It's not surprising that children and adults with Down syndrome have more than their share of skin problems. We will address those skin conditions and disorders that are more common in people with Down syndrome than the general population.
Newborns with Down syndrome frequently have blue hands and feet at birth and for several days afterwards. The medical term is called acrocynaosis, and is due to decreased circulation in the hands and feet. This is a harmless condition. Another skin condition seen in newborns is a bluish mottling of the skin, called cutis marmorata (latin for "marble-like skin"). Cutis marmorata is a response of the capillaries of the skin to being cool; it is common in all newborns, but it lasts several months longer in infants with Down syndrome.
Chronic Skin Conditions
Children with Down syndrome may have dry, rough skin. This is often referred to as xerosis. While often associated with vitamin A deficiencies in other children, this is not a common cause of xerosis in Down syndrome. This is best managed with nondrying soaps, adding oils to the bath water, and moisturizers.
is the presence of fissures and red, scaly skin at the corners of the mouth and lips. This is usually due to moisture collecting at the corners of the mouth, but can also be complicated by infection from bacteria or the yeast Candida. The application of a mild steroid cream is useful, along with treating infection when present.
is the presence of red, scaly, itchy skin. It is most likely to appear on the cheeks, behind the ears, behind the knees, and in the elbow creases. Treatment is with steroid creams and oral antihistamines. It shows up mostly in the first years of life. Seborrhea is a similar condition, but usually greasy and scaly, and appearing on the scalp and eyebrows. Dandruff shampoos or shampoos with either tar compounds or salicylates are used to treat seborrhea of the scalp. Occasionally antifungal preparations may be useful.
is very thick skin, and in people with Down syndrome occurs on the palms of the hands and soles of the feet. Treatment is only tried if the hyperkeratosis appears to bother the person with it, and consists of creams with salicyclic acid or a pumice stone. Hyperkeratosis of the feet can be decreased by wearing confortable shoes.
are benign skin tumors that arise from sweat ducts. They look like very small multiple raised nodules on the skin, with varying degrees of yellowish color. They are most often seen on the eyelids, neck and chest. Syringomas occur twice as often in females as in males. These do not require treatment, but they can be removed by lasers, shaving or scooping out with a curette.
Elastosis perforans serpiginosa
is a disorder of the elastic tissue of the skin, causing deep red raised lesions to appear in a linear or a circular pattern. These tend to occur on the back and sides of the neck, but may also be seen on the chin, the cheeks, arms and knees. These occur in males four times as often as in females. These may last for well over 10 years before going away on their own. Liquid nitrogen is the best current treatment, but this condition has a high rate of recurrence.
is a loss of pigmentation of the skin in well-defined areas. It may occur anywhere on the body and at any age. Vitiligo is not a common problem in people with DS, but is still more common than in the general population. The cause is unknown, but it may be caused by autoantibodies destroying melanocytes, which are cells in the skin that produce pigment.
is an increase in pigmentation. The darker skin is also slightly elevated and scaly, often with the appearance of dirt that won't wash off. One large study in Spain reported that out of 51 adults with Down syndrome, 26 had acanthosis nigrans. This condition most often appears on the back of the neck, the hands, and the groin. While acanthosis nigrans has been associated with type II diabetes mellitus, none of the affected adults with Down syndrome with acanthosis nigrans had evidence of diabetes.