Alternative titles and symbols : Ichthyosis hystrix gravior; Porcupine man;
Description : Anton-Lamprecht (1978) stated that 4 genetic disorders of keratinization are known
to have a structural defect of tonofibrils. (1) In the harlequin fetus (242500), an
abnormal x-ray diffraction pattern of the horn material points to a cross-beta-protein
structure instead of the normal alpha-protein structure of keratin. (2) Bullous ichthyosiform
erythroderma (EHK; 113800) is characterized by an early formation of clumps and perinuclear
shells due to an abnormal arrangement of tonofibrils. (3) In the Curth-Macklin form
of ichthyosis hystrix (146590), concentric unbroken shells of abnormal tonofilaments
form around the nucleus. (4) In ichthyosis hystrix gravior, only rudimentary tonofilaments
are found with compensatory production of mucous granules. Goldsmith (1976) used the
designation of epidermolytic hyperkeratosis for the condition that is called bullous
congenital ichthyosiform erythroderma (BCIE) when generalized and ichthyosis hystrix
when localized.;