Editing Ehlers–Danlos syndrome (section)

===Classical===
[[File:PMC3504533 1471-2415-12-47-2 (cropped).png|thumb|Individual with classical EDS displaying skin hyperelasticity.  Not all people with EDS have this trait.]]

Classical EDS is characterized by extremely elastic skin that is fragile and bruises easily and hypermobility of the joints. Molluscoid pseudotumors (calcified [[hematoma]]s that occur over pressure points) and spheroids (cysts that contain fat occurring over forearms and shins) are also often seen. A side complication of the hyperelasticity presented in many EDS cases makes wounds closing on their own more difficult.<ref name="Malfait_2018" /> Sometimes, motor development is delayed and [[hypotonia]] occurs.<ref name=GARD2017>{{cite web|title=Ehlers–Danlos syndromes | work = Genetic and Rare Diseases Information Center (GARD) – an NCATS Program | publisher = U.S. National Institutes of Health |url=https://rarediseases.info.nih.gov/diseases/6322/ehlers-danlos-syndromes |access-date=23 September 2017|date=20 April 2017|url-status=live|archive-url=https://web.archive.org/web/20170924001628/https://rarediseases.info.nih.gov/diseases/6322/ehlers-danlos-syndromes|archive-date=24 September 2017}}{{PD-notice}}</ref> The variation causing this type of EDS is in the genes ''[[COL5A2]], [[COL5A1]],'' and less frequently ''[[COL1A1]]''. It involves the skin more than hEDS.<ref name = "Malfait_2018">{{cite book | vauthors = Malfait F, Wenstrup R, De Paepe A | chapter = Classic Ehlers–Danlos Syndrome| date = July 2018 | chapter-url= http://www.ncbi.nlm.nih.gov/books/NBK1244/| title = GeneReviews |publisher=University of Washington, Seattle |pmid=20301422 |access-date=2019-06-03 | veditors = Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJ, Stephens K, Amemiya A}}</ref> In classical EDS, large variation in symptom presentation is seen. Because of this variance, EDS has often been underdiagnosed.<ref>{{cite journal | vauthors = Kapferer-Seebacher I, Lundberg P, Malfait F, Zschocke J | title = Periodontal manifestations of Ehlers–Danlos syndromes: A&nbsp;systematic review | journal = Journal of Clinical Periodontology | volume = 44 | issue = 11 | pages = 1088–1100 | date = November 2017 | pmid = 28836281 | doi = 10.1111/jcpe.12807 | s2cid = 36252998}}</ref> Without genetic testing, healthcare professionals may be able to provide a provisional diagnosis based on careful examination of the mouth, skin, and bones, as well as by neurological assessment.<ref>{{cite journal | vauthors = Castori M | title = Ehlers–Danlos syndrome, hypermobility type: an underdiagnosed hereditary connective tissue disorder with mucocutaneous, articular, and systemic manifestations | journal = ISRN Dermatology | volume = 2012 | page = 751768 | date = 2012 | pmid = 23227356 | doi = 10.5402/2012/751768 | pmc = 3512326 | doi-access = free}}</ref>

A good way to begin the diagnostic process is by reviewing a person's family history. EDS is an autosomal dominant condition, so is often inherited from parents.<ref name="Malfait_2018" /> Genetic testing remains the most reliable way to diagnose EDS.<ref>{{cite journal | vauthors = Rakhmanov Y, Maltese PE, Bruson A, Castori M, Beccari T, Dundar M, Bertelli M |date=2018-09-01|title=Genetic testing for vascular Ehlers–Danlos syndrome and other variants with fragility of the middle arteries|url=https://doaj.org/|journal=The EuroBiotech Journal|volume=2|issue=s1|pages=42–44|doi=10.2478/ebtj-2018-0034|s2cid=86589984|issn=2564-615X|doi-access=free}}</ref> No cure for type 1 EDS has been found, but a course of non-weight-bearing exercise can help with muscular tension, which can help correct some EDS symptoms. Anti-inflammatory drugs and lifestyle changes can help with joint pain. Lifestyle choices should also be made with children who have EDS to try to prevent wounds to the skin. Protective garments can help with this. In a wound, deep stitches are often used and left in place for longer than normal.<ref name="Malfait_2018" />