A skin condition called ichthyosis vulgaris causes patches of dry, scaly skin. In addition to being known by the fish scales, Ichthyosis vulgaris is one of the most common inherited skin disorders. It can affect anyone of any age and skin color, but is more common in people with fair skin.
The genetic mutation that causes ichthyosis vulgaris affects the production of a protein called filaggrin. Skin cells are able to stick together and shed properly when there is enough filaggrin. Without enough filaggrin, they do not separate easily and accumulate on the surface. This causes dryness, scaling, and thickening of the skin.
There are two types of ichthyosis vulgaris: inherited and acquired.
Inherited ichthyosis vulgaris is passed down from one or both parents who carry the mutated gene. A person who inherits the gene has a 50% chance of developing the condition.
Acquired ichthyosis vulgaris occurs later in life due to other factors, such as certain diseases (e.g., kidney failure, thyroid disease), medications (e.g., cimetidine, clofazimine), or vitamin deficiencies (e.g., nicotinic acid).
The symptoms of ichthyosis vulgaris vary depending on the severity and extent of the condition. Some common symptoms include:
Dry, itchy skin
Thickened skin that looks dirty or scaly
White, gray or brown scales on the front of the legs, back of the arms, scalp, back or stomach
Cracks or fissures on the palms or soles
Painful inflammation or infection
The symptoms are usually worse in winter when the air is colder and drier. They may also be triggered by stress, sun exposure, or harsh soaps.
A doctor specializing in skin disorders can diagnose ichthyosis vulgaris by examining your skin and asking about your medical history and family history. Tests may also be performed to confirm the diagnosis or rule out other factors.
Some tests that may be done include:
Skin biopsy: A small sample of your skin is taken and examined under a microscope to look for signs of abnormality.
Genetic test: A blood test or saliva test can be done to check for mutations in genes that are associated with ichthyosis vulgaris.
Patch test: A small area of your skin is covered with a chemical substance to see if you have an allergic reaction.
The main goals of treatment for ichthyosis vulgaris are to moisturize your skin regularly, protect it from sun damage and infections, and reduce inflammation and itching.
Some treatment options include:
Moisturizers: Creams or lotions that contain ingredients such as glycerin, lactic acid, urea or petrolatum can help hydrate your skin and soften scales.
Emollients: Ointments that contain ingredients such as lanolin or mineral oil can help seal in moisture and prevent water loss from your skin.
Retinoids: Vitamin A derivatives that can help stimulate cell turnover and improve elasticity of your skin.
Antibiotics: Medications that can help treat bacterial infections that may occur due to cracks or wounds on your skin.
Antihistamines: Medications that can help reduce itching caused by allergic reactions or inflammation.
Phototherapy: Exposure to ultraviolet (UV) light under medical supervision can help improve blood circulation and reduce scaling in some cases.
Surgery: In rare cases when other treatments fail to provide relief or when there are severe complications such as eye problems due to eyelid scales (blepharitis), surgery may be considered to remove excess tissue from affected areas.
There is no sure way to prevent ichthyosis vulgaris since it is caused by genetic factors that you cannot control. However, some general measures that may help reduce your risk include:
Avoiding harsh soaps or detergents that may irritate your skin
Using gentle cleansers and lukewarm water when washing your body
Applying moisturizer after bathing
Wearing loose-fitting clothing made from natural fibers such as cotton
Protecting your skin from sun exposure by wearing sunscreen with SPF 30 or higher
Avoiding scratching or picking at your scales
Seeking medical attention if you notice any signs of infection such as redness swelling pain fever pus
