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 affect other organs.
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.
Some forms of ichthyosis cause blisters, which may lead to bacterial infections.
Acquired ichthyoses
Acquired ichthyoses may be caused by a number of internal disorders, such as an underactive thyroid gland (hypothyroidism), lymphoma, and AIDS. 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 do 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 rule out 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
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,
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.
