. Large contiguous gene deletions in Sjögren-Larsson syndrome. Mol Genet Metab. May 30 2011;[Medline].

  12. Willemsen MA, de Jong JG, van Domburg PH, Rotteveel JJ, Wanders RJ, Mayatepek E. Defective inactivation of leukotriene B4 in patients with Sjogren-Larsson syndrome. J Pediatr. Feb 2000;136(2):258-60. [Medline].

  13. Willemsen MA, Rotteveel JJ, de Jong JG, et al. Defective metabolism of leukotriene B4 in the Sjogren-Larsson syndrome. J Neurol Sci. Jan 15 2001;183(1):61-7. [Medline].

  14. Willemsen MA, Rotteveel JJ, van Domburg PH, Gabreels FJ, Mayatepek E, Sengers RC. Preterm birth in Sjogren-Larsson syndrome. Neuropediatrics. Dec 1999;30(6):325-7. [Medline].

  15. Haddad FS, Lacour M, Harper JI, Fixsen JA. The orthopaedic presentation and management of Sjogren-Larsson syndrome. J Pediatr Orthop. Sep-Oct 1999;19(5):617-9. [Medline].

  16. Akdeniz N, Calka O, Anlar O, et al. Report of a Turkish child with Sjogren-Larsson syndrome associated with peripheral nerve involvement. J Dermatol. Mar 2003;30(3):222-5. [Medline].

  17. Cubo E, Goetz CG. Dystonia secondary to Sjogren-Larsson syndrome. Neurology. Oct 24 2000;55(8):1236-7. [Medline].

  18. Mirshahi A, Piri N. Fundus autofluorescence changes in two cases of Sjogren-Larsson syndrome. Int Ophthalmol. Oct 2 2008;[Medline].

  19. van der Veen RL, Fuijkschot J, Willemsen MA, Cruysberg JR, Berendschot TT, Theelen T. Patients with Sjögren-Larsson syndrome lack macular pigment. Ophthalmology. May 2010;117(5):966-71. [Medline].

  20. Van Mieghem F, Van Goethem JW, Parizel PM, et al. MR of the brain in Sjogren-Larsson syndrome. AJNR Am J Neuroradiol. Sep 1997;18(8):1561-3. [Medline].

  21. Altinok D, Yildiz YT, Seckin D, Altinok G, Tacal T, Eryilmaz M. MRI of three siblings with Sjogren-Larsson syndrome. Pediatr Radiol. Oct 1999;29(10):766-9. [Medline].

  22. Nakayama M, Tavora DG, Alvim TC, Araujo AC, Gama RL. MRI and 1H-MRS findings of three patients with Sjogren-Larsson syndrome. Arq Neuropsiquiatr. Jun 2006;64(2B):398-401. [Medline].

  23. van Domburg PH, Willemsen MA, Rotteveel JJ, et al. Sjogren-Larsson syndrome: clinical and MRI/MRS findings in FALDH-deficient patients. Neurology. Apr 22 1999;52(7):1345-52. [Medline].

  24. Willemsen MA, Van Der Graaf M, Van Der Knaap MS, et al. MR imaging and proton MR spectroscopic studies in Sjogren-Larsson syndrome: characterization of the leukoencephalopathy. AJNR Am J Neuroradiol. Apr 2004;25(4):649-57. [Medline].

  25. Fuijkschot J, Cruysberg JR, Willemsen MA, Keunen JE, Theelen T. Subclinical changes in the juvenile crystalline macular dystrophy in Sjogren-Larsson syndrome detected by optical coherence tomography. Ophthalmology. May 2008;115(5):870-5. [Medline].

  26. Sanders RJ, Ofman R, Dekker C, Kemp S, Wanders RJ. Enzymatic diagnosis of Sjogren-Larsson syndrome using electrospray ionization mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. Feb 1 2009;877(4):451-5. [Medline].

  27. Yamaguchi K, Handa T. Sjogren-Larsson syndrome: postmortem brain abnormalities. Pediatr Neurol. Apr 1998;18(4):338-41. [Medline].

  28. Willemsen MA, Rotteveel JJ, Steijlen PM, Heerschap A, Mayatepek E. 5-Lipoxygenase inhibition: a new treatment strategy for Sjogren-Larsson syndrome. Neuropediatrics. Feb 2000;31(1):1-3. [Medline].

  29. Taube B, Billeaud C, Labreze C, Entressangles B, Fontan D, Taieb A. Sjogren-Larsson syndrome: early diagnosis, dietary management and biochemical studies in two cases. Dermatology. 1999;198(4):340-5. [Medline].

  30. Haug S, Braun-Falco M. Adeno-associated virus vectors are able to restore fatty aldehyde dehydrogenase-deficiency. Implications for gene therapy in Sjogren-Larsson syndrome. Arch Dermatol Res. Jun 2005;296(12):568-72. [Medline].

  31. Haug S, Braun-Falco M. Restoration of fatty aldehyde dehydrogenase deficiency in Sjogren-Larsson syndrome. Gene Ther. Jul 2006;13(13):1021-6. [Medline].

  32. Gloerich J, Ijlst L, Wanders RJ, Ferdinandusse S. Bezafibrate induces FALDH in human fibroblasts; implications for Sjogren-Larsson syndrome. Mol Genet Metab. Sep-Oct 2006;89(1-2):111-5. [Medline].

  33. Fernandez-Vozmediano JM, Armario-Hita JC, Gonzalez-Cabrerizo A. Sjogren-Larsson syndrome: treatment with topical calcipotriol. Pediatr Dermatol. Mar-Apr 2003;20(2):179-80. [Medline].

  34. Lucker GP, van de Kerkhof PC, Cruysberg JR, der Kinderen DJ, Steijlen PM. Topical treatment of Sjogren-Larsson syndrome with calcipotriol. Dermatology. 1995;190(4):292-4. [Medline].

  35. van den Brink DM, van Miert JM, Wanders RJ. A novel assay for the prenatal diagnosis of Sjogren-Larsson syndrome. J Inherit Metab Dis. 2005;28(6):965-9. [Medline].

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.