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Rare disease
Case report
Sparse scalp hair and vision loss: think hypotrichosis with juvenile macular dystrophy
  1. Akshay Narayan1 and
  2. Mariya Moosajee2,3,4
  1. 1Department of Medicine, University College London Medical School, London, UK
  2. 2UCL Institute of Ophthalmology, London, UK
  3. 3Moorfields Eye Hospital NHS Foundation Trust, London, UK
  4. 4Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  1. Correspondence to Mr Akshay Narayan; akshay.narayan.13{at}ucl.ac.uk

Abstract

Here, we report the diagnostic challenge of a female patient of Russian descent with autosomal recessive hypotrichosis with juvenile macular dystrophy (HJMD). She presented to dermatology age one and a half years with sparse hair growth on her scalp, her parents were reassured this would grow, but it never manifested. She was found to be hypermetropic and prescribed glasses from age 2 but no retinal findings were noted. At age 23 years, the patient undertook an internet search and discovered the association of symptoms pointing towards HJMD. She sought genetic testing, revealing a homozygous missense mutation in Cadherin-3 (CDH3) gene. The patient presented to our Genetic Eye Disease Service at Moorfields Eye Hospital age 27 years, with reduced colour, central distance and near vision. Fundus examination and imaging confirmed atrophic macular changes. Currently, HJMD has no treatment, she wears a wig, UV-protected sunglasses in sunlight and maintains a healthy balanced diet.

  • dermatology
  • ophthalmology

https://doi.org/10.1136/bcr-2019-232342

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    Footnotes

    • Correction notice This article has been corrected since it was first published. The affiliation of the author "Mariya Moosajee" has been corrected.

    • Contributors MM treated the patient as a clinician and was responsible for data acquisition, analysis and interpretation. AN wrote the first draft of the manuscript and MM was involved in revising and critically appraising manuscript. AN and MM were involved in the final approval for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.