What is Ichthyosis Vulgaris?

Ichthyosis vulgaris is a congenital condition characterized by an impairment of the desquamation process that allows for the formation of dry patches to form on the skin. Fostered by protein accumulation in the skin, ichthyosis vulgaris has sometimes been referred to as fish scale disease because of the patterned scales that can develop. In the absence of a cure, treatment for ichthyosis vulgaris is centered on symptom management and complication prevention.

Normally, humans shed well over one million dead skin cells on any given day, a process known as desquamation. For individuals with ichthyosis, their shedding process is impaired due to excessive protein accumulation within the topmost layers of the skin. Resulting from a genetic mutation, the protein keratin accumulates in the upper dermal layers, inhibiting the skin's ability to discard dead cells and ultimately causing the affected skin to become scaly.

Delivered by a non-sex chromosome, a child who receives the mutated gene from a parent who is a carrier possesses a 50/50 chance of inheriting ichthyosis vulgaris. It is rare that dermal symptoms are present at the time of birth. In most cases, ichthyosis vulgaris signs and symptoms emerge during early childhood. As the child matures, his or her symptoms may subside and fall into remission until later in adulthood.

Once symptoms are present, a diagnosis of ichthyosis vulgaris may be confirmed with a comprehensive consultation and physical examination by a qualified health care provider. Educated to recognize and understand the epidemiology of this form of ichthyosis, a physician will normally make a diagnosis without the aid of additional diagnostic testing. In situations when there may be a secondary condition suspected, additional laboratory testing, such as a skin biopsy, may be performed.

The severity and prominence of one’s signs and symptoms is entirely dependent on the individual. The most common sign associated with this autosomal dominant condition is scaly and dry skin that adopts a scaled pattern. Many people often present with pigment discoloration in the affected area, such as brown or gray patches. Individuals with this condition are considered at an increased risk for complications, including secondary bacterial infection and anhidrosis, a lack of sweating.

Treatment for ichthyosis vulgaris involves controlling one’s symptoms. Topical, prescription medications are generally used to reduce dermal dryness and irritation. Restoring moisture to the affected area helps to ease the scaling of one’s skin. Severe presentations of ichthyosis vulgaris may require the use of additional oral medications designed to inhibit the generation of new skin cells. Individuals are encouraged to discuss additional, proactive home-care options that may help ease symptoms with their physician, including bathing recommendations and how to choose the right soap and moisturizers.