Epidermolysis bullosa simplex with nail dystrophy

disease
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Also known as EBSNDepidermolysis bullosa simplex 5D, generalised intermediate, autosomal recessiveepidermolysis bullosa simplex 5D, generalized intermediate, autosomal recessive

Summary

Epidermolysis bullosa simplex with nail dystrophy (MONDO:0014661) is a disease with 13 cohort genes.

At a glance

  • Cohort genes: 13
  • ClinVar variants: 5,755

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nameepidermolysis bullosa simplex with nail dystrophy
Mondo IDMONDO:0014661
OMIM616487
UMLSC4225309
MedGen906476
GARD0025010
Is cancer (heuristic)no

Also known as: EBSND · epidermolysis bullosa simplex 5D, generalised intermediate, autosomal recessive · epidermolysis bullosa simplex 5D, generalized intermediate, autosomal recessive · epidermolysis bullosa simplex with nail dystrophy

Data availability: 5,755 ClinVar variants.

Disease family

Classification path: disease › human disease › disease by body system or component › integumentary system disorder › skin disordervesiculobullous skin diseaseepidermolysis bullosainherited epidermolysis bullosaepidermolysis bullosa simplexepidermolysis bullosa simplex with nail dystrophy

Related subtypes (19): epidermolysis bullosa simplex 1A, generalized severe, epidermolysis bullosa simplex 1C, localized, epidermolysis bullosa simplex 1B, generalized intermediate, epidermolysis bullosa simplex 5A, Ogna type, epidermolysis bullosa simplex 2F, with mottled pigmentation, epidermolysis bullosa simplex 5B, with muscular dystrophy, epidermolysis bullosa simplex 1D, generalized, intermediate or severe, autosomal recessive, epidermolysis bullosa simplex 7, with nephropathy and deafness, epidermolysis bullosa simplex 2E, with migratory circinate erythema, epidermolysis bullosa simplex 5C, with pyloric atresia, epidermolysis bullosa simplex 4, localized or generalized intermediate, autosomal recessive, epidermolysis bullosa simplex 3, localized or generalized intermediate, with BP230 deficiency, epidermolysis bullosa simplex 6, generalized, with scarring and hair loss, suprabasal epidermolysis bullosa simplex, epidermolysis bullosa simplex with anodontia/hypodontia, epidermolysis bullosa simplex 2A, generalized severe, epidermolysis bullosa simplex 2B, generalized intermediate, epidermolysis bullosa simplex 2C, localized, epidermolysis bullosa simplex 2d, generalized, intermediate or severe, autosomal recessive

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

600 retrieved; paginated sample, class counts are floors:

300 uncertain significance, 221 likely benign, 34 benign, 22 conflicting classifications of pathogenicity, 13 benign/likely benign, 7 pathogenic, 3 pathogenic/likely pathogenic

ClinVarVariant (HGVS)GeneClassificationReview
1069886NM_201384.3(PLEC):c.12418C>T (p.Arg4140Ter)PLECPathogeniccriteria provided, single submitter
1071954NM_201384.3(PLEC):c.7336G>T (p.Glu2446Ter)PLECPathogeniccriteria provided, single submitter
1073588NM_201384.3(PLEC):c.13106C>A (p.Ser4369Ter)PLECPathogeniccriteria provided, single submitter
1074096NM_201384.3(PLEC):c.6510del (p.His2170fs)PLECPathogeniccriteria provided, single submitter
1174482NM_201384.3(PLEC):c.864GCT[3] (p.Leu292del)PLECPathogenicno assertion criteria provided
1251951NM_201378.4(PLEC):c.66C>G (p.Tyr22Ter)PLECPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1251952NM_201384.3(PLEC):c.8149C>T (p.Gln2717Ter)PLECPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1320041NM_201384.3(PLEC):c.6970C>T (p.Arg2324Ter)PLECPathogeniccriteria provided, multiple submitters, no conflicts
1323468NM_201384.3(PLEC):c.1465_1471del (p.Asn489fs)PLECPathogeniccriteria provided, multiple submitters, no conflicts
1324937NM_201384.3(PLEC):c.4468C>T (p.Arg1490Ter)PLECPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1001872NM_201384.3(PLEC):c.7634G>A (p.Arg2545Gln)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1003332NM_201384.3(PLEC):c.6427G>A (p.Glu2143Lys)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1004138NM_201384.3(PLEC):c.9317G>A (p.Arg3106Lys)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1006392NM_201384.3(PLEC):c.8140G>A (p.Ala2714Thr)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1007882NM_201384.3(PLEC):c.5555C>T (p.Ala1852Val)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1038192NM_201384.3(PLEC):c.13529G>T (p.Gly4510Val)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1044930NM_201384.3(PLEC):c.8492G>A (p.Arg2831Gln)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1048028NM_201384.3(PLEC):c.3850C>T (p.Leu1284Phe)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1058015NM_201384.3(PLEC):c.9295G>A (p.Glu3099Lys)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1123939NM_201384.3(PLEC):c.9840C>T (p.Thr3280=)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1124265NM_201378.4(PLEC):c.70+2T>CPLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1141659NM_201384.3(PLEC):c.5191C>T (p.Leu1731=)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1151961NM_201384.3(PLEC):c.5241G>A (p.Thr1747=)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1174478NM_201384.3(PLEC):c.8531C>T (p.Ala2844Val)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1194821NM_201384.3(PLEC):c.7703G>A (p.Arg2568His)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1195336NM_201384.3(PLEC):c.5920C>G (p.Gln1974Glu)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1215529NM_201384.3(PLEC):c.5795C>T (p.Ala1932Val)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
1216951NM_201384.3(PLEC):c.3784G>A (p.Gly1262Ser)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
129930NM_201384.3(PLEC):c.12615C>T (p.Ile4205=)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications
129932NM_000445.5(PLEC):c.133G>A (p.Gly45Ser)PLECConflicting classifications of pathogenicitycriteria provided, conflicting classifications

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 12 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
RP1L1Orphanet:247834Occult macular dystrophy
RP1L1Orphanet:791Retinitis pigmentosa
FREM2Orphanet:2052Fraser syndrome
FREM2Orphanet:93100Renal agenesis, unilateral
FREM2Orphanet:98949Complete cryptophthalmia
IDSOrphanet:217085Mucopolysaccharidosis type 2, severe form
IDSOrphanet:217093Mucopolysaccharidosis type 2, attenuated form
PLECOrphanet:1114Aplasia cutis congenita
PLECOrphanet:158684Epidermolysis bullosa simplex with pyloric atresia
PLECOrphanet:254361Plectin-related limb-girdle muscular dystrophy R17
PLECOrphanet:257Epidermolysis bullosa simplex with muscular dystrophy
PLECOrphanet:79401PLEC-related intermediate epidermolysis bullosa simplex without extracutaneous involvement

Cohort genes → proteins

13 cohort genes, 11 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence13

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
RP1L1HGNC:15946ENSG00000183638Q8IWN7Retinitis pigmentosa 1-like 1 proteinclinvar
BCLAF1HGNC:16863ENSG00000029363Q9NYF8Bcl-2-associated transcription factor 1clinvar
DCUN1D2HGNC:20328ENSG00000150401Q6PH85DCN1-like protein 2clinvar
ADCK5HGNC:21738ENSG00000173137Q3MIX3Uncharacterized aarF domain-containing protein kinase 5clinvar
ARHGAP21HGNC:23725ENSG00000107863Q5T5U3Rho GTPase-activating protein 21clinvar
FREM2HGNC:25396ENSG00000150893Q5SZK8FRAS1-related extracellular matrix protein 2clinvar
ARHGAP10HGNC:26099ENSG00000071205A1A4S6Rho GTPase-activating protein 10clinvar
MIR661HGNC:32917ENSG00000207574microRNA 661clinvar
CATSPERQHGNC:44155ENSG00000261587Q2WGJ8Cation channel sperm-associated auxiliary subunit thetaclinvar
GPR33HGNC:4489ENSG00000214943Q49SQ1Probable G-protein coupled receptor 33clinvar
IDSHGNC:5389ENSG00000010404P22304Iduronate 2-sulfataseclinvar
CCDSTHGNC:55988ENSG00000236427cervical cancer associated DHX9 suppressive transcriptclinvar
PLECHGNC:9069ENSG00000178209Q15149Plectinclinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
RP1L1Retinitis pigmentosa 1-like 1 proteinRequired for the differentiation of photoreceptor cells.
BCLAF1Bcl-2-associated transcription factor 1Death-promoting transcriptional repressor.
DCUN1D2DCN1-like protein 2Contributes to the neddylation of all cullins by transferring NEDD8 from N-terminally acetylated NEDD8-conjugating E2s enzyme to different cullin C-terminal domain-RBX complexes and plays an essential role in the regulation of SCF (SKP1-CU…
ADCK5Uncharacterized aarF domain-containing protein kinase 5The function of this protein is not yet clear.
ARHGAP21Rho GTPase-activating protein 21Functions as a GTPase-activating protein (GAP) for RHOA and CDC42.
FREM2FRAS1-related extracellular matrix protein 2Extracellular matrix protein required for maintenance of the integrity of the skin epithelium and for maintenance of renal epithelia.
ARHGAP10Rho GTPase-activating protein 10GTPase-activating protein that catalyzes the conversion of active GTP-bound Rho GTPases to their inactive GDP-bound form, thus suppressing various Rho GTPase-mediated cellular processes.
CATSPERQCation channel sperm-associated auxiliary subunit thetaAuxiliary component of the CatSper complex, a complex involved in sperm cell hyperactivation.
GPR33Probable G-protein coupled receptor 33Orphan receptor; could be a chemoattractant receptor.
IDSIduronate 2-sulfataseLysosomal enzyme involved in the degradation pathway of dermatan sulfate and heparan sulfate.
PLECPlectinInterlinks intermediate filaments with microtubules and microfilaments and anchors intermediate filaments to desmosomes or hemidesmosomes.

Protein-family classification

Druggable: 3 · Difficult: 3 · Unknown: 7 · Druggable fraction: 0.23

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.

FamilyGenesFoldFDR
Scaffold/PPI34.0×0.178
Phosphatase16.5×0.361
Kinase12.1×0.532
GPCR11.8×0.532
Other/Unknown71.0×0.666

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
RP1L1Other/UnknownnoDoublecortin_dom, Doublecortin_dom_sf
BCLAF1Other/UnknownnoTHRAP3_BCLAF1
DCUN1D2Other/UnknownnoPONY_dom, UBA-like_sf, DCN-prot
ADCK5KinaseyesABC1_dom, Kinase-like_dom_sf, ADCK1_dom
ARHGAP21Scaffold/PPInoRhoGAP_dom, PDZ, PH_domain
FREM2Other/UnknownnoCalx_beta, CalX-like_sf, CSPG_rpt
ARHGAP10Scaffold/PPInoRhoGAP_dom, SH3_domain, PH_domain
MIR661Other/Unknownno
CATSPERQOther/UnknownnoTMEM249
GPR33GPCRyesGPCR_Rhodpsn, Formyl_rcpt-rel, GPCR_Rhodpsn_7TM
IDSPhosphataseyes3.1.6.13Sulfatase_N, Alkaline_phosphatase_core_sf, Sulfatase_CS
CCDSTOther/Unknownno
PLECScaffold/PPInoPlectin_repeat, SH3_domain, Actinin_actin-bd_CS

Expression context

Cohort genes with no expression data: 0.

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

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)1
broad (>20)12
unknown0

Top tissues across cohort

TissueCohort genes
duodenum2
right hemisphere of cerebellum2
adrenal tissue2
male germ line stem cell (sensu Vertebrata) in testis2
bone marrow cell1
buccal mucosa cell1
primordial germ cell in gonad1
calcaneal tendon1
embryo1
tibia1
apex of heart1
cardiac ventricle1
heart left ventricle1
mucosa of transverse colon1
cerebellar cortex1
cerebellar hemisphere1
kidney epithelium1
renal medulla1
lower esophagus1
lower esophagus muscularis layer1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
RP1L130tissue_specificyesprimordial germ cell in gonad, buccal mucosa cell, bone marrow cell
BCLAF1295ubiquitousmarkercalcaneal tendon, tibia, embryo
DCUN1D2270ubiquitousmarkerapex of heart, heart left ventricle, cardiac ventricle
ADCK5136ubiquitousmarkermucosa of transverse colon, duodenum, right hemisphere of cerebellum
ARHGAP21225ubiquitousmarkerright hemisphere of cerebellum, cerebellar hemisphere, cerebellar cortex
FREM2160broadmarkeradrenal tissue, kidney epithelium, renal medulla
ARHGAP10202ubiquitousmarkermucosa of stomach, lower esophagus muscularis layer, lower esophagus
MIR66189yesadrenal tissue, vermiform appendix, blood
CATSPERQ123tissue_specificyesright testis, left testis, male germ line stem cell (sensu Vertebrata) in testis
GPR3310tissue_specificyesduodenum, leukocyte, colonic epithelium
IDS238ubiquitousmarkerright frontal lobe, cortical plate, descending thoracic aorta
CCDST111broadyesmale germ line stem cell (sensu Vertebrata) in testis, lower esophagus mucosa, quadriceps femoris
PLEC283ubiquitousmarkersural nerve, hindlimb stylopod muscle, tibial nerve

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
BCLAF14,230
PLEC3,529
ARHGAP211,768
FREM21,652
IDS1,123
RP1L11,004
ADCK5978
DCUN1D2612
ARHGAP10493
GPR33394

Structural data

PDB: 6 · AlphaFold-only: 5 · No structure: 2

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
PLECQ1514914
ARHGAP21Q5T5U33
BCLAF1Q9NYF82
IDSP223042
DCUN1D2Q6PH851
ARHGAP10A1A4S61

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
GPR33Q49SQ187.59
ADCK5Q3MIX382.08
CATSPERQQ2WGJ879.42
RP1L1Q8IWN738.97
FREM2Q5SZK8

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 22. Enrichment computed across 13 evidence-associated genes (5 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 5 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
MPS II - Hunter syndrome (HS-GAG degradation)12284.0×0.005IDS
MPS II - Hunter syndrome (CS/DS degradation)12284.0×0.005IDS
Regulation of PAK-2p34 activity by PS-GAP/RHG1011142.0×0.006ARHGAP10
RHOA GTPase cycle229.9×0.008ARHGAP21, ARHGAP10
CDC42 GTPase cycle228.9×0.008ARHGAP21, ARHGAP10
RAC1 GTPase cycle224.4×0.009ARHGAP21, ARHGAP10
Type I hemidesmosome assembly1207.6×0.014PLEC
Caspase-mediated cleavage of cytoskeletal proteins1190.3×0.014PLEC
CS/DS degradation1108.8×0.022IDS
HS-GAG degradation199.3×0.022IDS
RHOF GTPase cycle151.9×0.035ARHGAP21
RND3 GTPase cycle151.9×0.035ARHGAP21
RHOD GTPase cycle140.8×0.036ARHGAP21
Assembly of collagen fibrils and other multimeric structures140.1×0.036PLEC
RHOJ GTPase cycle140.1×0.036ARHGAP21
RHOQ GTPase cycle136.2×0.038ARHGAP21
RHOB GTPase cycle130.9×0.039ARHGAP21
RHOG GTPase cycle129.7×0.039ARHGAP21
RHOC GTPase cycle129.3×0.039ARHGAP21
RAC2 GTPase cycle125.4×0.043ARHGAP21
RAC3 GTPase cycle123.8×0.043ARHGAP21
Neddylation19.5×0.101DCUN1D2

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 9 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
protein-containing complex organization11872.4×0.018PLEC
actomyosin contractile ring assembly actin filament organization11872.4×0.018PLEC
skeletal myofibril assembly1936.2×0.018PLEC
leukocyte migration involved in immune response1624.1×0.018PLEC
cellular response to hydrostatic pressure1624.1×0.018PLEC
dermatan sulfate proteoglycan catabolic process1468.1×0.018IDS
photoreceptor cell development1468.1×0.018RP1L1
maintenance of Golgi location1468.1×0.018ARHGAP21
regulation of small GTPase mediated signal transduction232.0×0.018ARHGAP21, ARHGAP10
tight junction organization1374.5×0.018PLEC
positive regulation of protein neddylation1374.5×0.018DCUN1D2
glycosaminoglycan catabolic process1267.5×0.021IDS
hemidesmosome assembly1267.5×0.021PLEC
Golgi localization1234.1×0.021ARHGAP21
heparan sulfate proteoglycan catabolic process1208.1×0.021IDS
establishment of Golgi localization1208.1×0.021ARHGAP21
positive regulation of DNA-templated transcription initiation1208.1×0.021BCLAF1
keratinocyte development1170.2×0.023PLEC
peripheral nervous system myelin maintenance1170.2×0.023PLEC
cellular response to fluid shear stress1144.0×0.025PLEC
organelle transport along microtubule1133.8×0.025ARHGAP21
complement receptor mediated signaling pathway1124.8×0.025GPR33
T cell chemotaxis1124.8×0.025PLEC
regulation of vascular permeability1124.8×0.025PLEC
photoreceptor cell outer segment organization1117.0×0.026RP1L1
intermediate filament cytoskeleton organization1104.0×0.026PLEC
regulation of protein neddylation1104.0×0.026DCUN1D2
cell communication193.6×0.026FREM2
fibroblast migration193.6×0.026PLEC
respiratory electron transport chain193.6×0.026PLEC

Therapeutics

Drug target analysis

Approved (phase 4): 1 · Phase ≥3: 1 · Phased (≥1): 2 · Undrugged: 11

Druggability breadth: 4 of 13 evidence-associated genes (31%) 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.

SymbolExample approved molecule
ADCK5NERATINIB

Top cohort targets by molecule count

SymbolMoleculesMax phase
ADCK524
BCLAF112
RP1L100
DCUN1D200
ARHGAP2100
FREM200
ARHGAP1000
MIR66100
CATSPERQ00
GPR3300

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
NERATINIB4ADCK5
LINSITINIB3ADCK5
MOLIBRESIB2BCLAF1

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

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

SymbolAssaysType breakdown
PLEC12Binding:12
BCLAF18Binding:8
DCUN1D25Binding:5
ADCK52Binding:2

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
IDS3.1.6.13iduronate-2-sulfatase

Pharmacogenomics

Cohort genes with a PharmGKB record: 12; with CPIC/DPWG dosing guidelines: 0.

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

Chemical tractability of cohort targets

3 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.

CompoundMax phaseCohort target (bioactivity)
NERATINIB4ADCK5
LINSITINIB3ADCK5
MOLIBRESIB2BCLAF1

Druggability pyramid

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

TierDefinitionGenesSymbols
AApproved (phase 4 drug)1ADCK5
BPhased (≥1) drug, not yet approved1BCLAF1
CDruggable family + PDB, no drug1IDS
DDruggable family + AlphaFold only, no drug1GPR33
EDifficult family or no structure, no drug9RP1L1, DCUN1D2, ARHGAP21, FREM2, ARHGAP10, MIR661, CATSPERQ, CCDST, PLEC

Undrugged target profiles

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

SymbolChEMBL assaysDrugged partners (top 3)
RP1L10
DCUN1D25
ARHGAP210
FREM20
ARHGAP100
MIR6610
CATSPERQ0
GPR330
IDS0
CCDST0
PLEC12

Clinical trials & evidence

Clinical trials

Clinical trials: 0.