Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:54

Ichthyosis 805

Hodgkin’s disease (MOST COMMON), other lymphoprolifera-

tive disorders

Leukemia

Kaposi’s sarcoma

Carcinoma of breast, lung, or cervix

➣Common systemic diseases associated with ichthyosis

AIDS (MOST COMMON)

Sarcoidosis

Endocrinopathies – hyperparathyroidism, hypothyroidism,

hypopituitarism

Chronic renal disease

➣Acquired ichthyosis may also be caused by several drugs:

Cimetidine

Allopurinol

Niacin

Clofazamine

Signs & Symptoms

■Mild generalized hyperkeratosis characterized by small white to

brown scales with free edges

■Usually found on the trunk and extensor surfaces of the limbs

■Palms and soles are usually spared

■Affected skin may be pruritic

■Skin tends to be worse in cold, dry weather and better in warm,

humid areas.

tests

■The diagnosis of ichthyosis is generally made by clinical findings;

however, skin biopsy may prove useful; genetic testing is available

for some of the inherited forms of ichthyosis.

differential diagnosis

■Xerosis (normally distinguished from ichthyosis by clinical find-

ings – e.g., patchy distribution, lack of ichthyotic scale)

■Asteatotic dermatitis (normally distinguished from ichthyosis by

clinical findings – e.g., patchy distribution of inflammation)

■Widespread epidermal dermatophytosis (distinguished from ichth-

yosis by visualization of hyphae in KOH preparation and positive

culture)

■Hereditary ichthyosiform dermatoses