Pili torti-onychodysplasia syndrome

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Overview

Pili torti-onychodysplasia syndrome is an extremely rare genetic condition that affects the hair and nails. The name describes its two main features: "pili torti" refers to hair shafts that are flattened and twisted, making the hair brittle, dry, and prone to breaking easily. "Onychodysplasia" means abnormal development of the nails, which may appear thickened, ridged, discolored, or misshapen. Together, these features point to a problem with how the body builds certain structural proteins, particularly keratin, which is the main building block of both hair and nails. People with this syndrome typically notice that their hair is sparse, fragile, and difficult to grow to a normal length. The nails may be slow-growing, split easily, or have an unusual texture. In some reported cases, additional features such as dental abnormalities or mild skin changes have also been described, though the condition primarily affects the hair and nails. Because this syndrome is so rare, there is no specific cure or targeted treatment available. Management focuses on protecting the hair and nails from further damage, using gentle hair care products, and addressing any cosmetic concerns. Dermatologists and geneticists are the main specialists involved in diagnosis and care. While the condition is not life-threatening, it can have a significant impact on self-esteem and quality of life, especially during childhood and adolescence.

Key symptoms:

Twisted and flattened hair shaftsBrittle hair that breaks easilySparse or thin hairDry and lusterless hairAbnormally shaped nailsThickened or ridged nailsNails that split or crack easilySlow nail growthDiscolored nailsPossible dental abnormalities

Clinical phenotype terms (20)— hover any for plain English
Ectodermal dysplasiaHP:0000968Absent eyelashesHP:0000561Alopecia universalisHP:0002289Brittle hairHP:0002299TrichodysplasiaHP:0002552Generalized keratosis follicularisHP:0007439Congenital onychodystrophyHP:0008394KeloidsHP:0010562Cutaneous syndactylyHP:0012725Conjunctival hyperemiaHP:0030953
Inheritance

Autosomal recessive

Passed on when both parents carry the same gene change; often skips generations

Age of Onset

Childhood

Begins in childhood, roughly ages 1 to 12

Orphanet ↗NORD ↗

Treatments

No FDA-approved treatments are currently listed for Pili torti-onychodysplasia syndrome.

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No actively recruiting trials found for Pili torti-onychodysplasia syndrome at this time.

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Search ClinicalTrials.gov ↗Join the Pili torti-onychodysplasia syndrome community →

No specialists are currently listed for Pili torti-onychodysplasia syndrome.

View NORD Rare Disease Centers ↗Undiagnosed Disease Network ↗

Treatment Centers

8 centers
🏥 NORD

Baylor College of Medicine Rare Disease Center

Baylor College of Medicine

📍 Houston, TX

🏥 NORD

Stanford Medicine Rare Disease Center

Stanford Medicine

📍 Stanford, CA

🔬 UDN

NIH Clinical Center Undiagnosed Diseases Program

National Institutes of Health

📍 Bethesda, MD

🔬 UDN

UCLA UDN Clinical Site

UCLA Health

📍 Los Angeles, CA

🔬 UDN

Baylor College of Medicine UDN Clinical Site

Baylor College of Medicine

📍 Houston, TX

🔬 UDN

Harvard/MGH UDN Clinical Site

Massachusetts General Hospital

📍 Boston, MA

🏥 NORD

Mayo Clinic Center for Individualized Medicine

Mayo Clinic

📍 Rochester, MN

👤 Mayo Clinic Center for Individualized Medicine

🏥 NORD

UCLA Rare Disease Day Program

UCLA Health

📍 Los Angeles, CA

Travel Grants

No travel grants are currently matched to Pili torti-onychodysplasia syndrome.

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Community

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Caregiver Resources

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Mental Health Support

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Family & Caregiver Grants

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Social Security Disability

Learn how rare disease patients may qualify for SSDI/SSI benefits.

Questions for your doctor

Bring these to your next appointment

  • Q1.What specific type of hair and nail disorder does my child have, and how was the diagnosis confirmed?,Is genetic testing recommended for our family, and what would it tell us?,Are there any treatments or supplements that could improve hair or nail growth?,Will the hair and nail problems get better or worse over time?,What hair care and nail care routines do you recommend?,Should we see a genetic counselor to understand the chances of this condition in future children?,Can you recommend any psychological support resources for coping with the cosmetic effects?

Common questions about Pili torti-onychodysplasia syndrome

What is Pili torti-onychodysplasia syndrome?

Pili torti-onychodysplasia syndrome is an extremely rare genetic condition that affects the hair and nails. The name describes its two main features: "pili torti" refers to hair shafts that are flattened and twisted, making the hair brittle, dry, and prone to breaking easily. "Onychodysplasia" means abnormal development of the nails, which may appear thickened, ridged, discolored, or misshapen. Together, these features point to a problem with how the body builds certain structural proteins, particularly keratin, which is the main building block of both hair and nails. People with this syndrom

How is Pili torti-onychodysplasia syndrome inherited?

Pili torti-onychodysplasia syndrome follows a autosomal recessive inheritance pattern. Genetic counseling can help families understand recurrence risk and testing options.

At what age does Pili torti-onychodysplasia syndrome typically begin?

Typical onset of Pili torti-onychodysplasia syndrome is childhood. Age of onset can vary across affected individuals.