Information on ichthyosis and dry scaly skin.

What is Ichthyosis?

Ichthyosis is a common skin disorder characterized by the formation of dry, fish-like scales on the skin’s surface. The scales are small and polygonal in shape and may range from white to dirty gray to brown depending on the color of your skin. It is a genetic disorder that often begins in infancy or early childhood (usually before 4 years old), and disappears during the adult years, only to return much later.

It may also be associated with other skin disorders such as atopic dermatitis or keratosis pilaris. Although most cases of ichthyosis are mild, people with this disorder experience much discomfort and have to spend a large portion of their time managing the symptoms.

Types of ichthyosis include:

• Ichthyosis vulgaris causes dry, scaly skin and affects approximately 1 in every 250 people making it the most common type.
• X-linked ichthyosis causes the formation of dark brown or gray scales mainly on the skin in the neck, trunk and lower body areas.
• Ichthyosis lamellaris causes scaling that forms mainly in the joint areas including the groin, armpits, and neck.
• Harlequins ichthyosis causes large diamond-shaped scales which are so thick they limit movement. This is the most severe form of congenital ichthyosis.
• Bullous ichthyosis is another rare inherited Ichthyosis. At birth the baby's skin seems to be fragile and may show blisters, without much scaling. Later during first year of life, blistering reduces but is replaced with widespread redness, scaling and thickening of the skin which becomes more obvious through childhood
• Ichthyosis acquisita or acquired ichthyosis may develop in patients of any age with certain forms of malignant disease and infectious disease, in dietary and vitamin A deficiencies, as a side effect of cholesterol-lowering medication, in dialysis patients, hypothyroidism or for no apparent reason.
• Lamellar ichthyosis – severe form of ichthyosis that is present at birth and lasts throughout life
• X-linked ichthyosis – begins soon after birth and only occurs in males
• Epidermolytic hyperkeratosis – this rare form of ichthyosis is usually present at birth and is characterized by blistering skin

The symptoms and signs of ichthyosis include:

• Dry, scaling and flaking skin that usually appears on elbows, lower legs, and shins
• Deep, painful fissures in the palms and soles
• Mild itchy skin
• Scalp flaking
• Body odor as a result of spaces under and between skin flakes can harbor collections of bacteria or fungus
• Wax buildup in ears

What Causes Ichthyosis?

The cause of ichthyosis depends on the type. Inherited forms of ichthyosis occur as a result of a genetic mutation that is passed down from one generation to the next – sometimes only one person within a family is affected.

• Inherited forms of ichthyosis occur as a result of a genetic mutation that is passed down from one generation to the next or that occurs spontaneously – sometimes only one person within a family is affected
• Certain soaps and lotions containing fragrances
• Use of household detergents and chemicals
• Cold weather

Diagnosing Ichthyosis

Your doctor or dermatologist can diagnose ichthyosis by examining your skin and the characteristic scales. Certain factors such as your family history of ichthyosis, the age when it first started and the presence of other skin disorders are also taken into consideration. Other tests such as a skin biopsy where a small piece of skin is removed and examined under a microscope may also help to confirm the diagnosis.

Help for Ichthyosis

The primary aim of treatment is to manage this condition by caring for the skin properly and consulting your dermatologist regularly. Medicines such as creams or lotions that contain alpha hydroxyl acids (lactic and glycolic) increase moisture, control scaling and promote shedding may be prescribed.

Retinoids may also be prescribed in severe cases to reduce the production of skin cells. If a skin infection or body odor develops, antibiotics can help but have some harsh side effects such as eye and lip inflammation, hair loss, bone spurs and birth defects during pregnancy.

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