Acrocallosal syndrome (also known as ACLS) is an extremely rare autosomal recessive syndrome characterized by corpus callosum agenesis, polydactyly, multiple dysmorphic features, motor and intellectual disabilities, and other symptoms. The syndrome was first described by Albert Schinzel in 1979. Mutations in KIF7 are causative for ACLS, and mutations in GLI3 are associated with a similar syndrome. Signs and symptoms
Acrocallosal syndrome (ACLS, ACS, Schinzel-type, Hallux-duplication) is a rare, heterogeneous autosomal recessive disorder first discovered by Albert Schinzel (1979) in a 3-year-old boy. Characteristics of this syndrome include agenesis of the corpus callosum, macrocephaly, hypertelorism, poor motor skills, intellectual disability, extra fingers and toes (particularly hallux duplication), and cleft palate. Seizures may also occur. Mechanism
Mutations in the KIF7 gene are causative for ACLS. KIF7 is a 1343 amino acid protein with a kinesin motor, coiled coil, and Gli-binding domains. It is associated with ciliary motor function and is a key factor in the ciliary Hedgehog signaling pathway that is crucial during embryogenesis. Mutations in Hedgehog signaling components such as KIF7 and GLI3 may lead to ciliopathies and defects in the brain and other areas associated with ACLS and related disorders.Mutations in the GLI3 gene may cause ACLS or similar syndromes such as Greig cephalopolysyndactyly syndrome, Pallister–Hall syndrome, or certain types of polydactyly. KIF7 interacts with Gli transcription factors, so mutations in the KIF7 gene may be upstream effectors of GLI3, resulting in similar symptoms. Diagnosis
ACLS is typically diagnosed on the basis of physical examination. At least three of four core criteria published by Courtens et al.
It is also caused by trauma. In most cases, when white spots appear on a single or a couple of fingers or toes, the most common cause is injury to the base (matrix) of the nail. When this is the case, white spots disappear after around eight months, which is the amount of time necessary for nails to regrow completely. The pattern and number of spots may change as the nail grows. Longitudinal leukonychia
Longitudinal leukonychia is far less common and features smaller 1mm white longitudinal lines visible under the nail plate and parallel to the nail bed. It may be associated with Dariers disease. Cause
It is harmless and most commonly caused by minor injuries, such as nail biting, which occur while the nail is growing. Leukonychia occurs most commonly in healthy individuals, and is unrelated to any known nutritional or physiological deficiency. When caused by injury the marks will disappear as the nail grows outwards. While there are various sources that link dietary needs or vitamin deficiency with recurrent leukonychia, this notion has been challenged by some medical researchers.Other possible reasons for this problem with nail colour can be linked to:

Arsenic poisoning
Lead poisoning
Pneumonia
Heart disease
Kidney failure
Ill health
Hypoalbuminemia
Vitamin deficiency
Ulcerative colitis
Liver cirrhosis
Psychogenic stresses
Onychophagia
Trauma injury
Occupational trauma
Zinc deficiency
Protein deficiency
Psoriasis
Eczema
Iron deficiency

Diagnosis
A doctor will take a thorough medical history, and may take blood tests as well as examining liver and kidney function. Intracellular (red blood cell) assays are more sensitive than tests for plasma levels. Treatment
Improvements have been reported from treating malnutrition associated with zinc deficiency and other minerals. References


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