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Orofacial cleft 8 syndrome
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Orofacial cleft 8 syndrome

Contributors: Regina Parker, Susan Burgin MD
Other Resources UpToDate PubMed


There are 6 autosomal dominant p63-associated ectodermal dysplasia syndromes:
This summary focuses on OFC8.

All ectodermal dysplasias result from the abnormal development of structures derived from the outer embryonal layer such as the skin, hair, teeth, nails, and eccrine and sebaceous glands. While these 6 syndromes are classified as distinct entities, their overlapping phenotypes suggest that they may be part of a spectrum of related syndromes.

p63 is a transcription factor with homology to the tumor suppressor p53. Studies in mice have demonstrated that, unlike p53, p63 expression is localized to whiskers, oral mucosa, and distal limbs. Furthermore, mice lacking p63 are born with translucent skin and without appendages (whisker pads, teeth). It has been postulated that p63 plays an important role in epidermal stratification and the maintenance of epidermal stem cells.

While all 6 syndromes show abnormalities in p63, each syndrome tends to demonstrate mutations in specific domains. OFC8, EEC, SHFM4, and ADULT syndromes are associated with missense mutations in the DNA binding domain. In contrast, mutations in the sterile alpha motif / transcription inhibitory domain (SAM / TID), which is downstream of the DNA binding domain, result in AEC syndrome phenotypes. Missense mutations in between the transactivation domain and DNA binding domain or truncation of the SAM / TID are typical of limb-mammary syndrome.

In OFC8, clefting may involve the lip, the palate, or a combination of cleft lip and palate.


Q35.9 – Cleft palate, unspecified
Q36.9 – Cleft lip, unilateral

449790007 – Orofacial cleft

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Differential Diagnosis & Pitfalls

  • Nonsyndromic cleft lip and/or palate from other genetic mutations or environmental factors
  • Ankyloblepharon-ectodermal dysplasia-cleft lip and palate syndrome
  • Ectrodactyly-ectodermal dysplasia-clefting syndrome
  • Limb-mammary syndrome
  • Apert syndrome
  • CHARGE syndrome (coloboma, heart anomalies, choanal atresia, retardation of growth and development, and genital and ear anomalies)
  • Velocardiofacial syndrome

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Last Reviewed:08/16/2020
Last Updated:11/09/2023
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Orofacial cleft 8 syndrome
A medical illustration showing key findings of Orofacial cleft 8 syndrome
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