Intra-Familial Phenotypic Variability in Lipoid Proteinosis: A Case Series of Three Siblings.

Lipoid proteinosis (LP), or Urbach-Wiethe disease, is an ultra-rare autosomal-recessive disorder caused by loss-of-function variants in the ECM1 gene. It is characterized by the progressive deposition of hyaline-like material in the skin, mucosae, and central nervous system. This series describes th...

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Publicado en:Clinical Medicine Insights: Case Reports Vol. 19; pp. 1 - 12
Autores principales: Murtaza, Muhammad, Zafar, Insharah, Mubashar, Bareea, Samadi, Abedin, Raza, Ahmed Asad
Formato: case study pictorial Journal Article
Publicado: Sage Publications Inc. 6/25/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 6/25/2026
      vid: 19
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Intra-Familial Phenotypic Variability in Lipoid Proteinosis: A Case Series of Three Siblings.
      aug:
        au:
          Murtaza, Muhammad
          Zafar, Insharah
          Mubashar, Bareea
          Samadi, Abedin
          Raza, Ahmed Asad
        affil: Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
      sug:
        subj:
          Skin Diseases, Genetic Diagnosis
          Phenotype
          Extracellular Matrix Proteins
          Skin Diseases, Genetic Familial and Genetic
          Case Studies
          Adolescence
          Adult
          Hoarseness
          Skin Diseases, Vesiculobullous
          Eyelid Diseases
          Frenum (Oral)
          Genetics
          Male
          Female
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: Lipoid proteinosis (LP), or Urbach-Wiethe disease, is an ultra-rare autosomal-recessive disorder caused by loss-of-function variants in the ECM1 gene. It is characterized by the progressive deposition of hyaline-like material in the skin, mucosae, and central nervous system. This series describes three siblings (aged 16, 24, and 25) from Gujranwala, Pakistan, born to non-consanguineous parents. All patients presented with infant-onset hoarseness of voice and recurrent vesiculobullous eruptions that evolved into waxy papules and hyperkeratotic plaques. Physical examination revealed the pathognomonic "beaded" eyelid papules (moniliform blepharosis), pock-like facial scarring, and a thickened lingual frenulum restricting tongue protrusion. Despite shared genetics, intrafamilial variability was observed, with the male sibling exhibiting a more severe "leonine-like" facies. Neuropsychiatric symptoms, including aggression and insomnia, were noted across the series. Due to resource constraints, the diagnosis was established clinically. Management focused on symptomatic control using oral acitretin (0.5 mg/kg/day), antihistamines, and intensive topical emollients. At 12-week follow-up, patients showed significant reduction in pruritus and stabilization of skin lesions, though hoarseness and established scarring remained unchanged. This series underscores the importance of recognizing cardinal clinical triads—moniliform blepharosis, mucosal tethering, and early hoarseness—to diagnose LP in resource-limited settings where genetic or histological confirmation is unavailable.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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