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Dyskeratosis, Hereditary Benign Intraepithelial

OMIM ID:

autosomal dominant

Dyskeratosis, Hereditary Benign Intraepithelial

Alternate Names

HBID
DKBI

Defective Genes

NLRP1

Clinical Characteristics

Ocular Features

The conjunctival surface has elevated, granular-appearing white epithelial plaques usually in the interpalpebral areas.  These may extend onto the cornea and cause interference with vision.  The plaques may also shed spontaneously.  The lesions may have prominent blood vessels with associated conjunctival hyperemia with considerable cosmetic implications.

The plaque-like growths remain localized and do not invade tissue.  The surface epithelium is hyperkeratotic with acanthosis and individual cell dyskeratoses.

Systemic Features

The oral and lingual mucosa may also be involved.

Genetics

Inheritance

A segment of DNA localized at 4q35 is duplicated resulting in triple alleles for 2 linked markers suggesting that gene duplication is responsible for the disorder.  It occurs almost exclusively among members of a triracial isolate (Haliwa Indians) in North Carolina.

Families with autosomal dominant transmission have been reported.  In one French Canadian family in which mother and son were affected a nonsense mutation in NLRP1 (17p13.2) was found.  This may be a unique disorder.

Pedigree

Autosomal dominant

Autosomal dominant disorders require only one mutation for the disease to be expressed.  Since an affected parent has two chromosomes, only one of which has the mutant gene, parents can expect that half (50%) of their children will receive that one and inherit the disease.  It is common for individuals that inherit the mutation, however, to not have evidence of the disease (nonpenetrance).

Image
Sample pedigree of autosomal dominant inheritance

Autosomal dominant inheritance leads to a vertical pattern of transmission

Treatment & Management

Local excision as needed.

Selected Resources

Web Resources

Publications

Displaying 1 - 3 of 3

A Duplication in Chromosome 4q35 Is Associated with Hereditary Benign Intraepithelial Dyskeratosis

PubMedID: 11170897

Hereditary Benign Intraepithelial Dyskeratosis

PubMedID: 3827721

Whole exome sequencing identifies a mutation for a novel form of corneal intraepithelial dyskeratosis

PubMedID: 23349227