Fish scale disease

Alternative names
Common ichthyosis; Ichthyosis vulgaris

Definition

Ichthyosis vulgaris is a common inherited skin disorder causing dry, scaly skin.

Causes, incidence, and risk factors

Ichthyosis vulgaris is one of the most common of the inherited skin disorders. It may begin in early childhood, before a child is 4 years old. In most cases one parent and one-half of the children will be affected. It usually disappears during adulthood, but may recur when elderly.

Ichthyosis involves development of dry, scaly skin. It is usually most severe over the legs but may also involve the arms, hands, and trunk in some cases. It is usually associated with many fine lines over the palm of the hand. The condition is often more noticeable in the winter. It may be associated with atopic dermatitis , keratosis pilaris (small bumps on the back of the arms), or other skin disorders.

Symptoms

     
  • skin lesion/rash       o dry skin, severe       o scaly appearance, adherent scales       o may thicken  
  • itching of the skin, mild

Signs and tests

The diagnosis is made primarily on the basis of the skin appearance. The health care provider may need to rule out other possible causes of dry, scaly skin. A family history of similar skin dryness is often obtained.

Treatment
Intensive localized moisturizing may reduce symptoms. Creams and ointments are more effective than lotions. They are best applied to wet skin immediately after bathing. The use of mild, non-drying soaps is encouraged. Use of moisturizing creams that contain keratolytic agents (chemicals that help skin to shed normally), such as lactic acid, salicylic acid, and urea, are often very helpful in this condition.

Expectations (prognosis)
Ichthyosis may be annoying but seldom affects medical health. It usually improves during adulthood but may recur when a person becomes elderly.

Complications
Secondary bacterial skin infection may develop if scratching causes openings in the skin.

Calling your health care provider
Call for an appointment with your health care provider if ichthyosis symptoms persist despite treatment, if symptoms worsen, lesions spread, or if new symptoms develop.

Prevention
If you have this condition, be aware that your children are at risk for developing it.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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