Acquired Ichthyosis Facts, Treatment, Prevention

By: Juliet Cohen

Acquired ichthyosis is a disorder clinically and histologically similar to ichthyosis vulgaris. Acquired ichthyosis most often appears in adulthood. It may appear before or after the diagnosis of a systemic condition. It may develop in patients of any age with certain forms of malignant disease and infectious disease, in dietary and vitamin A deficiencies, as a side effect of cholesterol-lowering medication, in dialysis patients, hypothyroidism or for no apparent reason. Acquired ichthyosis has also been associated with the use of certain medications such as nicotinic acid, triparanol, butyrophenones, dixyrazine, cimetidine, and clofazimine. It can occur in people suffering from leprosy, AIDS, tuberculosis, and typhoid fever.

Acquired ichthyosis has been associated with various systemic diseases, although malignant conditions, especially hodgkin's lymphoma are the most commonly cited. The severity of acquired ichthyosis usually depends on the underlying condition present. As the systemic condition is treated, the ichthyosis generally improves. Diagnosis of acquired ichthyosis is usually based upon the skin symptoms present. If acquired ichthyosis appears before a systemic disease is diagnosed, the individual will be examined further for the presence of an underlying disorder. In any ichthyosis, minimizing bathing or showering is helpful. Soaps should be used only in intertriginous areas. Hexachlorophene products should not be used because of increased absorption and toxicity.

The main goal of treatment for acquired ichthyosis is to moisturise and exfoliate. This helps prevent dryness, scaling, cracking and build-up of skin. The skin affected by ichthyosis is treated by hydration with alpha-hydroxy acid lotions such as ammonium lactate. People with acquired ichthyosis have normal lifespan. However they may need to spend several hours each day caring for their skin so they can lead as much of a normal life as possible. Topical retinoid cream such as tretinoin may also be used. Topical calcipotriol cream has been used with success; however, this vitamin D derivative can result in hypercalcemia when used over broad areas, especially in small children. In severe cases they may prescribe oral retinoids such as acitretin or isotretinoin. This can help to reduce scaling. Oral antibiotics may be prescribed if secondary infection occurs.

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