Ichthyosis / Fish Scales Disease/Xeroderma

Ichthyosis is referred to skin disorder which is characterized by dry, thick, fish scaly skin surface. It can be either inherited or acquired. The inherited form are rare and are generally present from child birth and last lifelong due to faulty gene from where as acquired can be develop at any age due to number of medical conditions.

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There is no known cure for ichthyosis, but there are treatments available which can help in improving skin condition.

Race of Ichthyosis

Ichthyosis affects all races.It can affect either in acquired form or it may be inherited.

Classification

• Ichthyosis vulgaris: It causes dry, scaly skin. It is the most common form found.

• X-linked ichthyosis: The skin is dark brown or gray scales mainly on the neck, trunk and lower body areas. It appears soon after birth and occurs only in males.

• Lamellaris ichtyosis: It causes scaling of joints area including groin, armpits and neck.

• Harlequins ichthyosis: It causes large diamond-shape scales which are so thick that they limit movement. It is the most severe form of congenital ichthyosis.

• Bullous ichthyosis: It is a rare inherited ichythyosis, at birth the skin looks fragile and shows 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 prominent through childhood.

• Acquisita or acquired ichthyosis: It is passed from the parents to children.

• Lamellar ichthyosis: It is a severe form of ichthyosis that is present at birth and last  forever.

• Epidermolytic hyperkeratosis: One of the rare forms of ichthyosis , which is present at birth and is characterized by blistering skin.

Causes Of Ichthyosis

• Genetic mutations
• Family history
• Soaps and lotions containing fragrances
• Chemical reaction
• Cold weather

Signs and Symptoms

• Dry, scaling and flaking skin usually appears on elbow, lower legs and shins
• Deep,  painful fissures in the palm and soles
• Cracks in skin
• Possible skin thickening
• Tile-like, small scales, in polygon shapes
• Scalp flaking
• Mild itchy skin
• Body odor
• Ear wax

Investigations For Ichthyosis

• Complete case history
• Physical examination
• In very rare cases, skin biopsy is done

What Treatment To Be Done?

• istotretinoin

• Antibiotics

• Disinfectant soaps

• Cream or solution with lactic acid or salicylic acid.

• Cellophane bandaging after applying moisturizers

• Ointments based with Vitamin A

• Mineral oil

• Petroleum jelly

Prognosis Of Ichthyosis

Ichthyosis is not a life threatening disease. It usually disappears during adulthood, but may return years later.

Complications Of Ichthyosis

• Bacterial infection
• Cracked  dry skin
• Secondary skin infection
• Overheating of skin

Differential Diagnosis Of Ichthyosis

• Acrodermatitis enteropathica
• HIV
• Atopic dermatitis
• Herpes zoster
• Psoriasis
• Sarcoidosis
• Leukemias
• Acute retinal necrosis
• Kaposi sarcoma

Management Of Ichthyosis

• Apply lotions and creams to wet skin
• Rub  wet skin gently with pumice stone to remove extra skin
• Brush washed hair to remove scales from scalp
• Use antiseptics for washing
• Use mild soaps and detergents
• Use shampoos containing salicylic acid for scalp
• Maintain proper hygiene level
• Drink plenty of fluids

Homeopathic treatment for Ichthyosis

Arsenicum album:
• Skin dry, rough and scaly
• Psoriasis , eczema or ichthyosis
• Itching without eruptions
• Must scratch until it bleeds
• Ulcers, chronic, spreading and burning

Arsenicum iodatum:
• Skin harsh, dry and scaly
• Marked exfoliation of skin in the form of large scales
• Skin raw and exuding.
• Watery, ozzing, itching, worse with washing

Cadmium sulphuratum:
• Blue, yellow sallow scaly cracked skin
• Itching better scratching
• Worse exposure to sun and wind

Graphites:
• Skin rough, hard, persistently dry
• Eruptions, oozing out a sticky exudation
• Rawness in the bends of limbs
• Unhealthy skin; every little injury suppurates

Oleander:
• Itching, scurfy pimples
• Skin sensitive and numb, nocturnal burning
• Very sensitive skin; slightest friction causes soreness and chapping
• Violent itching eruption, bleeding, oozing.
• Pruritus, especially of scalp, which is sensitive

Petroleum:
• Itching at night
• Skin dry, constrictes, very sensitive , rough and cracked
• Slightest scratch makes skin suppurate.
• Skin thick, greenish crusts, burning and itching.
• Red raw cracked skin which bleeds easily.

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