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Congenital hemidysplasia with ichthyosiform nevus and limb defects (CHILD) syndrome is an exceedingly rare, X-linked dominant genetic disorder of lipid metabolism that arises from mutations in NAD(P) dependent steroid dehydrogenase-like gene (NSDHL), which encodes 3β-hydroxysteroid-dehydrogenase, an enzyme essential to cholesterol synthesis. Cholesterol plays a crucial role in hedgehog signaling during normal mammalian development, thus explaining the striking right-to-left unilateralism of both cutaneous and visceral manifestations typified by this condition.
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Fackler et al. (2018) studied this question.
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