Ichthyosis (Fish Scale Disease, Xeroderma)

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Definition

Ichthyosis is a dry skin condition. There are two general types:

  • Inherited ichthyosis (several forms exist)dryness and scaling of the skin due to hereditary factors
  • Acquired ichthyosisthickening and scaling of the skin that is not inherited but is associated with certain medical disorders

Causes

Inherited ichthyosis is caused by a genetic defect that is passed from parent to child or that occurs spontaneously.

Acquired ichthyosis is relatively rare but may be caused by any of the following:

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.Risk factors for ichthyosis include:

  • Family member with ichthyosis
  • Cold weather
  • Frequent or prolonged bathing, especially in hot water
  • Harsh soaps or detergents
  • Soaps or lotions containing certain scents or perfumes

Symptoms

Ichthyosis can develop on any part of the body, but most often occurs on the legs, arms, or trunk. The symptoms can vary from mild to severe. In severe cases, the condition may be disfiguring. Symptoms may include:

Dry, flaking skinScaling of skin that gives skin the appearance of fish scalesShedding of layers of the skinItching of skinIn severe cases, scarring and/or infection due to rubbing and scratching of scales or blisters With certain rare types of inherited ichthyosis, symptoms: Appear immediately at birthAre extremely severe, covering the entire bodyCause severe complications or death Diagnosis The doctor will ask about your symptoms and medical history, and perform a physical exam. The diagnosis of ichthyosis is usually based on signs and symptoms of the disorder. Rarely, blood tests or a skin biopsy may be required. Skin Biopsy 2008 Nucleus Medical Art, Inc. TreatmentSince there is no cure for ichthyosis, treatment consists of managing the symptoms. Most treatment is aimed at keeping the skin moist. In severe cases, medication may be prescribed. For the acquired form, treatment that lessens the severity of the underlying noninherited condition may also help lessen the symptoms of the associated ichthyosis. Moisturizing Skin Many types of moisturizing ointments, lotions, and creams are used to lessen or alleviate symptoms of ichthyosis. These include: Petroleum jellyMineral oilCreams, lotions, and ointments containing vitamin AA large variety of nonprescription, unscented moisturizers For ichthyosis that causes scaling:
Solutions or creams with lactic or salicylic acid or urea may help.In some cases, doctors may suggest wrapping affected areas with a plastic or cellophane "bandage" after applying moisturizing agent. Such bandages should not be used on children. Medications In severe cases, drugs are sometimes prescribed, including: Etretinate and isotretinoin These medications are retinoids, which are derivatives of vitamin A; excess amounts of vitamin A can be harmful. Antibiotics (if the skin becomes infected)Disinfecting soaps (eg, chlorhexidine) Prevention There are no guidelines for preventing the development of ichthyosis. However, steps to prevent this condition from getting worse include: Bathing less oftenApplying nonscented moisturizing agents regularly and frequently (especially in winter)Using only mild soap Avoiding: Harsh soapsSoaps with scents or perfumesSkin contact with detergentsCold, dry weather (when possible) RESOURCES: Foundation for Ichthyosis and Related Skin Typeshttp://www.scalyskin.org The National Registry for Ichthyosis and Related Disordershttp://depts.washington.edu/ichreg/ichthyosis.registry CANADIAN RESOURCES:
Canadian Dermatology Associationhttp://www.dermatology.ca/english/ Dermatologists.cahttp://www.dermatologists.ca/index.html References: Beers MH. The Merck Manual of Medical Information . 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003. The Foundation for Ichthyosis and Related Skin Types website. Available at: http://www.scalyskin.org . Accessed October 11, 2005. Ichthyosis vulgaris. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/001451.htm . Accessed October 11, 2005. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/ . Accessed October 11, 2005. Last reviewed November 2007 by Ross Zeltser, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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