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. 1988 Dec;25(12):809–818. doi: 10.1136/jmg.25.12.809

Hypomelanosis of Ito: a manifestation of mosaicism or chimerism.

D Donnai 1, A P Read 1, C McKeown 1, T Andrews 1
PMCID: PMC1051608  PMID: 3236362

Abstract

We describe three patients with the cutaneous manifestations of hypomelanosis of Ito. Two, with unusual abnormalities of their toes, had a mixture of diploid and triploid cells in cultured skin fibroblasts. The published clinical descriptions of hypomelanosis of Ito and diploid-triploid mosaicism are reviewed. Chromosome heteromorphisms, HLA types, and DNA fingerprints were studied in an attempt to elucidate the origin of the disease in our patients. We conclude that hypomelanosis of Ito is a manifestation of a heterogeneous group of disorders, the common factor being the presence of two genetically different cell lines. It can result from chromosomal mosaicism or chimerism, from a postzygotic mutation, or from X inactivation. The risk of recurrence is negligible if the proband is a male; if the proband is female the risk is also low but an X linked mutation must be considered.

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Selected References

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  1. BOOK J. A., SANTESSON B. Malformation syndrome in man associated with triploidy (69 chromosomes). Lancet. 1960 Apr 16;1(7129):858–859. doi: 10.1016/s0140-6736(60)90737-6. [DOI] [PubMed] [Google Scholar]
  2. Chemke J., Rappaport S., Etrog R. Aberrant melanoblast migration associated with trisomy 18 mosaicism. J Med Genet. 1983 Apr;20(2):135–137. doi: 10.1136/jmg.20.2.135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. David M., Chambon A., Laurent C., Plauchu H., Lindner D., Rouchon A., de Peretti E., Genoud J., Jeune M. La triploïdie chez l'enfant. I. Etude du phénotype. A propos d'une observation de triploïdie en mosaïque 46, XX/69, XXY. Pediatrie. 1975 Apr-May;30(3):281–298. [PubMed] [Google Scholar]
  4. Dewald G., Alvarez M. N., Cloutier M. D., Kelalis P. P., Gordon H. A diploid-triploid human mosaic with cytogenetic evidence of double fertilization. Clin Genet. 1975 Aug;8(2):149–160. doi: 10.1111/j.1399-0004.1975.tb04403.x. [DOI] [PubMed] [Google Scholar]
  5. Donnai D., McKeown C., Andrews T., Read A. P. Diploid/triploid mixoploidy and hypomelanosis of Ito. Lancet. 1986 Jun 21;1(8495):1443–1444. doi: 10.1016/s0140-6736(86)91588-6. [DOI] [PubMed] [Google Scholar]
  6. FERRIER P., STALDER G., BAMATTER F., FERRIER S., BUEHLER E., KLEIN D. CONGENITAL ASYMMETRY ASSOCIATED WITH DIPLOID-TRIPLOID MOSAICISM AND LARGE SATELLITES. Lancet. 1964 Jan 11;1(7324):80–82. doi: 10.1016/s0140-6736(64)91395-9. [DOI] [PubMed] [Google Scholar]
  7. Findlay G. H., Moores P. P. Pigment anomalies of the skin in the human chimaera: their relation to systematized naevi. Br J Dermatol. 1980 Nov;103(5):489–498. doi: 10.1111/j.1365-2133.1980.tb01663.x. [DOI] [PubMed] [Google Scholar]
  8. Fryns J. P., Vinken L., Geutjens J., Marien J., Deroover J., Van Den Berghe H. Triploid-diploid mosaïcism in a deeply mentally retarded adult. Ann Genet. 1980;23(4):232–234. [PubMed] [Google Scholar]
  9. Fulton A. B., Howard R. O., Albert D. M., Hsia Y. E., Packman S. Ocular findings in triploidy. Am J Ophthalmol. 1977 Dec;84(6):859–867. doi: 10.1016/0002-9394(77)90510-4. [DOI] [PubMed] [Google Scholar]
  10. Graham J. M., Jr, Hoehn H., Lin M. S., Smith D. W. Diploid-triploid mixoploidy: clinical and cytogenetic aspects. Pediatrics. 1981 Jul;68(1):23–28. [PubMed] [Google Scholar]
  11. Grosshans E. M., Stoebner P., Bergoend H., Stoll C. Incontinentia pigmenti achromians (ITO). Etude clinique et histo-pathologique. Dermatologica. 1971;142(2):65–78. [PubMed] [Google Scholar]
  12. Happle R. Cutaneous manifestation of lethal genes. Hum Genet. 1986 Mar;72(3):280–280. doi: 10.1007/BF00291899. [DOI] [PubMed] [Google Scholar]
  13. Happle R. Lyonization and the lines of Blaschko. Hum Genet. 1985;70(3):200–206. doi: 10.1007/BF00273442. [DOI] [PubMed] [Google Scholar]
  14. Happle R. The McCune-Albright syndrome: a lethal gene surviving by mosaicism. Clin Genet. 1986 Apr;29(4):321–324. doi: 10.1111/j.1399-0004.1986.tb01261.x. [DOI] [PubMed] [Google Scholar]
  15. Jackson R. The lines of Blaschko: a review and reconsideration: Observations of the cause of certain unusual linear conditions of the skin. Br J Dermatol. 1976 Oct;95(4):349–360. doi: 10.1111/j.1365-2133.1976.tb00835.x. [DOI] [PubMed] [Google Scholar]
  16. Jacobs P. A., Angell R. R., Buchanan I. M., Hassold T. J., Matsuyama A. M., Manuel B. The origin of human triploids. Ann Hum Genet. 1978 Jul;42(1):49–57. doi: 10.1111/j.1469-1809.1978.tb00930.x. [DOI] [PubMed] [Google Scholar]
  17. Jeffreys A. J., Wilson V., Thein S. L. Hypervariable 'minisatellite' regions in human DNA. Nature. 1985 Mar 7;314(6006):67–73. doi: 10.1038/314067a0. [DOI] [PubMed] [Google Scholar]
  18. Jelinek J. E., Bart R. S., Schiff S. M. Hypomelanosis of Ito ("incontinentia pigmenti achromians"). Report of three cases and review of the literature. Arch Dermatol. 1973 Apr;107(4):596–601. [PubMed] [Google Scholar]
  19. Lejeune J., Salmon C., Berger R., Réthoré M. O., Rossier A., Job J. C. Chimère 46,XX-69,XXY. Ann Genet. 1967 Dec;10(4):188–192. [PubMed] [Google Scholar]
  20. McLaren A., Gauld I. K., Bowman P. Comparison between mice chimaeric and heterozygous for the X-linked gene tabby. Nature. 1973 Jan 19;241(5386):180–183. doi: 10.1038/241180a0. [DOI] [PubMed] [Google Scholar]
  21. Niebuhr E. Triploidy in man. Cytogenetical and clinical aspects. Humangenetik. 1974 Feb 21;21(2):103–125. doi: 10.1007/BF00281030. [DOI] [PubMed] [Google Scholar]
  22. Pettenati M. J., Mirkin L. D., Goldstein D. J. Diploid-triploid mosaicism: report of necropsy findings. Am J Med Genet. 1986 May;24(1):23–28. doi: 10.1002/ajmg.1320240104. [DOI] [PubMed] [Google Scholar]
  23. Quiroz E., Orozco A., Salamanca F. Diploid-tetraploid mosaicism in a malformed boy. Clin Genet. 1985 Feb;27(2):183–186. doi: 10.1111/j.1399-0004.1985.tb00208.x. [DOI] [PubMed] [Google Scholar]
  24. Rubin M. B. Incontinentia pigmenti achromians. Multiple cases within a family. Arch Dermatol. 1972 Mar;105(3):424–425. [PubMed] [Google Scholar]
  25. Sacrez R., Clavert J., Willard D., Rumpler Y., M'Bede J., Meyer R., Korn R. La triploïdie chez l'enfant. Pediatrie. 1967 Apr-May;22(3):267–275. [PubMed] [Google Scholar]
  26. Schmid W., Vischer D. A malformed boy with double aneuploidy and diploid-triploid mosaicism 48,XXYY/71,XXXYY. Cytogenetics. 1967;6(2):145–155. doi: 10.1159/000129935. [DOI] [PubMed] [Google Scholar]
  27. Schwartz M. F., Jr, Esterly N. B., Fretzin D. F., Pergament E., Rozenfeld I. H. Hypomelanosis of Ito (incontinentia pigmenti achromians): a neurocutaneous syndrome. J Pediatr. 1977 Feb;90(2):236–240. doi: 10.1016/s0022-3476(77)80636-7. [DOI] [PubMed] [Google Scholar]
  28. Takematsu H., Sato S., Igarashi M., Seiji M. Incontinentia pigmenti achromians (Ito). Arch Dermatol. 1983 May;119(5):391–395. [PubMed] [Google Scholar]
  29. Tharapel A. T., Wilroy R. S., Martens P. R., Holbert J. M., Summitt R. L. Diploid-triploid mosaicism: delineation of the syndrome. Ann Genet. 1983;26(4):229–233. [PubMed] [Google Scholar]
  30. Turleau C., Taillard F., Doussau de Bazignan M., Delépine N., Desbois J. C., de Grouchy J. Hypomelanosis of Ito (incontinentia pigmenti achromians) and mosaicism for a microdeletion of 15q1. Hum Genet. 1986 Oct;74(2):185–187. doi: 10.1007/BF00282090. [DOI] [PubMed] [Google Scholar]
  31. Van den Berghe H. Triploid-diploid mosaicism in the lymphocytes of a liveborn child with multiple malformations. Humangenetik. 1970;11(1):18–21. doi: 10.1007/BF00296299. [DOI] [PubMed] [Google Scholar]
  32. Wettke-Schäfer R., Kantner G. X-linked dominant inherited diseases with lethality in hemizygous males. Hum Genet. 1983;64(1):1–23. doi: 10.1007/BF00289472. [DOI] [PubMed] [Google Scholar]
  33. Wittwer B. B., Wittwer H. B. Information about diploid-tetraploid mosaicism in a six-year-old male. Clin Genet. 1985 Dec;28(6):567–568. doi: 10.1111/j.1399-0004.1985.tb00429.x. [DOI] [PubMed] [Google Scholar]

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