CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment

Background Congenital hemidysplasia with ichthyosiform nevus and limb defects (CHILD) syndrome is a rare X-linked dominant disorder characterized by a peculiar ichthyosiform nevus and limb defects. Linear porokeratosis (LP) is a distinct subtype of porokeratosis with hyperkeratotic nevus typically f...

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Main Authors: Kai Chen, Bin Hu, Qiang Chen, Fei Su, Liu-Qing Chen
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Journal of Dermatological Treatment
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Online Access:https://www.tandfonline.com/doi/10.1080/09546634.2025.2478217
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author Kai Chen
Bin Hu
Qiang Chen
Fei Su
Liu-Qing Chen
author_facet Kai Chen
Bin Hu
Qiang Chen
Fei Su
Liu-Qing Chen
author_sort Kai Chen
collection DOAJ
description Background Congenital hemidysplasia with ichthyosiform nevus and limb defects (CHILD) syndrome is a rare X-linked dominant disorder characterized by a peculiar ichthyosiform nevus and limb defects. Linear porokeratosis (LP) is a distinct subtype of porokeratosis with hyperkeratotic nevus typically found on the extremities and linearly arranged along the lines of Blaschko. To our knowledge, the combination of CHILD syndrome and LP in a patient presenting inflammatory nevus on the limbs has never been reported.Patients and methods A fourteen-year-old Chinese girl presented with CHILD syndrome without limb abnormalities but with coexisting LP on her left leg and opisthenar. Clinical and laboratory examination, and Whole-Genome Sequencing (WGS) analysis of the NSDHL and PMVK gene were performed. The topical application of a compounded 2% lovastatin and 2% cholesterol ointment to skin lesions twice daily for up to 4 weeks, and treatment response was evaluated every week.Results Our patient presented with both of the clinical features of CHILD syndrome and LP. Further WGS revealed a genetic deletion in NSDHL (c.123delA, p.V42*) and a compound heterozygous mutation in the PMVK (c.88C > T, p.Q30*) gene, confirming the clinical diagnosis of our patient. Moreover, after 4 weeks of treatment, the skin lesion of the patient had displayed a good therapeutic response to the pathogenesis-directed therapy, and we didn’t observe any adverse events.Conclusions We report, for the first time in China, a case of a patient with both CHILD syndrome and LP with inflammatory nevi on the limbs. Furthermore, we provide evidence of the effectiveness of a topical lovastatin/cholesterol-based therapy for this patient.
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spelling doaj-art-47e0b333666e4e869e84e392783d109c2025-08-20T03:46:41ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532025-12-0136110.1080/09546634.2025.2478217CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointmentKai Chen0Bin Hu1Qiang Chen2Fei Su3Liu-Qing Chen4Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaBackground Congenital hemidysplasia with ichthyosiform nevus and limb defects (CHILD) syndrome is a rare X-linked dominant disorder characterized by a peculiar ichthyosiform nevus and limb defects. Linear porokeratosis (LP) is a distinct subtype of porokeratosis with hyperkeratotic nevus typically found on the extremities and linearly arranged along the lines of Blaschko. To our knowledge, the combination of CHILD syndrome and LP in a patient presenting inflammatory nevus on the limbs has never been reported.Patients and methods A fourteen-year-old Chinese girl presented with CHILD syndrome without limb abnormalities but with coexisting LP on her left leg and opisthenar. Clinical and laboratory examination, and Whole-Genome Sequencing (WGS) analysis of the NSDHL and PMVK gene were performed. The topical application of a compounded 2% lovastatin and 2% cholesterol ointment to skin lesions twice daily for up to 4 weeks, and treatment response was evaluated every week.Results Our patient presented with both of the clinical features of CHILD syndrome and LP. Further WGS revealed a genetic deletion in NSDHL (c.123delA, p.V42*) and a compound heterozygous mutation in the PMVK (c.88C > T, p.Q30*) gene, confirming the clinical diagnosis of our patient. Moreover, after 4 weeks of treatment, the skin lesion of the patient had displayed a good therapeutic response to the pathogenesis-directed therapy, and we didn’t observe any adverse events.Conclusions We report, for the first time in China, a case of a patient with both CHILD syndrome and LP with inflammatory nevi on the limbs. Furthermore, we provide evidence of the effectiveness of a topical lovastatin/cholesterol-based therapy for this patient.https://www.tandfonline.com/doi/10.1080/09546634.2025.2478217CHILD syndromelinear porokeratosisNSDHL genePMVK genetopical therapy
spellingShingle Kai Chen
Bin Hu
Qiang Chen
Fei Su
Liu-Qing Chen
CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment
Journal of Dermatological Treatment
CHILD syndrome
linear porokeratosis
NSDHL gene
PMVK gene
topical therapy
title CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment
title_full CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment
title_fullStr CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment
title_full_unstemmed CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment
title_short CHILD syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin/cholesterol ointment
title_sort child syndrome combined linear porokeratosis in a patient with a good response to the topical lovastatin cholesterol ointment
topic CHILD syndrome
linear porokeratosis
NSDHL gene
PMVK gene
topical therapy
url https://www.tandfonline.com/doi/10.1080/09546634.2025.2478217
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