Acquired Ichthyosis

Definition

Definition of Acquired Ichthyosis
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.

Symptoms

Symptoms of Acquired Ichthyosis
Acquired ichthyosis looks the same as hereditary ichthyosis. Typical symptoms are:

1. Areas of rough, dry skin
2. Areas of symmetrical scaling of the skin the scales may be small and fine or large and thick. Dark-skinned individuals often have darker scales. Different types of scaling may be found in different areas on the same individual.
3. Dry scaly scalp
4. Overgrowth (hyperkeratosis) of the skin on the palms and soles and sometimes the skin creases may crack during dry weather
5. Keratosis pilaris (follicular hyperkeratosis) on the side of the neck, back of the upper arms, buttocks and/or thighs

Acquired ichthyosis is associated with various types of cancers:

1. Hodgkin's Disease, Non-Hodgkin Lymphoma (Including Mycosis Fungoides), Lung Cancer, Breast Cancer, Ovarian Cancer and Cervical Cancer, among others
2. Sarcoidosis, Leprosy, Thyroid Disease, Hyperparathyroidism, Nutritional Disorders, Chronic Kidney Failure, HIV Infection
3. May occur after Bone Marrow Transplantation
4. Autoimmune Disorders, such as Systemic Lupus Erythematosus, Dermatomyositis

Causes

Causes of Acquired Ichthyosis
Acquired ichthyosis has been associated with various systemic diseases, although malignant conditions, especially hodgkin's lymphoma are the most commonly cited.

Diagnosis/Prognosis

Diagnosis/Prognosis of Acquired Ichthyosis
Diagnosis of acquired ichthyosis is usually based upon the skin symptoms present. In addition, a skin sample (biopsy) will be taken and examined under a microscope for changes characteristic of the disorder. If acquired ichthyosis appears before a systemic disease is diagnosed, the individual will be examined further for the presence of an underlying disorder.

Treatment

Treatment of Acquired Ichthyosis
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.