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Dr Yugandar
 The word ichthyosis comes from the Greek word for
a fish.
 ichthyosis : is a group of disorders that are
characterized by a persistent, non-inflammatory
scaling disorder of the skin surface.
 It is caused by abnormality in keratinization and
exfoliation of the horny cell layer.
 The ichthyoses are a clinically and genetically
heterogeneous group of skin disorders,
characterized by a diffuse, generally uniform and
persistent pattern of scaling without mucosal or
extracutaneous (except in ichthyosiform syndromes)
involvement.
 Acquired ichthyosis is clinically indistinguishable
from hereditary ichthyosis; however, acquired
ichthyosis is associated with various systemic
diseases.
 The appearance of ichthyosis in adulthood can
occur before or after the diagnosis of a systemic
condition.
 cancer (especially lymphoma, Hodgkin
disease, non-Hodgkin lymphoma,mycosis
fungoides, myeloma, Kaposi
sarcoma, leiomyosarcoma & carcinomas of
the lung, breast, ovary & cervix)
 sarcoidosis
 leprosy
 thyroid disease, hyperparathyroidism
 nutritional disorders
 chronic renal failure
 bone marrow transplantation
 HIV infection
 Autoimmune diseases, including systemic lupus
erythematosus and dermatomyositis
 certain medications has been linked to acquired
ichthyosis
 nicotinic acid, triparanol,
 butyrophenones, dixyrazine,
 cimetidine, and clofazimine
 Histology:
 compact orthokeratosis and/
 parakeratosis without spongiosis
 24 cases
 Lethal, AR
 Prematurity, fixed facial
expression, micrognathia, mouth in “O”
position
 Rigid and tense skin with erosions and
denudations & multiple joint
contractures
 Disorder of keratinization in which bizzare
migratory annular and polycyclic patches
occur
 Leave no scarring or pigmentary changes.
 Inheritance AR, patients are born
erythrodermic
 fatal complications.
 Most also have trichorrhexis invaginata
 May clear completely in summer time
 Ichthyosis, Myopathy
and lipid vacuoles ->
 Impaired degradation
of triacylglycerol-
derived diacylglycerol
 Dietary modulation of
fats aids in controlling
the disease Lipid vacuoles in granulocytes and monocytes
but not lymphocytes or erythrocytes
 IFAP = Ichthyosis
Follicularis, Alopecia, Photophobia
 Generalized spiny follicular lesions with xerosis
of non-follicular skin, striking alopecia.
 M>F 5:1
 X-linked recessive and AD forms reported
 Fatty alcohol oxidoreductase deficiency
 Infancy: generalized
erythroderma, ichthyosis, fine to large lamellar
scaling
 After Infancy: generalized darker scale without
erythema accentuated in flexures and lower
abdomen; spares central face.
 CNS: MR, spastic diplegia with scissor gait
 Eyes: atypical retinitis pigmentosa “glistening
dots” pattern-slit
 Dental dysplasia
 Tx: Low fat diet
•SJOGREN LARSSON SYNDROME - atypical retinitis pigmentosa “glistening dots”
pattern on slit lamp exam.
 Phytanol-CoA hydroxylase deficiency
 Leads to phytanic acid deposition in…
 Skin (ichthyosis)
 CNS (ataxia, peripheral neuropathy)
 Eyes (retininitis pigmentosa “salt & pepper”)
 Ears (deafness)
 Cardiac (arrhythmias, block, CHF)
 Musculoskeletal (wasting, skeletal
anomalies)
 TX: dietary restriction of phytanic acid.
 AR or X-linked
 Ichthyosis
 Hypogonadism
 Small stature
 MR, Epilepsy
 Macrocytic anemia
 Rule out Refsum’s Syndrome or Sjogren-
Larsson Syndrome
 Brittleness of hair d/t sulfur def
 Impairment of intelligence
 Decreased fertility
 Short stature
 K/a Trichothiodystrophy
 Some cases of BIDS a/w Lamellar
Ichthyosis
 I Stands for Ichthyosis
 AR inheritance
 P stands for Photosensitivity
 Defect in DNA repair
 Similar to cockayane syndrome &
xeroderma pigmentosum
 Keratitis
 Ichthyosis
 Deafness
DISTINCTIVE LEATHERY VERRUCOID
PLAQUES
 Leathery verrucous plaques
 Nails may be dystrophic
 Eye brows and eye lashes absent
 Partial anhidrosis
 Hypotrichosis
 A/w Mucocutaneous candidiasis.
 Cong Hemidysplasia
 Ichthyosiform erythroderma
 Limb defects
 Present at birth,females affected
 Ichthyosis confined to one half of body &
ipsilateral hypoplasia of bony structures
and brain.
 AR,first in 1983 identified
 Ocular COLOBOMAS
 Congenital HEART disease
 Migratory ICHTHYOSIFORM Dermatosis
 Mental Retardation
 Epilepsy
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Ichthyosis Types, Causes, Symptoms and Treatments

  • 2.  The word ichthyosis comes from the Greek word for a fish.  ichthyosis : is a group of disorders that are characterized by a persistent, non-inflammatory scaling disorder of the skin surface.  It is caused by abnormality in keratinization and exfoliation of the horny cell layer.
  • 3.  The ichthyoses are a clinically and genetically heterogeneous group of skin disorders, characterized by a diffuse, generally uniform and persistent pattern of scaling without mucosal or extracutaneous (except in ichthyosiform syndromes) involvement.
  • 4.
  • 5.  Acquired ichthyosis is clinically indistinguishable from hereditary ichthyosis; however, acquired ichthyosis is associated with various systemic diseases.  The appearance of ichthyosis in adulthood can occur before or after the diagnosis of a systemic condition.
  • 6.
  • 7.  cancer (especially lymphoma, Hodgkin disease, non-Hodgkin lymphoma,mycosis fungoides, myeloma, Kaposi sarcoma, leiomyosarcoma & carcinomas of the lung, breast, ovary & cervix)  sarcoidosis  leprosy  thyroid disease, hyperparathyroidism
  • 8.  nutritional disorders  chronic renal failure  bone marrow transplantation  HIV infection  Autoimmune diseases, including systemic lupus erythematosus and dermatomyositis
  • 9.  certain medications has been linked to acquired ichthyosis  nicotinic acid, triparanol,  butyrophenones, dixyrazine,  cimetidine, and clofazimine
  • 10.  Histology:  compact orthokeratosis and/  parakeratosis without spongiosis
  • 11.  24 cases  Lethal, AR  Prematurity, fixed facial expression, micrognathia, mouth in “O” position  Rigid and tense skin with erosions and denudations & multiple joint contractures
  • 12.  Disorder of keratinization in which bizzare migratory annular and polycyclic patches occur  Leave no scarring or pigmentary changes.  Inheritance AR, patients are born erythrodermic  fatal complications.
  • 13.  Most also have trichorrhexis invaginata  May clear completely in summer time
  • 14.
  • 15.  Ichthyosis, Myopathy and lipid vacuoles ->  Impaired degradation of triacylglycerol- derived diacylglycerol  Dietary modulation of fats aids in controlling the disease Lipid vacuoles in granulocytes and monocytes but not lymphocytes or erythrocytes
  • 16.  IFAP = Ichthyosis Follicularis, Alopecia, Photophobia  Generalized spiny follicular lesions with xerosis of non-follicular skin, striking alopecia.  M>F 5:1  X-linked recessive and AD forms reported
  • 17.  Fatty alcohol oxidoreductase deficiency  Infancy: generalized erythroderma, ichthyosis, fine to large lamellar scaling  After Infancy: generalized darker scale without erythema accentuated in flexures and lower abdomen; spares central face.
  • 18.  CNS: MR, spastic diplegia with scissor gait  Eyes: atypical retinitis pigmentosa “glistening dots” pattern-slit  Dental dysplasia  Tx: Low fat diet
  • 19. •SJOGREN LARSSON SYNDROME - atypical retinitis pigmentosa “glistening dots” pattern on slit lamp exam.
  • 20.  Phytanol-CoA hydroxylase deficiency  Leads to phytanic acid deposition in…  Skin (ichthyosis)  CNS (ataxia, peripheral neuropathy)
  • 21.  Eyes (retininitis pigmentosa “salt & pepper”)  Ears (deafness)  Cardiac (arrhythmias, block, CHF)  Musculoskeletal (wasting, skeletal anomalies)  TX: dietary restriction of phytanic acid.
  • 22.  AR or X-linked  Ichthyosis  Hypogonadism  Small stature
  • 23.  MR, Epilepsy  Macrocytic anemia  Rule out Refsum’s Syndrome or Sjogren- Larsson Syndrome
  • 24.  Brittleness of hair d/t sulfur def  Impairment of intelligence  Decreased fertility  Short stature  K/a Trichothiodystrophy
  • 25.  Some cases of BIDS a/w Lamellar Ichthyosis  I Stands for Ichthyosis
  • 26.  AR inheritance  P stands for Photosensitivity  Defect in DNA repair  Similar to cockayane syndrome & xeroderma pigmentosum
  • 27.  Keratitis  Ichthyosis  Deafness DISTINCTIVE LEATHERY VERRUCOID PLAQUES
  • 28.  Leathery verrucous plaques  Nails may be dystrophic  Eye brows and eye lashes absent  Partial anhidrosis  Hypotrichosis  A/w Mucocutaneous candidiasis.
  • 29.  Cong Hemidysplasia  Ichthyosiform erythroderma  Limb defects  Present at birth,females affected  Ichthyosis confined to one half of body & ipsilateral hypoplasia of bony structures and brain.
  • 30.  AR,first in 1983 identified  Ocular COLOBOMAS  Congenital HEART disease  Migratory ICHTHYOSIFORM Dermatosis  Mental Retardation  Epilepsy
  • 31. Thank You Very Much for Attention Have a Nice Day Thank You Very Much for ur Attention