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Ichthyosis

Clinical Manifestations and Practical Treatment Options

  • Therapy In Practice
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Abstract

Ichthyoses constitute a large group of cornification disorders that affect the entire integument. The skin is characterized by visible scaling and in many cases by inflammation, for example, in bullous/keratinopathic ichthyosis or Netherton syndrome. From the viewpoint of classification it is useful to distinguish nonsyndromic from syndromic types of ichthyosis. Ichthyosis vulgaris and recessive X-linked ichthyosis are common disorders—often of delayed onset, in contrast to congenital ichthyoses, which belong to the group of rare diseases and present at birth with either the features of collodion membrane or congenital ichthyosiform erythroderma.

The diagnostic steps are based on clinical data, analyses such as the steroid sulfatase activity test, skin biopsies, and genetic results. However, the dramatic increase in knowledge about the pathophysiology of these conditions has not led to a curative therapy so far. The therapeutic management is multidisciplinary and involves ichthyosis patient organizations in many countries. The mainstay of treatment remains with moisturizing creams containing, for example, urea, lactic acid and other humectants and keratolytics, regular bathing, and mechanical scale removal. Patients with lamellar ichthyosis or ichthyosiform erythroderma in particular profit from oral therapy with retinoids or retinoic acid metabolism-blocking agents.

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Acknowledgments

We are grateful to all our patients and to Selbsthilfe Ichthyose e.V., and want to thank Mrs Bückmann and Mr Wissel for help with the photographs. Our work is supported by the Network for Ichthyoses and Related Keratinization disorders (NIRK, Bundesministerium für Bildung und Forschung, GFGM01143901), the ichthyosis patient organization of Germany (Selbsthilfe Ichthyose e.V.), and the Foundation for Ichthyosis and Related Skin Types (F.I.R.S.T., North Wales, PA, USA). The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Dermatology, University of Münster, Münster, Germany

    Vinzenz Oji & Heiko Traupe

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Oji, V., Traupe, H. Ichthyosis. AM J Clin Dermatol 10, 351–364 (2009). https://doi.org/10.2165/11311070-000000000-00000

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