What is Hailey-Hailey disease?
Hailey-Hailey disease is also known as familial benign chronic
pemphigus. It is a rare inherited skin condition, in which red scaly
areas or small blisters appear at sites of friction.
What causes Hailey-Hailey disease?
A small error in the DNA code for a gene on chromosome number 3
(one of the 46 chromosomes that we all have) has been shown to cause
Hailey-Hailey disease. Normally this gene plays a part in ensuring that
the cells in the outer layer of the skin (the epidermis) stick together
properly. In Hailey-Hailey disease, this adhesion of cells is impaired,
resulting in separation of the cells in the epidermis, especially in
areas of skin prone to friction such as the groin and under the arms.
The altered gene runs in families and affects both men and women.
Hailey-Hailey disease is not contagious, or a result of allergies. There
is a tendency for Hailey-Hailey disease to get worse with sweating and
friction, as well as in hot weather.
Is Hailey-Hailey disease hereditary?
Yes – see above. The condition is inherited in a pattern known as
'dominant inheritance', which means that there is a 1 in 2 [50:50]
chance that each child of an affected parent will inherit the skin
problem.
What are the symptoms of Hailey-Hailey disease?
Affected skin may become uncomfortable and itchy if the skin
surfaces are continually rubbing against each other, such as in the
groin when walking. Outbreaks tend to settle down in a few days with
appropriate treatment (see below), and may improve without treatment.
Very rarely, a severe flare-up in an area such as the groin, genital
area or in the crease of the buttocks may make walking and working so
uncomfortable that a patient might need a few days rest.
What does Hailey-Hailey disease look like?
The first signs of the condition usually appear between the ages of
15 and 40 years, but it may begin outside this age range. The severity
varies enormously and is unpredictable. Red, scaly areas or small
blisters appear at areas of friction, especially at the sides of the
neck or in the skin folds under the arms, the groin or under the
breasts. The skin looks entirely normal inbetween active episodes, and
does not scar. Many patients notice that their condition improves as
they get older.
How will Hailey-Hailey disease be diagnosed?
It is very common for the condition to be mistaken for eczema,
contact dermatitis (due to an allergy), a sweat rash, a fungal infection
or impetigo (a bacterial skin infection). If required, the diagnosis of
Hailey-Hailey disease can be confirmed by examining a sample of the
skin (a biopsy) under the microscope.
Can Hailey-Hailey disease be cured?
No. The underlying genetic defect cannot be altered; however, treatment does help and long remissions are common.
For further information about Hailey-Hailey disease please see this page on the website of the British Association of Dermatologists
http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/HaileyHaileydisease.aspx
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