Abul Khair Zalan, Khadeejah Khalil Zubairy, Anser Maxood, Manahil Niazi, Hira Zaman, Anika Gul, Miraat Anser.
Papillon lefevre syndrome: diagnosis and management in two affected siblings - a case report.
J Pak Dent Assoc Jan ;29(4):264-8.

Papillon-Lefevre syndrome (PLS) an autosomal recessive disorder characterized by diffuse transgradient palmar-plantar hyperkeratosis, with premature loss of deciduous and permanent teeth, along with the calcification of the dura mater. This results in teeth radiographically appearing as "floating" in the soft tissue. Genetic studies of patients with PLS have mapped the major gene locus to chromosome 11q24-q21 and revealed mutation and loss of function of the cathepsin gene. It affects 1- 4 people per 1 million population with no gender or racial predilection. Dermatological manifestations, usually occurs before four years of age, include hyperkeratosis of palms and soles, nail dystrophy, hyperhidrosis and keratinization on elbows and knees with the lesions appearing as white, yellow-like or red plaques or patches that then develop cracks, crusts, or deep fissures.

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