Delayed diagnosis of holocarboxylase synthetase deficiency in three patients with prominent skin findings.

Creator(s)

Maxime Cadieux-Dion, Children's Mercy HospitalFollow
Jennifer L. Gannon, Children's Mercy HospitalFollow
Brandon D. Newell, Children's Mercy HospitalFollow
Amy J. Nopper, Children's Mercy HospitalFollow
Janda L. Jenkins, Children's Mercy HospitalFollow
Bryce Heese, Children's Mercy HospitalFollow
Carol J. Saunders, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

5-1-2021

Identifier

DOI: 10.1111/pde.14586

Abstract

Holocarboxylase deficiency (HLCSD) is caused by biallelic pathogenic variants in HLCS and is associated with poor feeding, emesis, lethargy, seizures, life-threatening metabolic acidosis, and hyperammonemia. Skin involvement in HLCSD is typically described as scaly, erythrodermic, seborrhea-like, or ichthyosiform, but there is a paucity of reports. We report three patients, including two siblings, with HLCSD and significant cutaneous manifestations including ichthyosiform dermatitis and a presentation with features of annular pustular psoriasis. In this report, we show that persistent, unexplained rash, even in the absence of other clinical findings, should warrant consideration and potential workup for HLCSD.

Journal Title

Pediatric dermatology

Volume

38

Issue

3

First Page

655

Last Page

658

MeSH Keywords

Biotin; Delayed Diagnosis; Holocarboxylase Synthetase Deficiency; Humans; Ichthyosis; Seizures

Keywords

multiple carboxylase deficiency; neonatal screening; rash

Recommended Citation

Cadieux-Dion M, Gannon J, Newell B, Nopper AJ, Jenkins J, Heese B, Saunders C. Delayed diagnosis of holocarboxylase synthetase deficiency in three patients with prominent skin findings. Pediatr Dermatol. 2021 May;38(3):655-658. doi: 10.1111/pde.14586. Epub 2021 Apr 19. PMID: 33870574.