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Ichthyosis vulgaris

Ichthyosis vulgaris is a rare skin condition in which the surface of the skin becomes thick, dry and scaly. It is also known as ‘fish scale disease’ due to its appearance. The severity of this condition can range from mild to severe. In general, ichthyosis vulgaris does not affect the overall health of the patient, but it can be bothersome. There are many types of ichthyosis but are very rare.

Symptoms

The severity of the symptoms of ichthyosis vulgaris vary from person to person and may include:

  • Extremely dry skin
  • Large dry scales
  • Flaky scalp
  • Mild itching of the skin
  • Skin thickening
  • Cracks on the skin

The symptoms usually worsen during the winter as the air is cold and dry. The dryness and scales formation is more severe on the lower legs, and elbows followed by the arms, hands, and the middle of the body. Sometimes several fine lines may appear on the palms. Occasionally, the moist areas such as armpits or groins can appear scaly.

Causes

Usually, ichthyosis vulgaris is inherited from the parents and is present at the time of birth, or it may develop in early childhood (especially between 2 to 5 years of age). However, adults can also rarely develop this condition.

Ichthyosis vulgaris occurs due to a genetic defect in the protein involved in skin hydration by creating a moisture retaining barrier on the skin surface. Consequently, the ability of the skin to retain water in the superficial layers is lowered leading to dryness. Over a period, the dehydrated skin cells become hard and thick. These cells move to the surface of the skin to form scales. This mutated gene can pass down through families and affect the progeny.

The other causes which may lead to ichthyosis vulgaris during adulthood are:

  • Use of certain medications
  • Diseases, such as thyroid disease, cancer, HIV or kidney failure

Ichthyosis vulgaris is not a contagious disease and does not spread from one person to the other with physical contact.

Risk factors

The following factors can increase the risk of a person to develop ichthyosis vulgaris:

  • A family history of the condition
  • Exposure to dry or cold environments

Complications

Ichthyosis vulgaris can lead to the following complications:

  • Skin irritation, redness, and itching
  • Increased likelihood of infections due to excessive scratching of the skin
  • Allergic conditions, such as eczema, hay fever, and asthma
  • Overheating of the body due to the interference of the sweating process with the scaly skin

Diagnosis

 

The healthcare provider may initially suspect ichthyosis vulgaris by visually examining the skin. Additionally, the family history of similar skin conditions of the patient is collected. However, further diagnosis is necessary to rule out other possible conditions. These may include blood tests and skin biopsy. A skin biopsy involves the microscopic examination of the affected skin surface or a cheek cell sample.

Treatment

Ichthyosis vulgaris cannot be completely cured, but the available treatments are aimed to ease the symptoms. The treatment approaches include:

  • Moisturizers, such as topical creams and ointments are recommended. These moisturizers act by suppressing the evaporation of water from the skin surface and prevent dryness. They should be applied immediately after taking a bath with a mild and non-drying soap.
  • Exfoliating creams and ointments may be prescribed to help in shedding the scaly skin and improve the moisture content.
  • Vitamin A containing medicines will be prescribed in severe cases to slow down the production of skin cells.

Self-care

The following self-care measures can help to manage ichthyosis vulgaris:

  • Staying in the humid environments
  • Using a humidifier to add moisture to the air in the rooms
  • Protecting the skin from wind
  • Exfoliating the skin with a pumice stone or a loofah to remove the dead or scaly skin
  • Soaking the affected skin in salt water
  • Brushing the hair carefully to remove scales on the scalp
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