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November 1985

Infection and Prematurity as the Cause of Linear Skin Atrophy, Alopecia, Anonychia, and Tongue Lesions?

Author Affiliations

Laboratorio de Citogenetica Instituto de Ciéncias Biomédicas Largo do Prof Abel Salazar, 2 4000 Porto Portugal; The Johns Hopkins University School of Medicine Baltimore, MD 21205

Arch Dermatol. 1985;121(11):1379-1380. doi:10.1001/archderm.1985.01660110027003

To the Editor.—  In the March 1985 issue of the Archives, Cohen et al1 described a patient (case 1) seen by us2 in the Division of Medical Genetics at The Johns Hopkins Hospital, Baltimore, as well as two additional patients with a similar disorder.It was our impression that the skin atrophy in our patient was the consequence of the healing of an early vesiculobullous eruption; this, in turn, would have been caused by either an intrauterine insult or congenital fragility of the connective tissue.3 The defect was found in one of monozygotic (MZ) twins (probability of monozygocity was.9998), strongly suggesting a nongenetic cause. Though a postzygotic, posttwinning mutation can explain discordance in MZ twins for genetic traits, the alternative theory of an intrauterine insult is clearly favored.It is of note that all three patients described by Cohen et al were premature and that gestational age seemed

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