Noonan syndrome with multiple lentigines (NSML) is a rare inherited disorder. People with this condition have problems with the skin, head and face, inner ear, and heart. The genitals may also be affected.
Noonan syndrome with multiple lentigines was formerly known as LEOPARD syndrome.
Causes
NSML is inherited as an autosomal dominant trait. This means the person only needs an abnormal gene from one parent in order to inherit the disorder.
Exams and Tests
Your health care provider will perform a physical exam and listen to the heart with a stethoscope.
Tests that may be done include:
- Electrocardiogram (ECG) and echocardiogram to check the heart
- Hearing test
- CT scan of the brain
- Skull x-ray
- EEG to check the brain's function
- Blood tests to check certain hormone levels
- Removing a small amount of skin for examination (skin biopsy)
Treatment
Symptoms are treated as appropriate. A hearing aid may be needed. Hormone treatment may be necessary at the expected time of puberty to cause the normal changes to occur.
Laser, cryosurgery (freezing), or bleaching creams may help lighten some of the brown spots on the skin.
Support Groups
More information and support for people with LEOPARD syndrome and their families can be found at:
- National Organization for Rare Disorders - rarediseases.org/rare-diseases/leopard-syndrome/
- Noonan Syndrome Foundation - www.teamnoonan.org/information
- Rasopathies Network - rasopathiesnet.org/
Possible Complications
Complications vary and include:
- Deafness
- Delayed puberty
- Heart problems
- Infertility
When to Contact a Medical Professional
Contact your provider if there are symptoms of this disorder.
Contact your provider for an appointment if you have a family history of this disorder and plan to have children.
Prevention
Genetic counseling is recommended for people with a family history of NSLM who want to have children.
Alternative Names
Multiple lentigines syndrome; LEOPARD syndrome; NSML
References
James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Melanocytic nevi and neoplasms. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 30.
Paller AS, Mancini AJ. Disorders of pigmentation. In: Paller AS, Mancini AJ, eds. Paller and Mancini – Hurwitz Clinical Pediatric Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 11.
Review Date 5/31/2023
Updated by: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.