Congenital Sensorineural Hearing Loss and Inborn Pigmentary Disorders: First Report of Multilocus Syndrome in Piebaldism

Auditory System Abnormalities in Early Graying of Hair: A Cross-Sectional Study

Background

Melanocytes in the hair and melanocytes in the stria vascularis of the inner ear have common origins. Many congenital and acquired disorders of cutaneous pigmentation have auditory abnormalities. There is a paucity of studies on the auditory associations of early graying.

Aim and Objectives

The aim of the study was to determine the association between early graying and auditory system abnormalities.

Materials and Methods

A cross-sectional analytical study was done on 100 patients with early graying and 100 controls. Pure tone audiometry was done at 0.25 to 4 kHz for bone conduction, conventional and high frequencies from 0.25 to 8 kHz for air conduction, and extended high frequencies from 9 kHz to 20 kHz for air conduction in both ears.

Results

Bilateral hearing loss >25 dB was present in three patients with early graying based on the four-frequency average of 0.5, 1, 2, and 4 kHz. Patients with early graying had significantly higher thresholds for hearing except at 0.25 kHz in the right ears and 0.25, 2, 10, and 11 kHz in the left ears.

Limitations

We did not assess cochlear function with otoacoustic emissions, and our study design did not allow us to assess causality and temporal association.

Conclusion

Our study found that early graying may be a visible marker of changes in auditory thresholds. Patients with early graying need periodic auditory evaluations and health education to prevent further hearing loss.

Novel retinal finding in a patient with 4q12 deletion

BACKGROUND

Chromosome 4q deletions are rare disorders phenotypically characterized by several features. The most commonly described ocular abnormalities include unilateral microphthalmia with bilateral colobomata, blue sclerae with pigmented retinal clumps, hypermetropia, and a divergent squint.

PURPOSE

To report a case of 4q12 deletion with a singular retinal feature.

MATERIALS AND METHODS

Case report.

RESULTS

A 20-year-old Caucasian female with a history of poliosis, progressive appearance of small areas of skin depigmentation along trunk and limbs since birth and diagnosis of learning deficit was referred for a complete ocular examination. The genetic counseling showed microdeletion in the 4q12 region. An audiometric test was performed, showing a progressive bilateral neurosensorial hypoacusia. Ocular examination showed the presence of multifocal, tiny, whitish deposits in the posterior pole. Multimodal imaging defined the lesions as small elevations of the retinal pigment epithelium with slight hyper-autofluorescence and staining in the late phase of fluoresceine angiography (FA). Visual acuity was 20/20. The retinal findings did not change during the three-month follow-up.

CONCLUSIONS

Although the findings herein reported have never been described before in patients affected by 4q12 mutations, we do not exclude that they could represent a manifestation of the peculiar genetic asset of the patient, related to dysfunction in pigment epithelium/neuroretinal metabolic activity.

Genodermatoses with hearing impairment

Hearing loss is a prominent feature in multiple genodermatoses. Underappreciation of auditory deficits can misdirect proper diagnosis by the treating dermatologist. This review reviews the anatomic, developmental, and embryologic aspects that characterize the ear and summarizes genodermatoses that have aberrant auditory findings. The latter are classified into neural crest, metabolic, pigmentary, craniofacial, and a miscellaneous category of disorders lacking specific cutaneous findings. The algorithms provided in this review enable treating dermatologists to better recognize and manage genodermatoses with ear involvement.