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Fish Scale Disease - Ichthyosis

Overview, Causes, & Risk Factors

Ichthyosis is a group of inherited disorders characterized by excessively scaly and dry skin.

What is going on in the body?

In various forms of ichthyosis, certain proteins that are important in producing proper skin adhesion are missing. This causes water to be lost through the skin.

What are the causes and risks of the condition?

Ichthyosis is one of the most common inherited skin conditions. It may begin in a child as young as 4 years old. It usually disappears during adulthood, and may reappear when a person becomes elderly.

Symptoms & Signs

What are the signs and symptoms of the condition?

Symptoms of ichthyosis can range from minor to severe. The most common symptom is dry, cracked skin that looks like fish scales. It is usually most severe on the shins, arms, and back. It generally doesn't affect the underarms or inner folds of the elbow and knee.

Diagnosis & Tests

How is the condition diagnosed?

The diagnosis of ichthyosis is made primarily on the appearance of the skin. A family history of similar skin dryness may also be a key to diagnosing the condition.

Prevention & Expectations

What can be done to prevent the condition?

There is no known prevention for ichthyosis.

What are the long-term effects of the condition?

There are no long-term effects from icthyosis. Occasionally a bacterial skin infection may develop if the person scratches the dry skin.

What are the risks to others?

Ichthyosis is not contagious. However it is an inherited disorder, so children of an affected parent are more at risk of developing this condition.

Treatment & Monitoring

What are the treatments for the condition?

Creams and ointments may reduce symptoms of ichthyosis. They are most effective when they are applied to wet skin right after bathing. Mild non-drying soaps should be used. Moisturizing creams that contain chemicals that help the skin to shed normally, such as lactic acid, salicylic acid, and urea, may also be used. In severe cases, oral medications known as systemic retinoids may be used.

What are the side effects of the treatments?

No side effects are likely to occur from topical treatment, but systemic retinoids must be carefully monitored for toxicity and side effects. These include liver toxicity, elevated blood lipids, excessive dryness, visual disturbances, joint and muscle pain, and easy sun burning. Pregnancy must be avoided while taking systemic retinoids.

What happens after treatment for the condition?

Ichthyosis is a chronic, inherited skin disorder that requires ongoing treatment.

How is the condition monitored?

Ichthyosis is monitored by the affected person. Any new or worsening symptoms should be reported to the healthcare provider.


Author:Lynn West, MD
Date Written:
Editor:Smith, Elizabeth, BA
Edit Date:08/16/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:07/13/01


The Merck Manual of Medical Information, 1997

Hill, Marcia J. Skin Disorders: Mosby's Clinical Nursing Series, 1994