Ankyloblepharon Filiforme Adnatum Cleft Palate Syndrome

Ankyloblepharon filiforme adnatum–cleft palate syndrome is a rare birth condition where a baby is born with thin strands of tissue that join the upper and lower eyelids (this is called ankyloblepharon filiforme adnatum, or AFA) and an opening in the roof of the mouth (a cleft palate, sometimes with a cleft lip). In most families and medical reports, this combination is part of a broader genetic disorder called AEC (Ankyloblepharon–Ectodermal defects–Cleft lip/palate) syndrome, also known as Hay–Wells syndrome. AEC is one of the TP63-related disorders. The TP63 gene helps guide early development of tissues that come from the ectoderm (skin, hair, nails, teeth, and some parts of the eye and mouth). Problems in this gene can explain why the eyelids, skin, hair, and mouth structures may form abnormally together. National Organization for Rare Disorders+3MedlinePlus+3Orpha+3

Ankyloblepharon filiforme adnatum (AFA) itself means partial or complete fusion of the eyelids by one or more thread-like bands. It is rare and can occur alone or with syndromes such as AEC. When it appears together with a cleft palate, the combination strongly points doctors to check for an underlying TP63-related syndrome like AEC. PMC+2neonet.ch+2

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Other names

• AEC syndrome (Ankyloblepharon–Ectodermal defects–Clefting syndrome)

• Hay–Wells syndrome

• Ankyloblepharon–ectodermal defects–cleft lip/palate syndrome
  These names all refer to the same core condition and are commonly used in medical references. MedlinePlus+2Orpha+2

Important note: AFA with cleft lip/palate can rarely occur in other genetic conditions (for example, Van der Woude syndrome related to IRF6), so doctors consider these in the differential diagnosis. PMC+1

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Types

Because this is a rare disorder, there is no single universal “type list.” Clinicians often use practical groupings based on how widely tissues are affected and how severe the features are:

1. Isolated AFA with cleft palate (no other ectodermal problems detected yet): Thin bands between eyelids plus cleft palate/lip; early genetic testing still needed to confirm or exclude AEC. PMC

2. Classic AEC (Hay–Wells) phenotype: AFA + cleft palate/lip with ectodermal features (skin erosions, hair/nail/tooth changes, reduced sweating). MedlinePlus+1

3. Severe AEC: Same as classic AEC but with extensive scalp/skin erosions, scarring, and more pronounced feeding, speech, and infection issues. NCBI

4. AFA–cleft palate with features suggesting other syndromes (differential): AFA + clefting where IRF6-related (Van der Woude) or other syndromes are suspected based on lip pits or other clues. Genetic testing sorts these out. PMC

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Causes

Because this syndrome is mainly genetic, the “causes” list focuses on the direct gene changes and developmental mechanisms that lead to the eyelid and palate findings, plus modifiers that influence how it looks in each person:

1. TP63 gene variants (mutations): The principal cause in AEC/Hay–Wells. TP63 controls many steps in ectoderm development. National Organization for Rare Disorders+1

2. Autosomal-dominant inheritance: One altered copy of TP63 can cause disease; many cases are de novo (new in the child). National Organization for Rare Disorders

3. Variants in key TP63 domains (e.g., SAM or transactivation domains): Certain regions are “hot spots” in TP63-related disorders and influence severity. NCBI+1

4. Abnormal eyelid separation in the embryo: Failure of normal breakdown of tissue between lids leads to AFA strands at birth. neonet.ch

5. Disrupted ectodermal signaling: TP63 dysfunction alters signals that guide skin, hair, nail, and ocular surface formation. MedlinePlus

6. Defective wound/epidermal barrier formation: Explains neonatal scalp erosions and fragile skin in AEC. NCBI

7. Abnormal palatal shelf fusion: Gene-driven disruption of palate formation results in cleft palate. MedlinePlus

8. Reduced sweat gland development (hypohidrosis): An ectodermal feature due to TP63 changes. Wikipedia

9. Abnormal hair/eyelash follicle development: Leads to sparse hair or lashes. Wikipedia

10. Abnormal tooth development (dental anomalies): Small, misshapen, or missing teeth reflect ectodermal dysplasia. Wikipedia

11. Nail matrix defects: Cause nail malformation or brittleness. Wikipedia

12. Variable expressivity: The same TP63 change can cause different severities in different people. NCBI

13. De novo variants: Many affected children have new TP63 changes not present in parents. National Organization for Rare Disorders

14. Mosaicism in a parent (rare): A parent with a gene change in some cells can have an apparently unaffected phenotype but still pass on the variant. (Inference from TP63 inheritance patterns in GeneReviews-style guidance.) NCBI

15. Modifier genes and background genetic factors: Can influence how severe skin or craniofacial features become. (General inference from TP63-related spectrum.) ScienceDirect

16. Environmental/gestational modifiers: Non-genetic factors may modify healing, infections, or nutrition in newborns but are not primary causes. (General clinical inference.)

17. Overlap with other gene disorders in the differential (e.g., IRF6): Not a cause of AEC, but explains why the AFA-cleft combination can also appear in other syndromes. PMC

18. Rare chromosomal abnormalities reported with AFA (e.g., trisomy 18 in isolated reports): Show that eyelid fusion can appear in some chromosomal syndromes. Turkish Journal of Pediatrics

19. Fraser syndrome association (rare): AFA has been reported with Fraser syndrome, highlighting pathway overlap in eyelid development. Turkish Journal of Pediatrics

20. Clinical misclassification: Early life skin erosions or limited features can delay recognition of the underlying TP63 disorder, which is why genetic testing matters. NCBI

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Symptoms and signs

1. Ankyloblepharon filiforme adnatum (AFA): Thin tissue bands connect upper and lower eyelids at birth; may partially close the eye and can affect vision unless divided. PMC+1

2. Cleft palate (with or without cleft lip): An opening in the roof of the mouth; causes feeding, ear, and speech problems until repaired. MedlinePlus

3. Ectodermal skin erosions (often on the scalp): Fragile skin with raw areas that can scar as they heal. NCBI

4. Sparse hair and eyebrows/eyelashes: Hair may be thin or patchy; lashes can be missing, increasing eye irritation. Wikipedia

5. Nail abnormalities: Nails may be absent, small, ridged, or brittle. Wikipedia

6. Tooth anomalies: Teeth can be small, peg-shaped, or missing; enamel may be thin. Wikipedia

7. Reduced sweating (hypohidrosis): Few or underactive sweat glands can cause overheating risk. Wikipedia

8. Eye irritation/dryness: AFA and reduced lashes disturb tear protection; irritation improves after eyelid bands are cut. PMC

9. Feeding difficulty in infancy: Cleft palate makes suction hard; special bottles or feeding support are used until surgery. MedlinePlus

10. Recurrent ear infections/ear fluid: Cleft palate affects the eustachian tube; ear tubes may be needed. (Cleft palate complication, widely documented.) MedlinePlus

11. Speech delay or nasal speech: Air escapes through the palate gap; speech therapy helps after repair. MedlinePlus

12. Skin infections of erosions: Open skin invites bacteria; careful wound care is essential. NCBI

13. Scarring alopecia on scalp: Healing of erosions can leave hairless scars. NCBI

14. Mouth opening limitation (trismus) in some patients: Reported in TP63 spectrum and complicates dental care. NCBI

15. Psychosocial stress for family: Feeding, surgeries, and visible differences require coordinated team support (cleft/craniofacial team). (General clinical practice for cleft care.) MedlinePlus

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Diagnostic tests

A) Physical examination (bedside)

1. Newborn general exam: Looks for AFA (eyelid bands), cleft palate/lip, and any skin erosions or scalp wounds to guide urgent care and referrals. MedlinePlus+1

2. Targeted eyelid inspection: Identifies the number, thickness, and position of the connecting bands; helps plan safe division. PMC

3. Oral and palate exam (with light): Confirms cleft type and extent to plan feeding help and the timing of surgery. MedlinePlus

4. Skin, hair, nail survey: Documents ectodermal features (erosions, sparse hair, nail changes) that support AEC diagnosis. NCBI

5. Temperature and hydration checks: Screens for overheating risk from reduced sweating and for feeding-related dehydration. Wikipedia

B) Manual/office-based procedures

6. Gentle eyelid-opening test (by ophthalmology): Assesses whether bands limit eye opening or corneal protection; informs whether bedside division is needed. PMC

7. Slit-lamp examination: A light-microscope look at the eye surface to detect irritation, epithelial defects, or exposure problems. (Standard ophthalmic assessment when eyelids or lashes are abnormal.) PMC

8. Feeding assessment by lactation/speech therapist: Determines the safest nipple/bottle system and positioning for cleft palate. MedlinePlus

9. Wound/skin care assessment: Nursing/dermatology review of erosions guides dressings and infection prevention. NCBI

10. Audiology screening (otoacoustic emissions): Early screen because cleft palate increases the risk of middle-ear fluid and hearing issues. (Cleft-care standard.) MedlinePlus

C) Laboratory and pathological tests

11. Genetic testing—TP63 sequencing and deletion/duplication analysis: The key test to confirm AEC/Hay–Wells. May be done as a single-gene test or as part of a craniofacial/ectodermal panel. NCBI+1

12. Craniofacial/cleft panel including IRF6 (differential diagnosis): Helps distinguish AEC from Van der Woude or other syndromes that can also present with clefting (and occasionally AFA). PMC

13. Microbiology cultures from skin erosions (if infected): Guides antibiotic therapy if wounds show signs of infection. NCBI

14. Basic labs for nutrition/hydration if feeding is poor: Monitors electrolytes and growth in infants with cleft-related feeding difficulties. MedlinePlus

15. Histopathology (rarely needed): Skin biopsy is uncommon in infants but may be used if the diagnosis is unclear; findings are consistent with ectodermal dysplasia. NCBI

D) Electrodiagnostic tests

16. Auditory Brainstem Response (ABR): Objective hearing test for infants if initial screening is abnormal; cleft palate raises the risk of hearing issues due to middle-ear dysfunction. (Cleft-care standard.) MedlinePlus

17. Electrocardiography and others: Not routinely required for this syndrome; used only if a separate clinical issue suggests it. (Clinical practice note.)

E) Imaging tests

18. Prenatal ultrasound and/or fetal MRI (when performed): May detect cleft lip/palate before birth; helps with delivery planning and early referrals. MedlinePlus

19. Postnatal craniofacial imaging (CT or 3D photography when surgery is planned): Helps surgeons plan cleft repairs and evaluate facial structures if needed. (Cleft-team practice.) MedlinePlus

20. Ophthalmic imaging/photography: High-resolution photos document eyelid bands before and after division and monitor the ocular surface. PMC

Non-pharmacological treatments (therapies & others)

Below are supportive treatments that do not rely on prescription drugs. Each item includes a brief purpose and mechanism (how it helps).

1. Early eyelid band release (lysis) by an ophthalmologist.
   Purpose: Open the eye to allow vision and eyelid motion.
   Mechanism: A tiny cut detaches the thin tissue bands that tie the lids together, lowering risk of amblyopia and surface dryness. PMC

2. Lubricating eye care.
   Purpose: Protect the eye surface after band release and during healing.
   Mechanism: Frequent sterile lubricants and tear substitutes lower friction and dryness on the cornea. EyeWiki

3. Wound-care nursing for skin erosions.
   Purpose: Speed skin healing and reduce infection risk.
   Mechanism: Non-stick dressings, gentle cleansing, and moisture balance support fragile ectodermal skin. PMC

4. Cleft palate/lip feeding support.
   Purpose: Improve nutrition and growth until surgery.
   Mechanism: Special bottles, careful positioning, and thickened feeds reduce nasal regurgitation and fatigue. MedlinePlus

5. Speech and language therapy.
   Purpose: Improve speech after palate repair and support early communication.
   Mechanism: Exercises and strategies address resonance and articulation linked to cleft palate. MedlinePlus

6. Heat and sweat-management education.
   Purpose: Prevent overheating due to low sweating (hypohidrosis).
   Mechanism: Cool rooms, fans, light clothing, and hydration keep body temperature safe. National Organization for Rare Disorders

7. Dental and orthodontic care.
   Purpose: Manage small, missing, or misshaped teeth and bite problems.
   Mechanism: Early dental visits, fluoride, sealants, and staged orthodontics protect enamel and guide jaw growth. PMC

8. Hearing assessment and audiology support.
   Purpose: Detect and treat conductive hearing loss common with cleft-related ear issues.
   Mechanism: Early screening and, when needed, hearing aids or tubes support language development. MedlinePlus

9. Lactation and nutrition counseling.
   Purpose: Maintain growth in infants with feeding difficulty.
   Mechanism: Tailored feeding plans and higher-calorie strategies meet energy needs pre- and post-surgery. MedlinePlus

10. Skin protection education.
    Purpose: Reduce skin breakdown and infections.
    Mechanism: Daily emollients, gentle cleansers, soft clothing, and avoiding irritants protect fragile skin. PMC

11. Humidification and nasal care.
    Purpose: Ease airway dryness and crusting.
    Mechanism: Room humidifiers and saline help mucosa that may be dry from ectodermal changes. National Organization for Rare Disorders

12. Sun-smart habits.
    Purpose: Protect sensitive skin.
    Mechanism: Shade, clothing, and broad-spectrum sunscreen lower sun damage on thin, erosive skin. PMC

13. Protective eye wear.
    Purpose: Shield cornea during healing and for dryness risk.
    Mechanism: Glasses and moisture chambers reduce exposure and debris contact. EyeWiki

14. Physiotherapy for general development.
    Purpose: Support motor milestones in children recovering from surgeries or frequent dressings.
    Mechanism: Gentle range-of-motion and play-based exercises maintain strength and flexibility. National Organization for Rare Disorders

15. Psychosocial counseling and peer support.
    Purpose: Reduce stress for families facing a rare condition.
    Mechanism: Counseling, support groups, and education improve coping and care follow-through. nfed.org

16. Multidisciplinary cleft/craniofacial team care.
    Purpose: Coordinate surgeries, dental, speech, ENT, and eye care.
    Mechanism: Team clinics align timing and follow-up for best outcomes. MedlinePlus

17. Genetic counseling.
    Purpose: Explain inheritance, recurrence risk, and testing options.
    Mechanism: Counselors review TP63 findings and family plans, including prenatal choices. National Organization for Rare Disorders

18. School-based learning supports.
    Purpose: Help with hearing, speech, and social confidence.
    Mechanism: Classroom accommodations and therapy services support communication and learning. MedlinePlus

19. Infection-prevention skills at home.
    Purpose: Cut the risk of skin and ear infections.
    Mechanism: Hand hygiene, gentle skin care, and early signs education prompt timely care. PMC

20. Caregiver training for wound and eye care.
    Purpose: Build confidence between visits.
    Mechanism: Step-by-step teaching on dressings, lubricants, and warning signs supports safe home care. PMC+1

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Drug treatments

Important note: There is no drug that “cures” AEC. Medicines are used to treat symptoms (skin, eye, ear, pain, itch) and prevent or treat infection. Doses must be set by the child’s clinicians. Below I explain common classes used in care plans.

1. Topical bland emollients (e.g., petrolatum, simple barrier creams).
   Class: Skin barrier agents. Purpose/Time: Daily, lifelong skin protection. Mechanism: Seal in moisture; reduce friction; help erosions heal. Side effects: Rare pore blockage or sensitivity. PMC

2. Non-steroidal topical anti-inflammatories are generally not standard for erosive ectodermal disorders; clinicians prefer bland barriers; this line is to underline the usual barrier-first strategy. Mechanism/Reason: Minimizes irritation on fragile skin. PMC

3. Topical corticosteroids (low-to-mid potency, short courses).
   Class: Anti-inflammatory. Purpose: Calm dermatitis flares around erosions. Mechanism: Lowers local immune overactivity. Side effects: Thinning or irritation if overused—use brief courses only. PMC

4. Topical antibiotics (e.g., mupirocin for localized impetigo).
   Class: Antibacterial. Purpose: Treat small areas of infected skin. Mechanism: Kills common skin bacteria. Side effects: Local burning or resistance risk if overused. PMC

5. Oral antibiotics (when skin infection is spreading or deep).
   Class: Systemic antibacterial. Purpose: Stop cellulitis or secondary infection. Mechanism: Systemic kill of target bacteria. Side effects: GI upset, allergy; use only when clearly needed. PMC

6. Antiseptic soaks/cleansers (e.g., dilute chlorhexidine as directed).
   Class: Topical antiseptic. Purpose: Lower bacterial load in wound care. Mechanism: Broad membrane disruption of microbes. Side effects: Irritation if too strong or frequent; follow specialist protocol. PMC

7. Ocular lubricants (artificial tears/ointments).
   Class: Tear substitutes. Purpose: Protect cornea after eyelid band lysis and for dryness. Mechanism: Replaces tear film; lowers friction. Side effects: Temporary blur after ointments. EyeWiki

8. Topical ophthalmic antibiotics (short course if corneal risk).
   Class: Antibacterial drops/ointment. Purpose: Prevent/treat eye surface infection during healing. Mechanism: Local control of bacteria. Side effects: Stinging; allergy. Use only if indicated. EyeWiki

9. Analgesics (e.g., acetaminophen; ibuprofen if appropriate).
   Class: Pain relievers. Purpose: Ease pain from skin care and surgeries. Mechanism: Central pain modulation; prostaglandin inhibition for NSAIDs. Side effects: Dosing limits and kidney/GI cautions—clinician-set dosing only. MedlinePlus

10. Antihistamines (e.g., cetirizine) for itch and sleep support.
    Class: H1 blockers. Purpose: Reduce itch that worsens skin trauma. Mechanism: Blocks histamine on skin nerves. Side effects: Drowsiness (some agents). PMC

11. Fluoride therapies and dental topical treatments.
    Class: Remineralizing agents. Purpose: Protect fragile enamel and prevent cavities. Mechanism: Strengthen enamel crystals. Side effects: Minimal when used as directed. PMC

12. Antifungals (topical/oral when yeast complicates erosions).
    Class: Antimycotic. Purpose: Treat candidiasis in moist, occluded areas. Mechanism: Disrupt fungal cell membranes. Side effects: Local irritation; monitor with oral agents. PMC

13. ENT peri-operative medicines (as part of cleft and ear surgery protocols).
    Class: Varies (analgesia, antiemetics, antibiotics per protocol). Purpose: Safe surgery and recovery. Mechanism/Side effects: As per standard pediatric cleft care; team-directed. MedlinePlus

14. Nasal saline sprays/drops.
    Class: Isotonic saline. Purpose: Ease crusting; improve nasal airflow with cleft-related changes. Mechanism: Moisturizes mucosa; clears secretions. Side effects: Rare irritation. MedlinePlus

15. Barrier pastes for perioral skin (during feeding challenges).
    Class: Zinc oxide-based protectants. Purpose: Prevent drool-related dermatitis. Mechanism: Physical barrier to moisture and enzymes. Side effects: Rare sensitivity. PMC

16. Short-course oral steroids are generally not routine for skin erosions in AEC; decisions are individualized due to risks in fragile skin. Purpose: This note cautions against default systemic steroid use. PMC

17. Gabapentinoids are not standard; neuropathic pain is not a core feature; use only for specific indications per specialist pain teams. Purpose: Avoid unnecessary sedation and side effects. PMC

18. Retinoids (e.g., acitretin) are not standard of care for AEC.
    Purpose: Some ectodermal disorders mention retinoids, but AEC skin is erosive and fragile; risks may outweigh benefits. Mechanism/Side effects: Keratinization modulation; significant adverse effects—specialist-only decisions. PMC

19. Antipyretics and hydration guidance during heat stress.
    Class: Supportive measures. Purpose: Manage fever/overheating in hypohidrosis. Mechanism: Temperature control; fluid replacement. Side effects: Follow pediatric dosing exactly. National Organization for Rare Disorders

20. Prophylactic antibiotics are not routinely advised.
    Purpose: Limit resistance; treat proven infection only. Mechanism: Stewardship approach. Side effects: Avoids unnecessary harm. PMC

Safety reminder: Medicine names and doses must be set by your own clinicians—especially for infants and children. Authoritative sources emphasize supportive care rather than specific curative drugs in AEC. PMC

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Dietary molecular supplements

Evidence for supplements in AEC is limited. Any use should be clinician-supervised, especially in infants. The following are general skin and wound-healing supports sometimes considered in ectodermal conditions—not AEC-specific cures.

1. Omega-3 fatty acids.
   Dose: Per pediatric guidance. Function: May help skin barrier and inflammation balance. Mechanism: Competes with pro-inflammatory lipids. Evidence is general, not AEC-specific. PMC

2. Vitamin D.
   Dose: Age-appropriate, avoid excess. Function: Bone, immune modulation, skin health. Mechanism: Nuclear receptor signaling in keratinocytes and immune cells. PMC

3. Biotin.
   Dose: Pediatric-safe amounts only. Function: Hair/nail support. Mechanism: Co-factor in keratin production pathways. Evidence mixed. PMC

4. Zinc.
   Dose: Based on labs; avoid overdose. Function: Wound healing and enzyme function. Mechanism: DNA repair and epithelial growth support. PMC

5. Vitamin C.
   Dose: Dietary allowance. Function: Collagen cross-linking for wound repair. Mechanism: Cofactor for prolyl/lysyl hydroxylases. PMC

6. Vitamin A (caution).
   Dose: Only if deficient; avoid excess. Function: Epithelial differentiation. Mechanism: Retinoid receptor signaling; excess can harm—specialist advice needed. PMC

7. Vitamin E.
   Dose: Food-based intake preferred. Function: Antioxidant support. Mechanism: Scavenges lipid peroxides in skin. PMC

8. Selenium (only if deficient).
   Function: Antioxidant enzymes. Mechanism: Glutathione peroxidase cofactor. Note: Narrow safety margin. PMC

9. Probiotics (case-by-case).
   Function: Gut-skin axis support; may reduce some infections in general pediatric settings. Mechanism: Microbiome modulation. Use with pediatric guidance. PMC

10. Iron (only if anemic).
    Function: Corrects anemia that can slow wound healing. Mechanism: Supports oxygen delivery to tissue. Check labs first. PMC

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Immunity-booster / regenerative / stem-cell drugs

Today, there are no approved immune-booster or stem-cell drugs that cure AEC. Research teams are exploring lab-grown skin models and patient-derived cells to better understand TP63 changes and test future treatments, but these are experimental and not standard care. That means no safe dosing guidance exists outside ethically approved clinical trials. Ask your specialists about research studies if you’re interested. nfed.org+1

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Surgeries

1. Eyelid band lysis (early).
   Procedure: Small cut of the filament bands under sterile conditions.
   Why: Opens the eye to protect vision and the cornea. PMC

2. Cleft lip repair (first months of life, timing varies).
   Procedure: Plastic surgery to close the split in the lip.
   Why: Improves feeding, growth, speech development, and facial form. MedlinePlus

3. Cleft palate repair (usually in first year, timing varies).
   Procedure: Surgery to close the hard/soft palate.
   Why: Improves feeding and speech; reduces ear problems. MedlinePlus

4. Ear tubes (myringotomy with ventilation tubes) when needed.
   Procedure: Small tube placed in eardrum to drain fluid.
   Why: Lowers ear infections and improves hearing important for speech. MedlinePlus

5. Skin procedures (select cases).
   Procedure: Debridement or grafting for large, non-healing erosions.
   Why: Speeds closure and lowers infection risk when conservative care fails. PMC

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Preventions

1. Genetic counseling before pregnancy to understand TP63 risks. National Organization for Rare Disorders

2. Early team referral to cleft/craniofacial and ophthalmology services. MedlinePlus

3. Daily skin barrier routine to prevent erosions. PMC

4. Heat safety plan for hypohidrosis (cool rooms, fluids). National Organization for Rare Disorders

5. Hand hygiene and gentle wound care to lower infections. PMC

6. Sun protection to reduce skin stress. PMC

7. Regular dental care beginning in infancy. PMC

8. Hearing checks with early action if loss is found. MedlinePlus

9. Eye lubrication and protection after eyelid surgery. EyeWiki

10. Immunization per schedule to prevent general childhood infections that can complicate care (standard pediatric best practice). MedlinePlus

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When to see doctors (urgent and routine)

Seek urgent care if you notice eye redness with pain or discharge, fast-spreading skin redness or fever, feeding trouble with dehydration, breathing noise or pauses, or signs of heat stress (hot, dry skin; confusion; sleepiness). Keep regular appointments with your cleft/craniofacial team, ophthalmology, dermatology, dentistry, ENT/audiology, speech therapy, and your pediatrician to monitor growth, hearing, tooth development, and skin healing. MedlinePlus+1

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What to eat and what to avoid

1. High-calorie, high-protein foods to support healing and growth. (Work with a dietitian.) MedlinePlus

2. Soft, easy-to-swallow textures before and after palate repair. MedlinePlus

3. Plenty of fluids to prevent dehydration, especially with heat intolerance. National Organization for Rare Disorders

4. Small, frequent feeds if fatigue limits intake. MedlinePlus

5. Limit spicy, acidic foods that can sting mouth sores. MedlinePlus

6. Gentle temperature foods (not very hot) to avoid mucosal injury. MedlinePlus

7. Adequate vitamins/minerals from foods; consider supplements only with clinician guidance. PMC

8. Avoid hard, sharp snacks that scrape the palate or lips during healing. MedlinePlus

9. Good oral hygiene after feeds to protect teeth and gums. PMC

10. Allergy-aware choices if a child reacts to certain formulas or foods. Coordinate with your pediatrician. MedlinePlus

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Frequently asked questions

1. Is AEC the same as “ankyloblepharon filiforme adnatum–cleft palate syndrome”?
   Yes. Those words describe the three hallmark features in many children and match what is widely called AEC (Hay-Wells) syndrome. nfed.org

2. What causes it?
   A change in the TP63 gene that guides early skin and face development. National Organization for Rare Disorders

3. Did we do something to cause it?
   No. Most cases are new (de novo) gene changes that happen by chance. National Organization for Rare Disorders

4. Is it inherited?
   It can be. The pattern is usually autosomal dominant; a parent with the mutation can pass it on. Many children, however, are the first in the family. Wikipedia

5. How is it diagnosed?
   By the pattern of features and genetic testing for TP63. BioMed Central

6. Is there a cure?
   Not yet. Supportive care and surgeries treat symptoms and protect function. Research is ongoing. PMC+1

7. Can the eyelid bands be fixed?
   Yes. Simple band release is usually done early to protect vision. PMC

8. Will my child need cleft surgery?
   Most do if a cleft is present. Timing is set by the cleft/craniofacial team. MedlinePlus

9. What about the skin?
   Daily barrier care and careful wound management are key; treat infections promptly. PMC

10. Is overheating a risk?
    Yes, with low sweating. Use cooling and hydration plans. National Organization for Rare Disorders

11. Will teeth and hair be affected?
    They can be. Plan early dental care and discuss cosmetic and functional supports. PMC

12. Will hearing be a problem?
    Ear issues can occur with cleft palate; hearing checks and tubes may help. MedlinePlus

13. What specialists should we see?
    Craniofacial/cleft team, ophthalmology, dermatology, ENT/audiology, dentistry/orthodontics, speech therapy, genetics, and pediatrics. MedlinePlus

14. Are stem-cell or gene therapies available?
    Not as approved treatments yet; they remain research topics. nfed.org

15. Where can we find reliable information and support?
    National Organization for Rare Disorders (NORD), MedlinePlus Genetics, Orphanet, EyeWiki, and NFED (patient support and research). nfed.org+4National Organization for Rare Disorders+4MedlinePlus+4

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Last Updated: September 19, 2025.

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