Incontinentia pigmenti
Bloch-Sulzberger syndrome
Incontinentia pigmenti is a skin condition passed down through families. It leads to unusual blistering and changes in skin color.
Causes
Incontinentia pigmenti (IP) is caused by an x-linked dominant genetic defect.
x-linked dominant
Sex-linked dominant is a rare way that a trait or disorder can be passed down through families. One abnormal gene on the X chromosome can cause a se...
The condition is most often seen in females. When it occurs in males, it is lethal.
Symptoms
Infants with IP are born with streaky, blistering areas. When the areas heal, they turn into rough bumps. Eventually, these bumps go away, but leave behind darkened skin, called hyperpigmentation . After several years, the skin returns to normal. In some adults, there may be areas of lighter colored skin ( hypopigmentation ).
Blistering
A vesicle is a small fluid-filled blister on the skin.
Hyperpigmentation
Skin that has turned darker or lighter than normal is usually not a sign of a serious medical condition.
Hypopigmentation
Patchy skin color is areas where the skin color is irregular. Mottling or mottled skin refers to blood vessel changes in the skin that cause a patch...
IP is associated with central nervous system problems, including:
Central nervous system
The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main "processing center" for your entir...
- Delayed development
- Loss of movement (paralysis)
- Intellectual disability
- Muscle spasms
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Seizures
Seizures
A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. The term "seizure...
People with IP may also have abnormal teeth, hair loss , and vision problems .
Vision problems
There are many types of eye problems and vision disturbances, such as: HalosBlurred vision (the loss of sharpness of vision and the inability to see ...
Exams and Tests
The doctor will perform a physical exam, look at the eyes, and test muscle movement.
There may be unusual patterns and blisters on the skin, as well as bone abnormalities. An eye exam may reveal cataracts , strabismus (crossed eyes), or other problems.
Strabismus
Strabismus is a disorder in which both eyes do not line up in the same direction. Therefore, they do not look at the same object at the same time. ...
To confirm diagnosis, these tests may be done:
- Blood tests
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Skin biopsy
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
-
CT
or
MRI
scan of the brain
CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
MRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
Treatment
There is no specific treatment for IP. Treatment is aimed at the individual symptoms. For example, glasses may be needed to improve vision. Medicine may be prescribed to help control seizures or muscle spasms.
Outlook (Prognosis)
How well a person does depends on the severity of central nervous system involvement and eye problems.
When to Call a Medical Professional
Call your health care provider if:
- You have a family history of IP and are considering having children
- Your child has symptoms of this disorder
Prevention
Genetic counseling may be helpful for those with a family history of IP who are considering having children.
References
Islam MP, Roach ES. Neurocutaneous syndromes. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 65.
James WD, Berger TG, Elston DM. Genodermatoses and congenital anomalies. James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology . 12th ed. Philadelphia, PA: Elsevier; 2016:chap 27.
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Incontinentia pigmenti on the leg - illustration
Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.
Incontinentia pigmenti on the leg
illustration
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Incontinentia pigmenti on the leg - illustration
Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.
Incontinentia pigmenti on the leg
illustration
-
Incontinentia pigmenti on the leg - illustration
Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.
Incontinentia pigmenti on the leg
illustration
-
Incontinentia pigmenti on the leg - illustration
Incontinentia pigmenti produces darkly-pigmented swirling marks on the skin. It occurs more frequently in females. The skin lesions are divided into three stages: blisters (vesicles and bullae) are present at birth or within the first 6 to 7 weeks, followed by a rough wart-like (verrucous) stage, and lastly, swirled and bizarre patterns of dark pigmentation (hyperpigmentation) appear.
Incontinentia pigmenti on the leg
illustration
Review Date: 4/14/2015
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.