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CASE 4.CASE 4.

DEFINITION. Causes. Symptoms. Exams and tests Treatment Refrences

TABLE OF CONTENTS.

Xeroderma pigmentosum is a rare condition

passed down through families in which the skin and tissue covering the eye are extremely sensitive to ultraviolet light.

DEFINITION

Xeroderma pigmentosum is an autosomal recessive

disorder. This means you must have two copies of an abnormal gene in order for the disease or trait to develop.

Ultraviolet light, such as from sunlight, damages the genetic material (DNA) in skin cells. Normally, the body repairs this damage. But in persons with xeroderma pigmentosum, the body does not fix the damage. As a result, the skin gets very thin and patches of varying colour (splotchy pigmentation) appear.

The condition also causes spidery blood vessels in the skin (telangiectasia) and skin cancer. Skin cancer often occurs before the child is 5 years old.

CAUSES.

• Sunburn that does not heal after just a little bit of

sun exposure• Blistering after just a little bit of sun exposure• Spider-like blood vessels under the skin• Patches of discoloured skin that get worse• Crusting of the skin• scaling of the skin• Oozing raw skin surface• Discomfort when being in bright light

(photophobia).• Skin cancer

Symptoms.

The doctor will perform a physical exam and ask

if you have a family history of xeroderma pigmentosum.

An eye exam may show: Clouding of the cornea Keratitis Lid tumours blepharitis

Exam and tests.

The following tests can help diagnose the condition

in a baby before the birth: Aminiocentensis• Chorionic villous sampling• Culture of amniotic cells The following tests can help diagnose the disorder

after the birth of the child:• Culture of skin fibroblasts.• Skin biopsy.

Contd.

Children with this condition need total protection

from sunlight. Even the light coming through windows or from fluorescent bulbs is dangerous.

When these children go out in the sun, they need to wear protective clothing.

Use high protection (SPF 70 or greater) sunscreen and very dark, UV sunglasses. Your doctor may prescribe medicine to help prevent certain precancerous growths from becoming skin cancers.

Treatment.

Lim HW, Hawk JLM. Photodermatologic

disorders. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 87.

Schadt C, Fine JD. Genetic disorders predisposing to skin malignancy. In: Rigel DS, Robinson JK, Ross M, et al. eds. Cancer of the Skin. 2nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 33

References.