Ichthyosis vulgaris is a disorder of cornification, characterised by persistently dry, thickened, “fish scale” skin. There are at least 20 varieties of ichthyosis, including inherited and acquired forms.
Ichthyosis Vulgaris has autosomal dominant inheritance, meaning an abnormal gene is inherited from a parent. Penetrance is 90%. Onset is delayed until at least 3 months of age.
Symptoms of ichthyosis vulgaris vary in severity and tend to be less severe in a warm, humid climate.
Atopic dermatitis (eczema) is present in 50% of people with ichthyosis vulgaris (and 8% of those with atopic eczema have the features of ichthyosis vulgaris).
When atopic dermatitis is associated with severe ichthyosis vulgaris, the dermatitis tends to be early in onset, severe, and more likely to persist into adult life. There is also an increased risk of asthma, rhinitis and food allergy.
Ichthyosis vulgaris is caused from loss-of-function mutations in the gene encoding the protein filaggrin (FLG), which is mapped on the epidermal differentiation complex on chromosome 1q21. The mutations lead to defective production of filaggrin.
Filaggrin is a filament-associated epidermal protein required for the binding of keratin fibres in epidermal cells, to form an effective skin barrier. It helps maintain the skin pH, retain moisture in the stratum corneum, and reduce trans-epidermal water loss (TEWL).
Xerosis or dryness results from the reduced skin hydration associated with defective filaggrin. Excessive scale results from the inability of the squames (skin cells) to remain hydrated as they move upward through the stratum corneum.
Hyperkeratosis results from compensatory repair mechanisms increasing cell proliferation.
Ichthyosis vulgaris is usually a clinical diagnosis. Mild ichthyosis is often just called “dry skin”.
Filaggrin mutations can be detected by research laboratories from a buccal smear or saliva sample.
On skin biopsy, histology shows hyperkeratosis in the stratum corneum and reduced or absent granular layer. Electron microscopy also shows reduced or absent keratohyaline granules, of which the main component is the protein pro-filaggrin, the precursor to the filaggrin.
The main aims of ichthyosis vulgaris treatment are:
Treatments to keep the skin hydrated:
Several methods exist to prevent ichthyosis vulgaris, which include:
A few alternative and homeopathic remedies exist for ichthyosis vulgaris.
The most basic of all cures for dry skin includes drinking plenty of water. There are many homemade remedies for maintaining skin moisture, including the mixture of organic granulated sugar, honey and extra virgin olive oil. Another skin treatment mixture is made of eggs, honey, olive oil and rose water.
Natural oils – almond, avocado, bitter orange, lemon and lime – are good for treating dry skin. Crisco vegetable shortening can be used to treat dry skin.
Vitamins and mineral supplements can assist in curing dry skin:
A milk bath is also a common home remedy to moisturize skin.
Holistic herbs for curing dry skin include these:
There are several risks and complications associated with ichthyosis vulgaris.
Ichthyosis vulgaris may cause:
Moreover it is often associated with atopic dermatitis and atopic asthma; in fact FLG deficiency provokes a paracellular barrier abnormality that reduces inflammatory thresholds to topical irritants, likely accounting for enhanced antigen penetration.
