Cited by 185dental development and anomaliesGenetic and rare skin diseases.Hair Growth and Disorders

Ectodermal dysplasias: Classification and organization by phenotype, genotype and molecular pathway.

Open access
Wright, John Timothy, Fete, Mary, Schneider, Holm, Zinser, Madelaine, Koster, Maranke I., Clarke, Angus J., Hadj‐Rabia, Smail, Tadini, Gianluca +10 more·2019·American Journal of Medical Genetics Part A

Abstract

We propose a working definition and classification system for ectodermal dysplasias integrating phenotype, genotype, and molecular pathway.

Integrity signals

Registry

Crossref · 10.1002/ajmg.a.61045

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

2 of 35 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Many genes involved in ectodermal dysplasias act in shared molecular pathways important for ectodermal derivative development, including NFkB, WNT, and TP63.

    “Further, it is now clear that many of the genes affected in EDs function in common molecular pathways that are known to be of importance in development of the ectodermal derivatives (e.g. NFkB “nuclear factor kappa-B”, WNT, TP63 pathways).[Cluzeau and others 2011; Kantaputra and Carlson 2018; Koster 2010]”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Cluzeau and others 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Kantaputra and Carlson 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Koster 2010 source

      The section on developmental disorders caused by alterations in the p63 pathway says that mutations in p63 and its target genes can produce related developmental disorders, supporting the TP63 portion of the claim. The passages from our copy do not establish the broader claim about NFkB and WNT pathways; searches for those pathways did not find supporting discussion. No page numbers are supplied in our copy. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Premisecitation

    Previous ectodermal dysplasia classification systems have grouped conditions by underlying functional defect, such as abnormal developmental regulation or structural protein.

    “Classification systems for ED have been proposed that categorize the conditions within groups based on the underlying functional defect such as abnormal developmental regulation or structural protein.[Priolo and Lagana 2001]”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Priolo and Lagana 2001 source
  • Findingreasoning

    Knowledge of developmental pathways and molecular structures, and of relationships among gene products, indicates that many ectodermal dysplasias arise from genes that jointly participate in critical developmental processes and structural assemblies of ectodermal derivatives.

    “Knowledge of developmental pathways and molecular structures, and the relationship of different gene products within these domains, show that many EDs result from genes that co-participate in critical developmental processes and structural assemblages of the ectodermal derivatives (Figures 1, 2, 3).”
    Quote in the paperSubstantial claim
  • Premisecitation

    A widely recognized nosology from the 1970s, created by Dr. Newton Freire-Maia, covered conditions with classical signs in hair, teeth, nails, and/or sweat glands.

    “The most widely known such nosology was developed by Dr. Newton Freire-Maia in the 1970s and included conditions with “classical signs” involving hair, teeth, nails, and/or sweat glands.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Freire-Maia 1971 source
    • cites Freire-Maia 1977

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Freire-Maia and Pinheiro 1984

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Premisecitation

    Early classification schemes for these conditions were made before molecular genetics and grouped them by observable traits and inheritance pattern.

    “Initial classification systems for the EDs predate molecular genetics and were categorized and grouped according to phenotypic features and mode of inheritance.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Freire-Maia 1971 source
    • cites Freire-Maia 1977

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims. 9
  • Classified as probably not a substantial claim. 6
  • May combine two claims.

    Premisecitation

    Ectodermal dysplasias are regarded as rare, yet published prevalence estimates conflict.

    “While the ectodermal dysplasias are considered rare conditions, there are contradictory reports on their prevalence.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nguyen-Nielsen and others 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisenone given

    Conditions historically labeled as ectodermal dysplasias differ in their genetic origins and clinical presentations.

    “Hereditary conditions historically classified as an ectodermal dysplasia (ED) are heterogeneous in their genetic causes and clinical phenotypes.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    That classification split disorders into Group A, requiring at least two of those tissues to be affected, and Group B, requiring one of them plus another ectodermal tissue such as mammary gland.

    “The disorders were subdivided into Group A – those having at least two of these tissues affected – and Group B – conditions affecting one of the aforementioned tissues and at least one other tissue of ectodermal origin (e.g. mammary gland).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Freire-Maia and Pinheiro 1984

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Nguyen-Nielsen and others 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    The same study identified 1224 possible HED cases from 1995 to 2010: 90 molecularly confirmed, 146 clinically diagnosed, and 988 possible.

    “The authors reported a possible 1224 HED cases between 1995 and 2010 with 90 of these confirmed at the molecular level, 146 clinically diagnosed, and 988 possible HED cases.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nguyen-Nielsen and others 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    The molecular origins of these varied conditions involve numerous genes, multiple developmental pathways, and components of complex molecular structures needed for normal ectodermal derivative formation, structure, and function.

    “The molecular causes of these diverse conditions involve many genes and multiple developmental pathways and components of complex molecular structures that are necessary for normal formation, structure, and function of the ectodermal derivatives.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Alterations in any of these genes can produce a phenotype resembling XLHED, and heterozygosity, compound heterozygosity, or homozygosity can cause the disorders.

    “Pathogenic alterations in any of these genes can result in a clinical phenotype similar to XLHED, and both heterozygosity and compound heterozygosity or homozygosity for these can cause the disorders.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Headon and others 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Wisniewski and Trzeciak 2012 source
    • cites Chassaing and others 2006

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Molecularly confirmed XLHED prevalence in that study was 1.6 per 100,000.

    “The prevalence of molecularly confirmed XLHED was 1.6:100,000.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nguyen-Nielsen and others 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The international ichthyosis workgroup acknowledged that a pathophysiologic classification of inherited ichthyoses should be developed as more information becomes available.

    “The international ichthyosis workgroup recognized, however, that a pathophysiologic classification of inherited ichthyoses should be developed as additional information becomes available.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Oji and others 2010

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    GJB2 mutations can cause isolated deafness, palmoplantar keratoderma, and ichthyosis, as well as KID syndrome.

    “For example, mutations in GJB2 “gap junction protein beta-2”, a gene coding for connexin, can give rise to isolated deafness, palmoplantar keratoderma, and ichthyosis, as well as K-I-D syndrome (kearatitis-icthyosis-deafness syndrome).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A Danish nationwide cross-sectional study using national registries and clinical departments indicated that X-linked hypohidrotic ectodermal dysplasia might be more frequent than earlier believed.

    “A nationwide cross-sectional study in Denmark that leveraged data from national registries and clinical departments suggests that X-linked hypohidrotic ED (XLHED; MIM #305100) may be more common than previously thought.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nguyen-Nielsen and others 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    The genetic basis is known for nearly half of conditions historically classified as ectodermal dysplasias, and the causative alterations are known for most of the more common ED conditions.

    “The genetic basis for nearly 50% of conditions historically classified as EDs and the causative genetic alterations underlying most of the more prevalent ED conditions are known.[Pagnan and Visinoni 2014; Wright and others 2009]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Pagnan and Visinoni 2014 source
    • cites Wright and others 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    Some genes can have alterations linked to syndromes, while in other cases they are linked to changes in just one ectodermal tissue.

    “Numerous genes may have alterations that are associated with syndromes while in other instances they are associated with changes in only one ectodermal tissue.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites van den Boogaard and others 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Yang and others 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

12 of 12
  • The paper relies on this without support.

    Every ectodermal dysplasia condition is a genetically determined developmental defect of tissues of ectodermal origin.

    “A unifying feature is that all of the ED conditions are genetically determined developmental defects of tissues of ectodermal origin.”
  • The paper relies on this without support.

    In some ectodermal dysplasias, epithelial-mesenchymal interaction disturbances affect endodermal as well as ectodermal structures, such as mucous gland formation defects in the lung and colon in XLHED.

    “It should be noted that in some ectodermal dysplasias there are disturbances of epithelial-mesenchymal interaction affecting endodermal as well as ectodermal structures, such as the defects of mucous gland formation in the lung and the colon in XLHED.”
  • The paper relies on this without support.

    Other genes and variants associated with ectodermal dysplasias encode proteins important for cell structure and/or function.

    “Other genes and their genetic variants associated with EDs code for proteins important for the structure and/or function of cells.”
  • The paper relies on this without support.

    XLHED is the most prevalent form of HED.

    “In the case of EDA, this also happens to coincide with XLHED being the most prevalent form of HED.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Ectodermal dysplasias are currently divided into four groups based on the pathway involved: ectodysplasin/NFKB, WNT10, TP63, and structural.

    “They are currently divided into four groups of disorders based on the pathway involved, which includes the ectodysplasin/nuclear factor-kappa B (NFKB) pathway, wingless-type MMTV integration site family, member 10 ([wingless related integration site] WNT10), tumor protein p63 (TP63), and the structural group.”

    From Ectodermal Dysplasia – An Overview and Update (2024) · cites this paper as [1]

    In “Classification Scheme and Clustering” (page unavailable), the paper groups ectodermal dysplasias by genotype, molecular pathway and phenotype, identifying EDA-, WNT- and TP63-associated genes alongside genes involved in cellular structure. It does not state that the disorders are divided into exactly four groups, and it names the broader WNT pathway rather than a WNT10 group. (LLM, conf=0.85)

    Experimental — accuracy not yet measured
  • Only syndromes included in the most recent ED classification [3] were listed in Table 2.

    “Only syndromes included in the most recent ED classification [3] were listed.”
  • Ectodermal dysplasias are a heterogeneous group of inherited disorders characterized by abnormal development or homeostasis of two or more ectodermal derivatives, including hair, teeth, nails, and sweat glands.

    “Ectodermal dysplasias are a heterogeneous group of disorders that are characterized by abnormal development of ectodermal structures like hair, teeth, nails, and sweat glands.”

    From Ectodermal Dysplasia – An Overview and Update (2024) · cites this paper as [1]

  • The child's capacity to manage and adapt to dental treatment is a key factor influencing the choice and timing of restorative interventions, particularly in cases requiring complex or extended care.

    “Moreover, the child’s capacity to manage and adapt to dental treatment is a key factor influencing the choice and timing of restorative interventions, particularly in cases requiring complex or extended care [8].”

    From Application of a Conservative Prosthodontic Approach in the Rehabilitation of a 10-Year-Old Child with Hypohidrotic Ectodermal Dysplasia (2025) · cites this paper as [8]

    The Abstract and Introduction discuss the classification and diagnosis of ectodermal dysplasias, including conditions affecting teeth. Searches for a child’s ability to manage dental treatment and for cooperation during complex restorative care found no passage addressing how that ability affects the choice or timing of interventions. No page numbers were provided in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured
  • Additional features of XLHED include dry, wrinkled skin, frontal bossing, saddle nose, and periorbital hyperpigmentation.

    “Additional features include dry, wrinkled skin, frontal bossing, saddle nose, and periorbital hyperpigmentation [4].”

    From X‐Linked Anhidrotic Ectodermal Dysplasia in A 19‐Year‐Old Male: A Classic Phenotype (2026) · cites this paper as [4]

    The Introduction discusses XLHED and the classification of ectodermal dysplasias, but the passages in our copy do not describe the claimed skin or facial features. Searches for the listed features, including frontal bossing and periorbital pigmentation, found no passage that verifies them. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

Cites

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Cited by

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Authors
Wright, J. T., Fete, M., Schneider, H., Zinser, M., Koster, M. I., Clarke, A. J., Hadj‐Rabia, S., Tadini, G., Pagnan, N., Visinoni, A. F., Bergendal, B., Abbott, B., Fete, T., Stanford, C., Butcher, C., D'Souza, R. N., Sybert, V. P., & Morasso, M. I.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • National Foundation for Ectodermal Dysplasias (US)
  • Universitätsklinikum Erlangen (DE)
  • Cardiff University (GB)
  • Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), INSERM U1163, Descartes ‐ Sorbonne Paris Cité University, Imagine Institute, Necker‐Enfants Malades Universitary Hospital Paris France
  • University of Milan (IT)
  • Universidade Federal do Paraná (BR)
  • Positivo University Curitiba Brazil
  • Jönköping University (SE)
  • University of Illinois Chicago (US)
  • University of Missouri (US)
  • Academic Affairs and Education, Health Sciences The University of Utah Salt Lake City Utah
  • University of Washington (US)
  • Laboratory of Skin Biology National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health Bethesda, MD
Corresponding author
Wright, John Timothy
Venue
American Journal of Medical Genetics Part A
Publisher
Wiley
Published
2019-01-31
Volume
179
Issue
3
Pages
442-447
ISSN
  • 1552-4825 (ISSN-L)
  • 1552-4833
OpenAlex
W2914468110
Cited by
185
References
31
Citations by year
2026: 23 · 2025: 29 · 2024: 31 · 2023: 25 · 2022: 34 · 2021: 28 · 2020: 11 · 2019: 4
FWCI
1.69
Type
journal article
Language
en
Open access
Locations
  • American Journal of Medical Genetics Part A (publishedVersion)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Dental and Craniofacial Research (R13DE018845, R01DE016079)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › dental development and anomalies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and rare skin diseases.
  • Health Sciences › Medicine › Urology › Hair Growth and Disorders
Keywords
ectodermal dysplasia, classification systems, genotype-phenotype correlation, molecular pathways, Wnt signaling, p63, tooth agenesis, mode of inheritance, genetic variants, connexins, keratin, cadherins
MeSH terms
Alleles, Ectodermal Dysplasia, Genotype, Humans, Phenotype, Signal Transduction, Biomarkers, Genetic Predisposition to Disease, Databases, Genetic, Genetic Association Studies

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Claims read under definition version 3 (extract-v3) on 2026-09-28.

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