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A seminal finding that monozygotic twins are epigenetically indistinguishable early in life but, with age, exhibit substantial differences in epigenetic markers underscores the important role played by the environment in shaping the epigenome (Fraga et al. To the best of our knowledge, the occurrence of CES in 3 siblings, including a pair of monozygotic twins, and the auricular abnormality we observed have not been described before. Studies of the prevalence of autoimmune disease in monozygotic twins show that genetic as well as environmental factors (such as infection) are necessary for the disease to develop (6). |
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