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Ablepharon macrostomia syndrome is an extremely rare multiple congenital malformation syndrome characterized by the association of ablepharon, macrostomia, abnormal external ears, syndactyly of the hands and feet, skin findings (such as dry and coarse skin or redundant folds of skin), absent or sparse hair, genital malformations and developmental delay (in 2/3 of cases). Other reported manifestations include malar hypoplasia, absent or hypoplastic nipples, umbilical abnormalities and growth retardation. It is a mainly sporadic disorder, although a few familial cases having been reported, and it displays significant clinical overlap with Fraser syndrome.
Features include always present findings: Microtia, first degree; and very common findings: Sparse hair, Hypoplastic labia majora, and Wide mouth. 37 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Arms and legs | 4 | Toe syndactyly, Hypoplastic fingernail, Cutaneous finger syndactyly |
TWIST2 function has not been fully characterized.
Ablepharon macrostomia syndrome is associated with mutations in the TWIST2 gene on chromosome 2.
Genetic testing for TWIST2 is available. Testing is considered confirmatory for diagnosis.
Phenotype severity distribution: 1 always present feature, 3 very common features, 14 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for ablepharon macrostomia syndrome.
3 publications have been identified in PubMed for ablepharon macrostomia syndrome. Research spans Case Report / Case Series (100%).
Boza T (2025). [PMID: 39792429](https://pubmed.ncbi.nlm.nih.gov/39792429/). *Orbit*. [Case Report / Case Series]
Zhu GQ (2025). [PMID: 40656194](https://pubmed.ncbi.nlm.nih.gov/40656194/). *Front Pediatr*. [Case Report / Case Series]
Vaishnav YJ (2024). [PMID: 38967579](https://pubmed.ncbi.nlm.nih.gov/38967579/). *Ophthalmic Plast Reconstr Surg*. [Case Report / Case Series]
Data assembled from 6 of 12 sources · Last updated Sep 18, 2026, 6:03 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about ablepharon macrostomia syndrome
Skin
4 |
Dry skin, Redundant skin, Premature skin wrinkling |
Ears | 1 | Hearing loss (hearing impairment) |
Head and neck | 1 | Short upper lip |
Bones and joints | 1 | Hypoplasia of the zygomatic bone |
Brain and nerves | 1 | Delayed speech and language development |