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Living with Nail and teeth abnormalities-marginal palmoplantar keratoderma-oral hyperpigmentation syndrome

A rare inherited condition that affects nails, teeth, and skin on the palms and soles, with darker patches in the mouth.

Understanding Nail and teeth abnormalities-marginal palmoplantar keratoderma-oral hyperpigmentation syndrome

Nail and teeth abnormalities-marginal palmoplantar keratoderma-oral hyperpigmentation syndrome is a rare inherited ectodermal dysplasia.

Features include short height, poorly formed or missing nails, dark patches on the lining of the mouth or tongue, and tooth differences. The edges of the palms and soles have thick skin. Trouble swallowing with a narrowed esophagus, hearing loss, asthma, and severe iron-deficiency anemia have also been seen. GARD lists onset in infancy.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Poorly formed nails (nail dystrophy)
  • Thick skin on palms and soles
  • Delayed or missing teeth
  • Underdeveloped tooth enamel
  • Trouble swallowing (dysphagia)
  • Short stature

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include genetic specialists and skin, hair, and nail specialists.

  3. Consider genetic testing

    Changes in GRHL2 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    National Foundation for Ectodermal Dysplasias may keep lists of experts for this condition.

Care & treatment

Care team
Genetic specialists (geneticists); Skin, hair, and nail specialists (dermatologists)
Expert care
Expert lists: National Foundation for Ectodermal Dysplasias
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with National Foundation for Ectodermal Dysplasias and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Should we have genetic testing for the GRHL2 gene?
How should swallowing problems be checked?
How often should hearing and iron levels be checked?

Quick facts

Symptoms usually startInfant
InheritanceAutosomal Recessive
GenesGRHL2

GARD lists changes in the GRHL2 gene. A child inherits a changed copy of the gene from each parent (autosomal recessive).

GeneticSkin

Also known as: ectodermal dysplasia short stature syndrome; ectodermal dysplasia-short stature syndrome; ectodermal dysplasia/short stature syndrome; nail and tooth abnormalities, marginal palmoplantar keratoderma, oral hyperpigmentation syndrome; short stature-nail dysplasia-marginal palmoplantar keratoderma-oral hyperpigmentation syndrome; short stature, nail dysplasia, marginal palmoplantar keratoderma, oral hyperpigmentation syndrome

Patient organizations

Source: NIH GARD · Nail and teeth abnormalities-marginal palmoplantar keratoderma-oral hyperpigmentation syndromeGARD ID 17703 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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