Ectodermal dysplasia in females and inversion of chromosome 9

Absence of sweat glands, hypotrichosis, hypodontia, characteristic facial features, and intolerance to heat, without dystrophia of the nails, are manifestations of sex linked hypohydrotic ectodermal dysplasia. Three males and two females were affected in a family in which the affected females were also carrying a pericentric inversion of chromosome 9. Those phenotypically normal females in this pedigree who were obligate carriers had normal karyotypes. One of the affected females (the proband) had, in addition, primary amenorrhoea, absence of the mammary glands, and rudimentary internal genitalia. The fact that clinical manifestations of ectodermal dysplasia in the carrier females of this family are only observed in those also carrying a pericentric inversion of chromosome 9 in peripheral blood leucocytes perhaps suggests that non-random inactivation of the paternal X chromosome has occurred as a consequence of the inversion.