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July 20th, 2011
05:18 PM ET

What is the scaly skin disease ichthyosis?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Kay, Via CNN.com comments

A dermatologist told my sister she has ichthyosis. What is it, and how is it treated? She has been on medication for six months, and it is still not gone.

Expert answer

Ichthyosis is a group of more than two dozen skin diseases that vary in severity. Most are mild inconveniences, and some are life-threatening.

They have in common that the skin is thickened with scaly patches, especially on the shins, the forearms and upper arms, and the palms of the hands and the bottoms of the feet. The skin of the fingers is dry and bleeds easily. Opposing skin in the armpits, the groin, the elbow and the knee is usually not effected.

There are huge psychological problems due to appearance. Patients have issues with self-image and may withdraw.

People with the severe forms of the disease are prone to skin infection. Some of these skin infections are actually treated in burn units of hospitals due to their seriousness.

Most cases of ichthyosis are genetic in that a parent with the disease can pass it on to their children. It is not uncommon for a parent to have mild ichthyosis and the child to have more severe disease. Most children with icthyosis are born without evidence of the disease and develop symptoms in later childhood.

Some forms of ichthyosis are also more severe in childhood, improve in young adulthood and worsen in old age. The disease can wax and wane throughout life.

It is also interesting that many, perhaps most, patients with this condition also have skin allergies, eczema and/or asthma. The patient with moderate to severe icthyosis often has problems sweating due to the buildup of scales on the skin. The scales essentially seal the sweat glands. This can cause a tremendous itch known as "prickly itch."

Patients can also have serious sensitivity to heat. The most effective treatments are exfoliating chemicals to remove the scales and allow the skin underneath to function normally.

These exfoliating drugs often must be applied several times a day, and treatment may continue for years. The itch can be treated with Benadryl creams and topical steroids.

A dry-air conditioned environment and consumption of alcohol have been reported as making icthyosis worse. Avoiding these may improve symptoms.

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soundoff (23 Responses)
  1. Dan

    I have had ichthyosis for over sixty five years. When I was young when summer came the scales would just go away, there was nothing then to help keep the scales off. As I aged assuming the scales went away in the summer, come sept. I would put ammonium lactate lotion 12% on. it is a over the counter cream that if used daily after shower it keeps it off me year round. I have vulgaris ichthyosis and this cream has worked wonders for me. For best results make sure to use after shower or bath when you skin is moist.

    July 20, 2011 at 18:56 | Report abuse | Reply
    • John

      I have a similar case to yours,I believe,self diagnosed via the internet,similar age-57,I was very interested to read of the positive results using the ammonium lactate lotion.Mine is concentrated legs, arms, trunk,scalp possibily a mild case,very irratating in colder months!

      December 25, 2012 at 17:46 | Report abuse |
  2. AZShawn

    "Opposing skin in the armpits, the groin, the elbow and the knee is usually not effected."

    According to New Oxford American Dictionary:

    Affected - 1. influenced or touched by an external factor : apply moist heat to the affected area.

    Effected - cause (something) to happen; bring about : nature always effected a cure | budget cuts that were quietly effected over four years.

    Please do better copy editing prior to posting articles. Precision in language matters. Doctors, of all people, should know that.

    July 20, 2011 at 22:47 | Report abuse | Reply
    • J

      Affect is a fun word to use. I like the following use of the word:

      AZShawn affects an artificial air of superiority as he corrects people on the internet.

      July 20, 2011 at 23:08 | Report abuse |
    • Brandon

      @J – AZShawn does have a point. What is the purpose of having a degree in journalism(that is, if CNN is hiring qualified writers)? Writers and Editors are getting paid to do a job. What is wrong about asking someone to do his or her job properly?

      July 20, 2011 at 23:23 | Report abuse |
    • Pete

      You have managed to copy the dictionary correctly but fail to understand the words. By "not affected" the article was explaining that the described areas were 'not influenced' by the condition (i.e. icthyosis). They were NOT saying that the areas were 'not caused' by the condition. Think about it. Then look to oneself before correcting others. Peace and good reading.

      July 21, 2011 at 06:05 | Report abuse |
    • AZShawn

      @J – Troll...

      @ Pete – That was my point. The article used "effected," which I quoted but did not clearly state that I was quoting the article, not correcting it. There is nothing wrong with expecting that professionals use our language properly, especially within fields, such as the medical industry, in which miscommunication could be harmful or fatal. In journalism, lack of copyediting can look unprofessional, giving less credibility to both the writer and the publication, as Brandon infers above.

      July 29, 2011 at 00:16 | Report abuse |
  3. MikeGCNY

    I have one of the minor dieseases that fall under icthyosis called Keratosis Pilaris... It is annoying at best... basically all the folicles on the back of my forearm and on top of my thighs are enflamed. They are very often capped off and cause the hair to fall out. Lotion and a vitamin A, B, and E rich diet has helpped me. However, the writers sister seems to have a more severe disorder that I as there is not need for treatment in my case. It could be worse... "harloquin icthyosis" very scary.

    July 21, 2011 at 07:04 | Report abuse | Reply
  4. Younan MarketingAnd Management Associates Inc, Int'l Intst'r

    that disease described above may be a diabetes pancreatic disease that needs treatment and healing. once the pancreas is infected you get those allergies plus you get some allergies that make you sensitive to metals for example and scratching too much causes scaly bumping red patches as well and sometimes bleeding. it can also cause an aged wrinkly damaged skin. you need lots of hydrocortisone cream as well heavily applied and applied three times a day to rejuvenate and recover skin health. don't listen to perscription directions normally given, and i think it is .5% hydrocortisone that is used for it. i have proven that result well tested it. you have to use plastic utensils as well not eat with silverware. avoid metal pens, and other metal contact. so that means also that you may suffer anyway if you have to do the dishes and wash pots and pans or if you have metal bird cages and have to clean those. i am not sure why the elbows are sometimes affected if the allergy is metal aggravated especially. that may related to mineral content food intake that may end up in your elbow area a lot. because their are metals or minerals that you need for nutritional health but once the pancreas is damaged and maybe too the liver in conjunction with it you have reactions to the iron though you need special pill form, and to magnesium, i can't remember the others now.

    July 21, 2011 at 07:22 | Report abuse | Reply
  5. Paul Kelly

    Don't know what just happened but lost reply-start over

    Can this just affect 2 fingers and a thumb? Have this problem for over two years and can't find a Dermotologist that has a clue. Used Clobetasol Propionate Ointment .05% but only could use for 3 weeks(?)

    Really annoying

    July 21, 2011 at 08:40 | Report abuse | Reply
  6. Vera

    The Breast Health and Healing Foundation believes that finding the causes of breast cancer will lead us to prevent this disease. We are trying to fund trials on Dr. Vincent Tuohy's breast cancer vaccine [Cleveland Clinic] which was completely effective at preventing breast cancer in mice that normally get this disease. It also slowed the growth of tumors in the control group of mice. BHHF is also trying to fund Dr. Beatriz Pogo's work on the human mammary tumor virus, which is present in approximately forty percent of all breast cancers! Please donate to BHHF! 40% of your money will go to FUND TUOHY'S VACCINE, 40% will go to FUND the POGO VIRUS, 10% will be spent on EDUCATING THE PUBLIC on BREAST CANCER PREVENTION & 10% will be used to offset administrative costs at BHHF. Send checks to: 36 Newark Avenue, Suite 130, Belleville, New Jersey 07109. Donations can be made via PayPal at http://www.breasthealthandhealing.org. BHHF is a tax-exempt non-profit.

    July 21, 2011 at 13:40 | Report abuse | Reply
  7. Lee

    I also have the vulgaris form of icthyosis. I never knew what was wrong with my skin (family doctors didn't have a clue), but was finally able to find out from doing internet research. I've found that lac-hydrin lotion, pumice stones, and humidity are the best coping mechanisms for this condition. I also swear by hemp or coconut body butter from The Body Shop. Most lotions don't last long enough in the winter, but these have an almost 24-hr moisterizing life.

    July 21, 2011 at 18:31 | Report abuse | Reply
  8. Jeremy

    There is a great website Skinsight.com with pictures and lots of information on Ichthyosis Vulgaris and tons of other conditions.

    http://www.skinsight.com/adult/ichthyosisVulgaris.htm

    July 22, 2011 at 10:20 | Report abuse | Reply
  9. Moureen

    The Foundation for Ichthyosis & Related Skin Types, would be happy to be a resource for all individuals and families affected by ichthyosis. We can be found at http://www.firstskinfoundation.org. We are the only patient advocacy in the United State and our mission is to educate, inspire, and connect those touched by ichthyosis and related disorders through emotional support, information, advocacy, and research funding for better treatments and eventual cures.

    July 25, 2011 at 12:24 | Report abuse | Reply
    • Anil

      Undine, in the most ridiculous oethmd of justifying the name un (one in French) + deien (ten in Old French.) In another messed translation oethmd since eleven in German is elf, I suppose you any name that has elf in the meaning. Alva, Alfred, Alberich, Alvar.

      April 9, 2012 at 13:06 | Report abuse |
    • John

      Is there a branch in Australia?

      December 25, 2012 at 18:15 | Report abuse |
  10. JoeSulliva91

    I love the content on your site. I have this one bookmarked as a reference to keep coming back to. Keep up the good work, I will be back for more.

    July 29, 2011 at 00:31 | Report abuse | Reply
  11. Marivic

    Wow! I didn't know that this condition icthyosis.. or whaterver we call it is passed on genetically... I may have to research on this some more, my family might have it. thanks

    August 20, 2011 at 22:11 | Report abuse | Reply
  12. Jarmo

    Cappy, I often wonder what has hnaeeppd to that girl. Will anyone marry her? At least her father was respected in the village (head of the mosque), that probably protected her from some level of ostracism or abuse. Good to hear from you Happy New Year!Cookie

    April 8, 2012 at 15:34 | Report abuse | Reply
  13. The Greatest Iron On Transper Paper

    Usually I don't read article on blogs, however I wish to say that this write-up very compelled me to try and do so! Your writing style has been amazed me. Thanks, quite nice post.

    June 26, 2012 at 01:40 | Report abuse | Reply
  14. Karinf Delveechios

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    July 8, 2012 at 04:19 | Report abuse | Reply
  15. John

    Is there a branch in Australia?

    December 25, 2012 at 18:16 | Report abuse | Reply
    • FIRST

      John, While there is no formal group dedicated to ichthyosis in Australa, FIRST has several members in Australia. Contact Moureen in the FIRST office at mwenik@firstskinfoundation.org and she will help you connect with someone. Are you also affected with ichthyosis?

      January 7, 2013 at 10:07 | Report abuse |

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.