Ichthyosis

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It is a scaly skin disease.

There are inherited types to it, which appear from birth or childhood, and acquired ones. Acquired ones are usually associated with drugs, or be manifestations of some kind of disease: hypothyroidism, sarcoidosis, HIV, lymphomas, breast cancer, lung cancer, multiple myeloma, mycosis fungoides, etc.

It usually presents as a mild skin disease, although there are severe forms that appear as disfiguring. A dry and rough skin with scales (white, grey or brown) is the main manifestation; it can also affect the scalp. It is a diffuse disease, exacerbated in the torso and limbs and generally not present in areas of flexion. Sometimes they have painful cracks that can get infected.

The diagnosis is clinical. The genetic or acquired origin must be differentiated and, in this case, try to look for the underlying cause (if it is not yet known). A dermatologist should be consulted, who will sometimes perform a skin biopsy.

The treatment will depend on the type and cause of ichthyosis. In general, good hydration and lubrication of the skin must be maintained, and the skin should be washed with antiseptic soaps.

Bibliographic references
  1. Saral S, Vural A, Wollenberg A, Ruzicka T. A practical approach to ichthyosis with systemic manifestations. Clin Genet. 2017 Jun;91(6):799-812.
  2. Vega Almendra N, Aranibar Duran L. Hereditary ichthyosis: A diagnostic and therapeutic challenge. Rev Chil Pediatr. 2016 May-Jun;87(3):213-23.
  3. Takeichi T, Akiyama M. Inherited ichthyosis: Non-syndromic forms. Dermatol. 2016 Mar;43(3):242-51
  4. Hernández-Martín A, Torrelo-Fernández A, de Lucas-Laguna R, Casco F, González-Sarmiento R, Vega A, Pedreira-Massa JL, de Unamuno-Pérez P, Larcher F, Arroyo I, Traupe H. First symposium of ichthyosis experts. Actas Dermosifiliogr. 2013 Dec;104(10):877-82.
  5. Patel N, Spencer LA, English JC, Zirwas MJ. Acquired ichthyosis. J Am Acad Dermatol. 2006 Oct;55(4):647-56. Review.
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Symptoms

    Brown flakes


    Scales on the skin


    Skin lesions worsen with cold and improve with warmth


    Skin with scaly red patches


    Yellowish-white flakes

Symptoms to watch out for

Fever (temperature higher than 38 ºC)
Reddened and painful ulcer in the affected area
Reddish sores that are itchy, break open, and ooze clear fluid or pus

Self-care

Have prolonged immersion baths.
Use a moisturising cream or lubricant on damp skin after showering.
Apply over-the-counter products with urea, lactic acid or low concentration of salicylic acid twice daily.
Check with your general practitioner to discuss retinoid treatment.