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A rare congenital developmental disorder characterized by the presence of stippled foci of calcification in the hyaline cartilage, joint contractions, mental retardation and ichthyosis.
No HPO annotations are available for this condition.
Age of onset: before birth.
NSDHL-related disorders include CHILD (congenital hemidysplasia with ichthyosiform nevus and limb defects) syndrome, an X-linked disorder that is usually male lethal during gestation and thus predominantly affects females; and CK syndrome, an X-linked disorder that affects males.
For the purposes of this GeneReview, the terms "male" and "female" are narrowly defined as the individual's biological sex at birth as it determines clinical care . No consensus clinical diagnostic criteria for NSDHL-related disorders have been published.
An NSDHL-related disorder should be suspected in an individual with features of CHILD (congenital hemidysplasia with ichthyosiform nevus [also known as ichthyosiform erythroderma] and limb defects) syndrome (typically in females) or CK syndrome (intellectual disability and associated features in males) as follows.
No approved treatments are currently available for chondrodysplasia punctata. The disease remains an area of unmet medical need.
No clinical practice guidelines for NSDHL-related disorders have been published. In the absence of published guidelines, the following recommendations are based on the authors' personal experience managing individuals with CHILD syndrome and CK syndrome.
CHILD syndrome. To establish the extent of disease and needs in an individual diagnosed with CHILD syndrome, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations summarized in and are recommended. Table 6a. CHILD Syndrome: Recommended Surveillance
2 clinical trials registered, 2 recruiting. Interventions under study include other interventions. Research is primarily sponsored by academic and government institutions.
40 publications have been identified in PubMed for chondrodysplasia punctata. Research spans Case Report / Case Series (54%), Basic Science / Preclinical (19%), and Epidemiology / Natural History (8%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 20 | 54% |
Data assembled from 5 of 12 sources · Last updated Sep 18, 2026, 8:31 PM UTC
European rare disease database
Genetic and Rare Diseases Info Center
Dermatologic findings
Source: GeneReviews — "NSDHL-Related Disorders"
Source: GeneReviews — "NSDHL-Related Disorders"
Table 2.
Genes of Interest in the Differential Diagnosis of CHILD Syndrome
Gene(s) | Disorder | MOI | Key Features of Disorder
Overlapping w/CHILD syndrome | Distinguishing from CHILD syndrome
EBP | Chondrodysplasia punctata 2, X-linked | XL | • ≥95% of affected persons are female.
Linear or blotchy scaly ichthyosiform plaques in newborns; later appearance of linear or whorled atrophic patches involving hair follicles (follicular atrophoderma) scarring
Asymmetric limb shortening, kyphoscoliosis, chondrodysplasia punctata (epiphyseal stippling)
| • Absence of strict midline demarcation lack of unilaterality seen in CHILD syndrome
Skin findings fade over time.
Most persons have follicular atrophoderma by age 2 yrs.
Ocular anomalies are prominent (develop early in life).
HRAS
KRAS
Source: GeneReviews — "NSDHL-Related Disorders"
Biomarker and diagnostic research for chondrodysplasia punctata has been reported in the published literature.
Table 4a.
CHILD Syndrome: Recommended Evaluations Following Initial Diagnosis
System/Concern | Evaluation | Comment
| Dermatologic eval |
| • Radiographs as needed of extremities spine
Clinical assessment for joint contractures scoliosis
Referral to orthopedist as needed
| Evaluate for skeletal malformations incl scoliosis.
| • Referral to neurologist
EEG
Brain MRI/CT
|
Developmental assessment | • To incl motor, adaptive, cognitive, speech-language eval
Eval for early intervention/ special education
| Echocardiogram | Evaluate for congenital heart disease.
| Chest imaging | Evaluate for lung hypoplasia.
| Abdominal pelvic ultrasound | Evaluate for renal or other genitourinary anomalies.
| By genetics professionals1 | To obtain a pedigree inform affected persons their families re nature, MOI, implications of CHILD syndrome to facilitate medical personal decision making
MOI = mode of inheritance
Source: GeneReviews — "NSDHL-Related Disorders"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "NSDHL-Related Disorders"
2 trials found
Evaluation |
|---|
Frequency |
|---|
Integument | Examine for new cutaneous manifestations; new lesions may occur in puberty or early adulthood. | As needed Musculoskeletal |
CK Syndrome: Recommended Surveillance System/Concern | Evaluation | Frequency |
Developmental | Monitor developmental progress educational needs. | Annually or as needed Neurobehavioral/ Psychiatric |
Ophthalmologic | Follow-up ophthalmology exam | As recommended by ophthalmologist |
Transition to adult care | Develop realistic plans for adult life (see American Epilepsy Society Transitions from Pediatric Epilepsy to Adult Epilepsy Care). | Starting by age ~10 yrs ADHD = attention-deficit/hyperactivity disorder |
Source: GeneReviews — "NSDHL-Related Disorders"
Laboratory research |
7 |
19% |
Disease patterns and progression | 3 | 8% |
Testing and diagnosis research | 2 | 5% |
Research summaries | 2 | 5% |
Clinical study results | 2 | 5% |
Other research | 1 | 3% |
Zhou SY (2026). [PMID: 41940214](https://pubmed.ncbi.nlm.nih.gov/41940214/). *Obstet Med*. [Review / Meta-Analysis]
Ahangari N (2026). [PMID: 41787707](https://pubmed.ncbi.nlm.nih.gov/41787707/). *Annals of pediatric endocrinology & metabolism*. [Basic Science / Preclinical]
Villarreal EG (2026). [PMID: 41735768](https://pubmed.ncbi.nlm.nih.gov/41735768/). *The Laryngoscope*. [Case Report / Case Series]
A R (2026). [PMID: 42173544](https://pubmed.ncbi.nlm.nih.gov/42173544/). *BMJ Case Rep*. [Case Report / Case Series]
Deng Q (2026). [PMID: 42170480](https://pubmed.ncbi.nlm.nih.gov/42170480/). *Am J Transl Res*. [Case Report / Case Series]
Maddaluno M (2026). [PMID: 42103217](https://pubmed.ncbi.nlm.nih.gov/42103217/). *J Biol Chem*. [Basic Science / Preclinical]
Matsuda R (2026). [PMID: 42104561](https://pubmed.ncbi.nlm.nih.gov/42104561/). *J Paediatr Child Health*. [Case Report / Case Series]
Morishima N (2026). [PMID: 42203567](https://pubmed.ncbi.nlm.nih.gov/42203567/). *Pediatr Neonatol*. [Diagnostic / Biomarker]
Shi X (2025). [PMID: 40193659](https://pubmed.ncbi.nlm.nih.gov/40193659/). *Medicine*. [Case Report / Case Series]
Otsuka K (2025). [PMID: 40112088](https://pubmed.ncbi.nlm.nih.gov/40112088/). *JBJS case connector*. [Case Report / Case Series]