July 20th, 2011
05:18 PM ET
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.
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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