Bazex-Dupré-Christol syndrome is a rare genodermatosis characterised by the triad of congenitalhypotrichosis and follicularatrophoderma, with subsequent development of multiple basal cell carcinomas. It is categorised as an 'ectodermal dysplasia with an hereditary tumour' syndrome.
It is sometimes called 'follicular atrophoderma-basal cell carcinoma' and 'Bazex syndrome'; the latter is best avoided as acrokeratosis neoplastica is also known as 'Bazex syndrome', an unrelated rare paraneoplastic syndrome.
Bazex-Dupré-Christol syndrome: classic triad of clinical features
Images from: Chauhan P, Meena D, Dhanta A, Kansal NK, Durgapal P. Bazex-Dupré-Christol syndrome: first report in an Indian family. Indian J Dermatol Venereol Leprol. 2018;84(4):451–6.
Who gets Bazex-Dupré-Christol syndrome?
Bazex-Dupré-Christol syndrome is rare, reported in approximately 20 families worldwide. Males and females are equally affected, but male-to-male inheritance does not occur. Sporadic cases have been described.
What causes Bazex-Dupré-Christol syndrome?
Bazex-Dupré-Christol syndrome is an X-linked dominant inherited disorder. This means 50% of children of an affected female, and all daughters of an affected male will inherit the syndrome.
Bazex-Dupré-Christol syndrome results from a mutation in the ACTRT1gene causing depletion of the tumour suppressor ARP-T1, a non-coding mRNA. ARP-T1 is required for the assembly of cilia, microtubule organelles.
What are the clinical features of Bazex-Dupré-Christol syndrome?
Bazex-Dupré-Christol syndrome typically shows some clinical features at birth, although these may not always be recognised at that time. Males tend to always have severe disease whereas females can show a range of severity.
Follicular atrophoderma
Present at birth
Ice pick scars
Backs of hands, elbows, feet, and face
Require careful examination to see
Hair abnormalities
Present at birth
Hypotrichosis - reduced body and scalp hair
May be mild or absent in females
Hair shaft abnormalities including pili torti may be also found
Images from: Chauhan P, Meena D, Dhanta A, Kansal NK, Durgapal P. Bazex-Dupré-Christol syndrome: first report in an Indian family. Indian J Dermatol Venereol Leprol. 2018;84(4):451–6.
What are the complications of Bazex-Dupré-Christol syndrome?
Psychosocial impact of having multiple skin cancers and their treatment.
What is the differential diagnosis of Bazex-Dupré-Christol?
Rombo syndrome - is clinically similar but has autosomal dominant inheritance
How is the diagnosis of Bazex-Dupré-Christol made?
Bazex-Dupré-Christol syndrome is a clinical diagnosis and should be considered in patients with early-onset or familial basal cell carcinomas. Follicular atrophoderma should be looked for carefully as this is an early sign easily missed.
What is the treatment for Bazex-Dupré-Christol syndrome?
Avoid radiotherapy due to the risk of provoking more skin tumours
What is the outcome for Bazex-Dupré-Christol syndrome?
Basal cell carcinomas continue to develop lifelong. There is no association with internal malignancies.
Bibliography
AlSabbagh MM, Baqi MA. Bazex-Dupré-Christol syndrome: review of clinical and molecular aspects. Int J Dermatol. 2018;57(9):1102–6. doi:10.1111/ijd.14065. PubMed
Castori M, Castiglia D, Passarelli F, Paradisi M. Bazex-Dupré-Christol syndrome: an ectodermal dysplasia with skin appendage neoplasms. Eur J Med Genet. 2009;52(4):250–5. doi:10.1016/j.ejmg.2008.12.003. PubMed
Chauhan P, Meena D, Dhanta A, Kansal NK, Durgapal P. Bazex-Dupré-Christol syndrome: first report in an Indian family. Indian J Dermatol Venereol Leprol. 2018;84(4):451–6. doi:10.4103/ijdvl.IJDVL_599_17. Journal
Glaessl A, Hohenlautner U, Landthaler M, Vogt T. Sporadic Bazex-Dupré-Christol-like syndrome: early onset basal cell carcinoma, hypohidrosis, hypotrichosis, and prominent milia. Dermatol Surg. 2000;26(2):152–4. doi:10.1046/j.1524-4725.2000.99146.x. PubMed
Park HS, Papanastasi E, Blanchard G, et al. ARP-T1-associated Bazex-Dupré-Christol syndrome is an inherited basal cell cancer with ciliary defects characteristic of ciliopathies. Commun Biol. 2021;4(1):544. doi:10.1038/s42003-021-02054-9. Journal