PLACK syndrome is potentially treatable with intralipids.

Abstract:

:We describe an 11-year-old girl with PLACK Syndrome (peeling skin, leukonychia, acral punctate keratosis, cheilitis, and knuckle pads), who was found to have a novel homozygous variant in CAST, the pathogenicity of which was confirmed using blood-derived RNA. There is no established treatment for PLACK syndrome. However, we demonstrate for the first time that this condition is associated with low levels of vitamin A and essential fatty acids, which prompted us to consider a potential treatment strategy. Indeed, we initiated this patient on intravenous lipid infusion (Vitalipid®; an emulsion of fat-soluble vitamins and lipofundin-MCT/LCT 20%) and the response was dramatic. Following the fourth monthly course of treatment, pruritis disappeared and the skin lesions showed remarkable objective improvement. PLACK syndrome is a very rare genodermatosis and only six families have been described to date with pathogenic CAST variants. This is the first report of an objective response to a therapeutic agent, which suggests that PLACK is a potentially treatable condition. The remarkable response we report and the relative safety of the intervention should prompt healthcare providers who care for PLACK syndrome patients to explore this as a potential treatment strategy in future studies.

journal_name

Clin Genet

journal_title

Clinical genetics

authors

Sawan ZA,Almehaidib A,Binamer Y,Monies D,Alsaleem KA,Aldekhail W,Alkuraya FS,Abanemai M

doi

10.1111/cge.13919

subject

Has Abstract

pub_date

2021-01-07 00:00:00

eissn

0009-9163

issn

1399-0004

pub_type

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