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Lipoid proteinosis (LP) is a rare genodermatosis characterized clinically by mucocutaneous lesions, hoarseness developing in early childhood and, at times, neurological complications.
Data assembled from 7 of 12 sources · Last updated Oct 3, 2026, 2:28 PM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Features include always present findings: Multiple eyelid beaded papules and Hoarse voice; and very common findings: Scarring. 20 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Skin | 8 | Patchy alopecia, Thickened skin, Multiple eyelid beaded papules |
Brain and nerves | 6 | Memory problems (memory impairment), Seizure, Generalized non-motor (absence) seizure |
Age of onset: infancy.
Lipoid proteinosis (LP) is characterized by deposition of hyaline-like material that results in a hoarse voice from early infancy and characteristic skin lesions. To date, more than 400 individuals have been identified with biallelic pathogenic variants in ECM1 . The following description of the phenotypic features associated with this condition is based on these reports. Table 2. Lipoid Proteinosis: Frequency of Select Features Feature | Frequency
In nearly all | Common | Infrequent |
|---|---|---|
Hoarse voice | Severe dysphonia /or complete aphonia | Breathing difficulties |
Moniliform blepharosis | Hyperkeratotic verrucous lesions | Patchy diffuse alopecia |
Source: GeneReviews — "Lipoid Proteinosis"
ECM1 encodes extracellular matrix protein 1 (540 aa). Involved in endochondral bone formation as negative regulator of bone mineralization. Stimulates the proliferation of endothelial cells and promotes angiogenesis. Inhibits MMP9 proteolytic activity Highest expression in Esophagus Mucosa (987.1 TPM) and Vagina (235.0 TPM).
Lipoid proteinosis is associated with mutations in the ECM1 gene on chromosome 1.
ECM1 is classified as a druggable target (Druggable Genome category) with score 0.0.
No ECM1 genotype-phenotype correlations have been identified .
Source: GeneReviews — "Lipoid Proteinosis"
Lipoid proteinosis (LP), which is characterized by deposition of hyaline-like material in the larynx, oral cavity, skin, and internal organs, should be suspected in individuals with the following clinical manifestations, neuroimaging findings and family history. Clinical manifestations (in order of their importance for diagnosis):
Source: GeneReviews — "Lipoid Proteinosis"
Table 3.
Genes and Disorders of Interest in the Differential Diagnosis of Lipoid Proteinosis
Gene | Disorder | MOI | Overlapping Features | Distinguishing Features
| Pseudoxanthoma elasticum (PXE) | AR | Some skin changes in LP (e.g., yellowish papules seen on the neck) are reminiscent of those in PXE. | Ocular manifestations are different:
LP is characterized by moniliform blepharosis.
PXE is characterized by subretinal neovascularization w/hemorrhage that can cause significant visual impairment.
FECH | Autosomal recessive erythropoietic protoporphyria (EPP) | AR | The early vesicular lesions in LP can resemble those in EPP. |
Source: GeneReviews — "Lipoid Proteinosis"
Genetic testing for ECM1 is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for lipoid proteinosis has been reported in the published literature.
No approved treatments are currently available for lipoid proteinosis. The disease remains an area of unmet medical need.
No clinical practice guidelines for lipoid proteinosis (LP) have been published. Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with LP, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. Recommended Evaluations Following Initial Diagnosis in Individuals with Lipoid Proteinosis (LP)
System/Concern | Evaluation | Comment |
|---|---|---|
Skin lesions | Dermatologist | Assess for hemorrhagic or crusting lesions. |
Upper airway | Otolaryngologist | Assess for airway obstruction assoc w/vocal cord infiltration. |
Epilepsy | Neurologist | If clinical findings suggest seizures Neuropsychiatric |
disorders | Neurobehavioral testing | Assess for memory impairment, hallucinations, paranoia, aggressive behavior. Brain MRI |
counseling | By genetics professionals1 | To inform patients families re nature, MOI, implications of LP in order to facilitate medical personal decision making Family support resources |
Source: GeneReviews — "Lipoid Proteinosis"
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 — "Lipoid Proteinosis"
View trials for lipoid proteinosis
Table 6.
Recommended Surveillance for Individuals with Lipoid Proteinosis (LP)
System/Concern | Evaluation | Frequency
| Otolaryngologist assessment of airway vocal cords | Every 6 mos
Cutaneous papules
plaques | Dermatologic exams
| Neurologic eval | Annually
Neuropsychiatric
disorders | Monitor for emotional cognitive development.
Source: GeneReviews — "Lipoid Proteinosis"
Phenotype severity distribution: 2 always present features, 1 very common feature, 2 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for lipoid proteinosis.
30 publications have been identified in PubMed for lipoid proteinosis. Research spans Case Report / Case Series (80%), Review / Meta-Analysis (10%), and Diagnostic / Biomarker (3%).
Research Type | Count | % of Total |
|---|---|---|
Patient case studies | 24 | 80% |
Research summaries | 3 | 10% |
Testing and diagnosis research | 1 | 3% |
Clinical study results | 1 | 3% |
New treatment approaches | 1 | 3% |
Yang Y (2026). [PMID: 41562451](https://pubmed.ncbi.nlm.nih.gov/41562451/). *J Craniofac Surg*. [Case Report / Case Series]
Baltaci MA (2026). [PMID: 41693020](https://pubmed.ncbi.nlm.nih.gov/41693020/). *Rheumatology (Oxford)*. [Diagnostic / Biomarker]
LeWitt TM (2026). [PMID: 33760528](https://pubmed.ncbi.nlm.nih.gov/33760528/). *Unknown Journal*. [Review / Meta-Analysis]
Demofonte I (2026). [PMID: 40391438](https://pubmed.ncbi.nlm.nih.gov/40391438/). *Dermatol Reports*. [Case Report / Case Series]
Xu S (2026). [PMID: 41927423](https://pubmed.ncbi.nlm.nih.gov/41927423/). *Oral Surg Oral Med Oral Pathol Oral Radiol*. [Case Report / Case Series]
Van Alfen B (2025). [PMID: 40351997](https://pubmed.ncbi.nlm.nih.gov/40351997/). *Cureus*. [Case Report / Case Series]
An İ (2025). [PMID: 38876475](https://pubmed.ncbi.nlm.nih.gov/38876475/). *Int J Dermatol*. [Clinical Trial Publication]
Ng XG (2025). [PMID: 40385837](https://pubmed.ncbi.nlm.nih.gov/40385837/). *Cureus*. [Case Report / Case Series]
Ashby N (2025). [PMID: 40262684](https://pubmed.ncbi.nlm.nih.gov/40262684/). *J AAPOS*. [Case Report / Case Series]
Gowda SK (2025). [PMID: 41311674](https://pubmed.ncbi.nlm.nih.gov/41311674/). *SAGE Open Med Case Rep*. [Case Report / Case Series]
Treatment of Manifestations in Individuals with Lipoid Proteinosis (LP) Manifestation/Concern |
Treatment |
Considerations/Other |
Airway obstruction | Microlaryngoscopic excision of laryngeal deposits | Improves airway access voice quality Tracheostomy |
plaques | Oral dimethylsulfoxide, D-penicillamine, oral retinoid (e.g., acitretin) | For skin softening concomitant amelioration of mucosal lesions hoarseness |
Seizures | ASM as determined by neurologist | Some persons are resistant to ASMs.; Successful treatment w/ASMs incl Tegretol® Keppra® has been reported . ASM = anti-seizure medication Surveillance Table 6. |
Recommended Surveillance for Individuals with Lipoid Proteinosis (LP) System/Concern | Evaluation | Frequency |
Airway obstruction | Otolaryngologist assessment of airway vocal cords | Every 6 mos Cutaneous papules plaques |
Seizures | Neurologic eval | Annually Neuropsychiatric disorders |