Dermatologic Manifestations of Waardenburg Syndrome Workup

Updated: Jun 21, 2022
  • Author: Lyubomir A Dourmishev, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Other Tests

Partington used the following three interocular distances for determining the presence of dystopia cantorum (The referent value between distance of the medial canthi of the eyelids and the length between the pupils was 0.6 mm.):

  • Between the inner canthal angles

  • The near papillary distance

  • Between the other canthal angles

Arias and Mota developed the W index, as follows, for the diagnosis of lateral displacement of the inner canthi (A W index of more than 2.07 shows dystopy, while an index of less than 1.87 is normal.):

  • W index = X + Y + alb

  • Where X = [a - {0.21119c + 3.909}]/c and Y = [2a - {0.2497b + 3.909}]/b in mm

  • Distance a is between inner canthi; distance b, between pupils; and distance c, between outer canthi.


Histologic Findings

Histochemical studies in the achromic skin of persons with Waardenburg syndrome show that the melanocytes are absent, or that only a few dihydroxyphenylalanine-positive cells are present.

Ultrastructural observations do not reveal melanocytes, indeterminate dendritic cells, or melanosomes in the keratinocytes of depigmented skin; however, the number of Langerhans cells in the epidermis is normal. The number of melanocytes on the edge of the leukodermas is reduced, and numerous cytoplasmic nuclear abnormalities are noted. Some melanosomes surrounded by a clear halo are found inside of vacuoles. The number of melanocytes in the hypopigmented patches of Waardenburg syndrome is dramatically reduced. These dendritic cells contained poorly melanized melanosomes.

Histopathologic examination of the inner ears of persons with Waardenburg syndrome shows absent organs of Corti, atrophy of the spinal ganglion, and reduced numbers of nerve fibers.