0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:54
Ichthyosis 807■If inherited ichthyosis is considered, careful family history is re-
quired.
General Measures
■Several treatments may improve the patient’s symptoms, but therapy
of the underlying disorder is essential.
specific therapy
Treatment Options
■Emollients (e.g., hydrated petrolatum) are the mainstay of therapy;
these agents should be applied liberally and frequently during the
day.
➣Long baths followed by application of emollients are recom-
mended to hydrate the skin and prevent subsequent transepi-
dermal water loss.
■Keratolytic agents may be used in addition to emollients.
➣40–60% propylene glycol in water applied h.s. after bath with
occlusion can be performed weekly to enhance removal of excess
scale.
➣Alpha hydroxy acids (lactic, citric, glycolic) can also be used.
➣Salicylic acid 5–10% in petrolatum
■Retinoids
➣Topical retinoids
➣Systemic retinoids may be useful for severe congenital forms of
ichthyosis.
■Humidifying the home can improve symptoms as well.
follow-up
■Frequency of follow-up and studies to be done are generally dictated
by the underlying disease.complications and prognosis
Complications
■Complications of acquired ichthyosis are infrequent; extremely vig-
orous scratching may lead to erosions and/or ulcerations and risk of
secondary infection; dehydration and electrolyte abnormalities can
occur in neonates with inherited forms of ichthyosis.
Prognosis
■Treatment of acquired ichthyosis can significantly improve symp-
toms but will not cure the disorder.
■Long-term prognosis is directly related to underlying disorder.
■Congenital ichthyoses are life-long disorders.