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Crouzon syndrome with acanthosis nigricans (CAN) is a very rare, clinically heterogeneous form of faciocraniostenosis with Crouzon-like features and premature synostosis of cranial sutures (Crouzon disease), associated with acanthosis nigricans (AN).
Features include always present findings: Midface retrusion, Acanthosis nigricans, and Proptosis; and common findings: Hydrocephalus. 9 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Head and neck | 1 | Craniosynostosis |
Brain and nerves | 1 | Hydrocephalus |
Individuals with achondroplasia have short stature with rhizomelic shortening of the limbs, macrocephaly, characteristic facies with frontal bossing and midface retrusion, exaggerated lumbar lordosis, limitation of elbow extension and rotation, genu varum, brachydactyly, and trident appearance of the hands. Excess mobility of the knees, hips, and most other joints is common . Growth. Average adult height for men with achondroplasia is 129.9 ± 6.25 cm (51 inches) and for women, 122.4 ± 5.9 cm (48 inches). There are updated growth charts available for length, weight, head circumference, and height-to-weight ratio . Vosoritide, a C-type natriuretic peptide (CNP) analog, was approved to increase height in individuals with achondroplasia starting at birth. Studies showed an average of 1.
Source: GeneReviews — "Achondroplasia"
FGFR3 encodes fibroblast growth factor receptor 3 (806 aa). Tyrosine-protein kinase that acts as a cell-surface receptor for fibroblast growth factors and plays an essential role in the regulation of cell proliferation, differentiation and apoptosis. Highest expression in Skin Not Sun Exposed Suprapubic (364.5 TPM) and Skin Sun Exposed Lower leg (356.5 TPM).
Crouzon syndrome-acanthosis nigricans syndrome is caused by mutations in the FGFR3 gene on chromosome 4.
FGFR3 is classified as a druggable target (Cell Surface, Clinically Actionable, Drug Resistance, Druggable Genome, Kinase, and Tyrosine Kinase categories) with score 1.6.
Penetrance is 100%; all individuals who have an FGFR3 heterozygous pathogenic variant associated with achondroplasia have the clinical manifestations of the disorder.
Source: GeneReviews — "Achondroplasia"
The clinical and radiologic features that can establish the diagnosis of achondroplasia have been well defined .
The diagnosis of achondroplasia should be suspected in a newborn with the following clinical features; characteristic radiographic features can confirm the diagnosis.
• Clinical features in a newborn
Proximal shortening of the arms
Large head
Narrow chest
Short fingers with a trident configuration
• Radiographic features in a newborn that can establish the diagnosis
Square ilia and horizontal acetabula
Narrow sacrosciatic notch
Proximal radiolucency of the femurs
Generalized metaphyseal abnormality including flaring
Decreasing interpedicular distance caudally
Source: GeneReviews — "Achondroplasia"
While more than 700 skeletal dysplasias are recognized , many are extremely rare, and virtually all have clinical and radiographic features that readily distinguish them from achondroplasia. Conditions that may be confused with achondroplasia are listed in .
Table 3.
Achondroplasia: Differential Diagnosis
Gene(s) | Disorder | MOI | Clinical Characteristics
| Hypochondroplasia | AD | See .
Severe achondroplasia w/developmental delay acanthosis nigricans (SADDAN) (OMIM 616482)
Thanatophoric dysplasia
Source: GeneReviews — "Achondroplasia"
Genetic testing for FGFR3 is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for Crouzon syndrome-acanthosis nigricans syndrome has been reported in the published literature.
No approved treatments are currently available for Crouzon syndrome-acanthosis nigricans syndrome. The disease remains an area of unmet medical need.
Recommendations for health supervision of children with achondroplasia were outlined by the American Academy of Pediatrics Committee on Genetics . These recommendations serve as guidelines and do not replace individual decision making. The review by also provides management recommendations. Specialized skeletal dysplasia clinics exist; their recommendations may vary slightly from these general guidelines. Evaluations Following Initial Diagnosis Clinical manifestations in achondroplasia vary modestly. In order to establish the extent of disease in an individual diagnosed with achondroplasia, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. Achondroplasia: Recommended Evaluations Following Initial Diagnosis
System/Concern | Evaluation | Comment |
|---|---|---|
Growth | Documentation of length, weight, head circumference compared w/achondroplasia-specific growth standards | — |
Hydrocephalus | Brain imaging as soon after diagnosis as possible to assess ventricular size | Neurologic/ Musculoskeletal |
Development | Developmental assessment | To incl motor, adaptive, cognitive, speech-language eval; Eval for early intervention Restrictive pulmonary disease |
Obstructive sleep apnea (OSA) | If polysomnography shows OSA, referral to ENT | Significant OSA can occur w/craniocervical junction stenosis given that it may worsen hypotonia. MRI of craniocervical junction should be obtained in newborn period. |
Hearing |
Source: GeneReviews — "Achondroplasia"
1 trial found
Recommendations for surveillance are incorporated into the American Academy of Pediatrics guidelines . To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations summarized in are recommended. Table 7. Achondroplasia: Recommended Surveillance
System/Concern | Evaluation | Frequency |
|---|---|---|
General | Consider eval w/geneticist or other provider experienced in care of persons w/bone dysplasias. | At least every 6 mos in infants toddlers, annually in children, every 5 yrs in adults |
Growth | Monitor height weight using growth curves standardized for achondroplasia.1 | At each visit Obesity |
Head growth/ Hydrocephalus | Measure occipitofrontal circumference use charts standardized for achondroplasia.5 | At every visit until age ~6 yrs then throughout childhood at well checks clinical genetics visits |
Narrow craniocervical junction | Neurologic exam incl monitoring for signs of cervical myelopathy such as persistent hypotonia, hyperreflexia, clonus, asymmetries on neurologic exam or w/function | At every visit in infancy childhood Development |
Restrictive pulmonary disease | Assess for persistent tachypnea, poor weight gain, or evidence of respiratory failure. | At each visit throughout infancy |
Source: GeneReviews — "Achondroplasia"
Phenotype severity distribution: 3 always present features, 1 common feature.
Estimated prevalence: Unknown (Unknown prevalence).
1 clinical trial registered, 1 recruiting. Interventions under study include other interventions. Research is primarily sponsored by academic and government institutions.
128 publications have been identified in PubMed for Crouzon syndrome-acanthosis nigricans syndrome. Research spans Review / Meta-Analysis (70%), Basic Science / Preclinical (14%), and Epidemiology / Natural History (9%).
Research Type | Count | % of Total |
|---|---|---|
Research summaries | 89 | 70% |
Laboratory research | 18 | 14% |
Disease patterns and progression | 11 | 9% |
Other research | 4 | 3% |
Patient case studies | 4 | 3% |
Testing and diagnosis research | 2 | 2% |
Buel KL (2026). [PMID: 41569909](https://pubmed.ncbi.nlm.nih.gov/41569909/). *FP Essent*. [Review / Meta-Analysis]
Papazachariou A (2026). [PMID: 41128447](https://pubmed.ncbi.nlm.nih.gov/41128447/). *Curr Opin Clin Nutr Metab Care*. [Review / Meta-Analysis]
Anderson EN (2026). [PMID: 41468891](https://pubmed.ncbi.nlm.nih.gov/41468891/). *Am J Hum Genet*. [Basic Science / Preclinical]
Amado C (2026). [PMID: 40975490](https://pubmed.ncbi.nlm.nih.gov/40975490/). *Ann Allergy Asthma Immunol*. [Review / Meta-Analysis]
Onur H (2026). [PMID: 42084887](https://pubmed.ncbi.nlm.nih.gov/42084887/). *Turk Arch Pediatr*. [Basic Science / Preclinical]
Robinson KR (2025). [PMID: 41056948](https://pubmed.ncbi.nlm.nih.gov/41056948/). *Am J Hum Genet*. [Basic Science / Preclinical]
Brokke KE (2025). [PMID: 40634186](https://pubmed.ncbi.nlm.nih.gov/40634186/). *Br J Anaesth*. [Review / Meta-Analysis]
Kaul A (2025). [PMID: 40915300](https://pubmed.ncbi.nlm.nih.gov/40915300/). *Lancet Rheumatol*. [Review / Meta-Analysis]
He C (2025). [PMID: 40249538](https://pubmed.ncbi.nlm.nih.gov/40249538/). *Aging Clin Exp Res*. [Epidemiology / Natural History]
Kröll-Hermi A (2025). [PMID: 41260215](https://pubmed.ncbi.nlm.nih.gov/41260215/). *Am J Hum Genet*. [Basic Science / Preclinical]
Data assembled from 9 of 12 sources · Last updated Sep 20, 2026, 4:38 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Common questions about Crouzon syndrome-acanthosis nigricans syndrome
— |
Genetic counseling | By genetics professionals3 | To obtain a pedigree inform affected persons their families re nature, MOI, implications of achondroplasia to facilitate medical personal decision making Family support |
resources | By clinicians, wider care team, family support organizations | Assessment of family social structure to determine need for:; Community or; Social work involvement for parental support AFMS = Achondroplasia Foramen Magnum Score; ENT = otolaryngology; MOI = mode of inheritance; OSA = obstructive sleep apnea; SD = standard deviation 1. 2. |
Achondroplasia: Targeted Therapy Treatment | Dosage | Consideration |
Vosoritide(C-type natriuretic peptide analog) | 15-30 g/kg subcutaneously daily depending on age | To height in children w/achondroplasia until growth plates close1; Injections should be given after a meal drinking 8-12 oz of fluids to minimize hypotension. In younger children, give after a feeding. Phase III studies showed an increase in annualized growth velocity of 1. |