Autosomal dominant palmoplantar keratoderma and congenital alopecia

Summary

Autosomal dominant palmoplantar keratoderma and congenital alopecia (MONDO:0007083) is a disease caused by GJA1 (GenCC Strong), with 1 cohort gene.

At a glance

• Prevalence: <1 / 1 000 000 (Worldwide) [Orphanet-validated]
• Causal gene: GJA1 (GenCC Strong)
• Cohort genes: 1
• ClinVar variants: 9
• Phenotypes (HPO): 25

Clinical features

Epidemiology

Prevalence records

2 prevalence record(s), Orphanet:

Type	Class	Value	Geography	Validation
Cases/families		10	Worldwide	Validated
Point prevalence	<1 / 1 000 000		Worldwide	Validated

Signs & symptoms

Clinical features (HPO)

25 HPO clinical features (Orphanet curated; top 25 by frequency):

HPO ID	Term	Frequency
HP:0000653	Sparse eyelashes	Very frequent (80-99%)
HP:0000982	Palmoplantar keratoderma	Very frequent (80-99%)
HP:0001597	Abnormality of the nail	Very frequent (80-99%)
HP:0002209	Sparse scalp hair	Very frequent (80-99%)
HP:0008404	Nail dystrophy	Very frequent (80-99%)
HP:0045075	Sparse eyebrow	Very frequent (80-99%)
HP:0000958	Dry skin	Frequent (30-79%)
HP:0001807	Ridged nail	Frequent (30-79%)
HP:0004528	Generalized hypotrichosis	Frequent (30-79%)
HP:0010491	Digital constriction ring	Frequent (30-79%)
HP:0011838	Sclerodactyly	Frequent (30-79%)
HP:0012785	Flexion contracture of finger	Frequent (30-79%)
HP:0032152	Keratosis pilaris	Frequent (30-79%)
HP:0001041	Facial erythema	Occasional (5-29%)
HP:0001058	Poor wound healing	Occasional (5-29%)
HP:0002223	Absent eyebrow	Occasional (5-29%)
HP:0002298	Absent hair	Occasional (5-29%)
HP:0002435	Meningocele	Occasional (5-29%)
HP:0009886	Trichorrhexis nodosa	Occasional (5-29%)
HP:0009900	Unilateral deafness	Occasional (5-29%)
HP:0031057	Skin fissure	Occasional (5-29%)
HP:0040189	Scaling skin	Occasional (5-29%)
HP:0100018	Nuclear cataract	Occasional (5-29%)
HP:0000613	Photophobia	Very rare (<1-4%)
HP:0001250	Seizure	Very rare (<1-4%)

Identifiers

Disease identifiers

Field	Value
Canonical name	autosomal dominant palmoplantar keratoderma and congenital alopecia
Mondo ID	MONDO:0007083
OMIM	104100
Orphanet	1010
DOID	DOID:0111244
ICD-11	1745113656
SNOMED CT	719518004
UMLS	C4304669
MedGen	930338
GARD	0000604
Is cancer (heuristic)	no

Also known as: alopecia congenita with hyperkeratosis of the palms and soles · autosomal dominant palmoplantar hyperkeratosis and congenital alopecia · palmoplantar keratoderma and congenital alopecia 1 · palmoplantar keratoderma and congenital alopecia type 1 · palmoplantar keratoderma and congenital alopecia, Stevanovic type · palmoplantar keratoderma with congenital alopecia · PPK-CA, Stevanovic type · PPKCA1

Data availability: 9 ClinVar variants · 4 GenCC gene-disease records.

Disease family

Classification path: disease › human disease › disease by body system or component › integumentary system disorder › skin disorder › keratosis › palmoplantar keratosis › hereditary palmoplantar keratoderma › diffuse palmoplantar keratoderma › autosomal dominant palmoplantar keratoderma and congenital alopecia

Related subtypes (31): dermatopathia pigmentosa reticularis, Clouston syndrome, epidermolytic palmoplantar keratoderma, 1, palmoplantar keratoderma-deafness syndrome, palmoplantar keratoderma-hereditary motor and sensory neuropathy syndrome, keratosis palmaris et plantaris-clinodactyly syndrome, Bart-Pumphrey syndrome, Naegeli-Franceschetti-Jadassohn syndrome, palmoplantar keratoderma-sclerodactyly syndrome, autosomal recessive palmoplantar keratoderma and congenital alopecia, Schöpf-Schulz-Passarge syndrome, hereditary palmoplantar keratoderma, Gamborg-Nielsen type, Papillon-Lefevre disease, Haim-Munk syndrome, mal de Meleda, odonto-onycho-dermal dysplasia, palmoplantar keratoderma, Bothnian type, diffuse nonepidermolytic palmoplantar keratoderma, loricrin keratoderma, skin fragility-woolly hair-palmoplantar keratoderma syndrome, Curly hair - acral keratoderma - caries syndrome, CEDNIK syndrome, palmoplantar keratoderma-XX sex reversal-predisposition to squamous cell carcinoma syndrome, corneal intraepithelial dyskeratosis-palmoplantar hyperkeratosis-laryngeal dyskeratosis syndrome, hypohidrosis-enamel hypoplasia-palmoplantar keratoderma-intellectual disability syndrome, palmoplantar keratoderma, Nagashima type, erythrokeratodermia variabilis, diffuse palmoplantar keratoderma with painful fissures, KID syndrome, diffuse palmoplantar keratoderma - acrocyanosis syndrome, hearing loss with skin disease

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

9 retrieved; paginated sample, class counts are floors:

6 uncertain significance, 2 pathogenic, 1 conflicting classifications of pathogenicity

ClinVar	Variant (HGVS)	Gene	Classification	Review
203467	NM_000165.5(GJA1):c.23G>T (p.Gly8Val)	GJA1	Pathogenic	no assertion criteria provided
435323	NM_000165.5(GJA1):c.119C>T (p.Ala40Val)	GJA1	Pathogenic	criteria provided, multiple submitters, no conflicts
16991	NM_000165.5(GJA1):c.1127G>A (p.Arg376Gln)	GJA1	Conflicting classifications of pathogenicity	criteria provided, conflicting classifications
1050474	NM_000165.5(GJA1):c.932del (p.Ala311fs)	GJA1	Uncertain significance	criteria provided, multiple submitters, no conflicts
1206770	NM_000165.5(GJA1):c.1039C>A (p.Leu347Ile)	GJA1	Uncertain significance	criteria provided, multiple submitters, no conflicts
2185470	NM_000165.5(GJA1):c.826G>A (p.Ala276Thr)	GJA1	Uncertain significance	criteria provided, multiple submitters, no conflicts
3592998	NM_000165.5(GJA1):c.305A>T (p.Lys102Met)	GJA1	Uncertain significance	criteria provided, multiple submitters, no conflicts
3779697	NM_000165.5(GJA1):c.137G>C (p.Gly46Ala)	GJA1	Uncertain significance	criteria provided, single submitter
4796597	NM_000165.5(GJA1):c.488C>G (p.Ser163Cys)	GJA1	Uncertain significance	criteria provided, single submitter

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 25 · Orphanet: 7 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

Gene	Classification	Inheritance	Disease	Records
GJA1	Strong	Autosomal dominant	autosomal dominant palmoplantar keratoderma and congenital alopecia	25

Orphanet rare-disease linkage (cohort genes)

Gene	Orphanet ID	Rare disease
GJA1	Orphanet:1010	Autosomal dominant palmoplantar keratoderma and congenital alopecia
GJA1	Orphanet:1522	Craniometaphyseal dysplasia
GJA1	Orphanet:2248	Hypoplastic left heart syndrome
GJA1	Orphanet:2710	Oculodentodigital dysplasia
GJA1	Orphanet:317	Erythrokeratodermia variabilis
GJA1	Orphanet:90636	Rare autosomal recessive non-syndromic sensorineural deafness type DFNB
GJA1	Orphanet:93404	Syndactyly type 3

Cohort genes → proteins

1 cohort genes, 1 distinct canonical proteins.

Evidence partition

Subset	Genes
multi_evidence	1

Cohort genes (full)

Symbol	HGNC	Ensembl	UniProt	Name	Evidence
GJA1	HGNC:4274	ENSG00000152661	P17302	Gap junction alpha-1 protein	gencc,clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

Symbol	Protein name	Function (lead sentence)
GJA1	Gap junction alpha-1 protein	Structural component of the gap junction, a specialized intercellular structure consisting of a cluster of closely packed pairs of transmembrane channels, the connexons, that allow passage of small molecules and electrical signals between…

Protein-family classification

Druggable: 0 · Difficult: 0 · Unknown: 1 · Druggable fraction: 0.0

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

Family	Genes	Fold	FDR
Other/Unknown	1	1.8×	0.558

Per-gene assignment

Symbol	Family	Druggable?	EC	InterPro (top 3)
GJA1	Other/Unknown	no		Connexin, Connexin43, Connexin_N

Expression context

Cohort genes with no expression data: 0.

1 cohort gene are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

Bucket	Genes
narrow (1-5 tissues)	0
moderate (6-20)	0
broad (>20)	1
unknown	0

Top tissues across cohort

Tissue	Cohort genes
dorsal motor nucleus of vagus nerve	1
hair follicle	1
lateral globus pallidus	1

Per-gene tissue summary (top 30)

Symbol	Bgee breadth	FANTOM5 breadth	SCXA	Top tissues
GJA1	292	ubiquitous	marker	lateral globus pallidus, dorsal motor nucleus of vagus nerve, hair follicle

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

Symbol	Interactor count
GJA1	4,942

Structural data

PDB: 1 · AlphaFold-only: 0 · No structure: 0

Cohort genes with PDB structures (top 30)

Symbol	UniProt	PDB entries
GJA1	P17302	19

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 11. Enrichment computed across 1 evidence-associated genes (1 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

Pathway	Cohort genes	Fold	FDR	Sample cohort genes
Oligomerization of connexins into connexons	1	3806.7×	1e-03	GJA1
Transport of connexins along the secretory pathway	1	3806.7×	1e-03	GJA1
Regulation of gap junction activity	1	3806.7×	1e-03	GJA1
SARS-CoV-2 targets PDZ proteins in cell-cell junction	1	2284.0×	0.001	GJA1
Formation of annular gap junctions	1	1038.2×	0.002	GJA1
Gap junction degradation	1	951.7×	0.002	GJA1
Mechanical load activates signaling by PIEZO1 and integrins in osteocytes	1	671.8×	0.002	GJA1
Microtubule-dependent trafficking of connexons from Golgi to the plasma membrane	1	543.8×	0.003	GJA1
Gap junction assembly	1	292.8×	0.004	GJA1
RHOJ GTPase cycle	1	200.3×	0.005	GJA1
RHOQ GTPase cycle	1	181.3×	0.006	GJA1

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 1 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO term	Cohort genes	Fold	FDR	Sample cohort genes
microtubule-based transport	1	16852.0×	9e-04	GJA1
positive regulation of mesodermal cell differentiation	1	16852.0×	9e-04	GJA1
negative regulation of gonadotropin secretion	1	8426.0×	0.001	GJA1
positive regulation of morphogenesis of an epithelium	1	5617.3×	0.001	GJA1
cell communication by electrical coupling	1	4213.0×	0.001	GJA1
negative regulation of trophoblast cell migration	1	2407.4×	0.002	GJA1
gap junction assembly	1	2106.5×	0.002	GJA1
glutamate secretion	1	1685.2×	0.002	GJA1
atrial cardiac muscle cell action potential	1	1685.2×	0.002	GJA1
export across plasma membrane	1	1685.2×	0.002	GJA1
cell communication by electrical coupling involved in cardiac conduction	1	1404.3×	0.002	GJA1
cardiac conduction system development	1	1053.2×	0.002	GJA1
bone remodeling	1	936.2×	0.002	GJA1
xenobiotic transport	1	842.6×	0.003	GJA1
positive regulation of stem cell proliferation	1	526.6×	0.004	GJA1
establishment of mitotic spindle orientation	1	481.5×	0.004	GJA1
maintenance of blood-brain barrier	1	481.5×	0.004	GJA1
positive regulation of vascular associated smooth muscle cell proliferation	1	432.1×	0.004	GJA1
cellular response to amyloid-beta	1	391.9×	0.004	GJA1
bone development	1	276.3×	0.005	GJA1
monoatomic ion transmembrane transport	1	208.1×	0.007	GJA1
positive regulation of cold-induced thermogenesis	1	163.6×	0.008	GJA1
negative regulation of cell growth	1	144.0×	0.009	GJA1
intracellular protein localization	1	104.7×	0.012	GJA1
heart development	1	78.8×	0.015	GJA1
positive regulation of canonical NF-kappaB signal transduction	1	72.6×	0.016	GJA1
cell-cell signaling	1	69.6×	0.016	GJA1
positive regulation of gene expression	1	38.7×	0.028	GJA1
spermatogenesis	1	35.2×	0.029	GJA1
signal transduction	1	16.1×	0.062	GJA1

Therapeutics

Drug target analysis

Approved (phase 4): 1 · Phase ≥3: 1 · Phased (≥1): 1 · Undrugged: 0

Druggability breadth: 1 of 1 evidence-associated genes (100%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

Symbol	Example approved molecule
GJA1	KANAMYCIN

Top cohort targets by molecule count

Symbol	Molecules	Max phase
GJA1	1	4

Drugs targeting cohort genes (top 30)

Molecule	Max phase	Targets in cohort
KANAMYCIN	4	GJA1

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

Symbol	Assays	Type breakdown
GJA1	4	Binding:4

Pharmacogenomics

Cohort genes with a PharmGKB record: 1; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

1 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Compound	Max phase	Cohort target (bioactivity)
KANAMYCIN	4	GJA1

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

Tier	Definition	Genes	Symbols
A	Approved (phase 4 drug)	1	GJA1
B	Phased (≥1) drug, not yet approved	0
C	Druggable family + PDB, no drug	0
D	Druggable family + AlphaFold only, no drug	0
E	Difficult family or no structure, no drug	0

Undrugged target profiles

0 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

Clinical trials & evidence

Clinical trials

Clinical trials: 0.