Ichthyosis is scaling and flaking of the skin that ranges from mild but annoying dryness to severe and disfiguring skin disease.
(See also Itching and Dry Skin (Xeroderma).)
Ichthyosis is a form of severe dry skin. Ichthyosis causes scale to form on the skin in excessive amounts. Scale is areas of heaped-up, dead skin cells that appear as flaky, dry, rough patches.
Unlike xeroderma, which is ordinary dry skin, ichthyosis is dry skin that results from an inherited disorder (called inherited ichthyosis) or from a number of other disorders or medications (called acquired ichthyosis).
Inherited ichthyoses
Inherited ichthyoses (the most common forms) are the result of genetic mutations that are usually passed on from parent to child but that sometimes occur spontaneously.
Inherited ichthyoses are seen at birth or develop during infancy or childhood.
There are many different types of inherited ichthyoses. Some affect only the skin, and others are just one part of inherited disorders that can affect other organs. Sometimes ichthyosis can cause the formation of a tight parchment-like covering around the baby's skin at birth.
Depending on the form, the scale may be fine or it may be large, thick, and warty. Scale may form on only the palms of the hands and soles of the feet, or it may cover most of the body.
Itching, peeling, and skin tightness can occur. Some forms of ichthyosis cause blisters, which may lead to bacterial infections.
Dryness of the mouth and eyes is also common in people with inherited ichthyosis.
Acquired ichthyoses
Acquired ichthyoses may be caused by a number of internal disorders, such as an underactive thyroid gland (hypothyroidism), lymphoma, and late-stage HIV. Some medications can cause acquired ichthyosis (such as nicotinic acid, triparanol, and butyrophenones).
Acquired ichthyoses typically develop during adulthood.
Diagnosis of Ichthyosis
Development of characteristic scales
For inherited ichthyoses, tests and consultation with a geneticist
For acquired ichthyoses, sometimes skin biopsy
Inherited ichthyoses are diagnosed when infants are born with or children develop the characteristic scales on their skin. Doctors order tests and consult experts in genetics (geneticists) to determine the cause of inherited ichthyoses.
Acquired ichthyoses are diagnosed when people develop the characteristic scales after taking a medication or developing an internal disorder.
Doctors may do a skin biopsy to exclude other causes of skin dryness and flaking and sometimes to determine an internal cause.
Treatment of Ichthyosis
For any ichthyosis, moisturizers
For inherited ichthyosis, certain medications
For acquired ichthyoses, treatment of cause
For possible infection, antibiotics
Moisturizers are used to treat any form of ichthyosis. Ones that contain petroleum jelly, mineral oil, salicylic or lactic acid, ammonium lactate, ceramides, dexpanthenol, or urea should be applied immediately after bathing while the skin is still wet. Excess moisturizer can be removed by blotting with a towel.are used to treat any form of ichthyosis. Ones that contain petroleum jelly, mineral oil, salicylic or lactic acid, ammonium lactate, ceramides, dexpanthenol, or urea should be applied immediately after bathing while the skin is still wet. Excess moisturizer can be removed by blotting with a towel.
To help remove the scales, adults can apply a solution of propylene glycol in water to the affected areas after bathing. The areas are then covered with a thin plastic film or bag overnight. The solution can be applied to children twice a day, but no film or bag is used.
For inherited ichthyosis, creams or pills containing substances related to vitamin A (retinoids), such as tretinoin cream, oral isotretinoin, or oral acitretin, help the skin shed the excessive scales.creams or pills containing substances related to vitamin A (retinoids), such as tretinoin cream, oral isotretinoin, or oral acitretin, help the skin shed the excessive scales.
For acquired ichthyosis, the underlying disorder is treated or the medication causing the ichthyosis is stopped.
People who are at risk of bacterial infection may be given antibiotics by mouth.
