Ichthyosis vulgaris: Signs and symptoms

This type of ichthyosis often begins in childhood. Most children have normal skin at birth. Between 3 months and 5 years of age is when parents usually notice changes to their child’s skin. Sometimes, these changes begin when the child is younger or older.

When the changes begin, parents may notice one or more of the following:

• Dry skin: A mild case of ichthyosis vulgaris can be mistaken for dry skin.

• Scales: These tend to be white, gray, or brown. The edges often curl, making the skin feel rough.

You’ll usually see scales on one or more of these areas — fronts of the legs, backs of the arms, scalp, back, or belly. Scales can develop on other areas, too, but tend to skip the armpits, creases of the elbows, backs of the knees, and the diaper area.

• Thickened skin: This tends to be most noticeable on the palms and soles. The thickened skin can look dirty.

• Many lines on the palms and soles: If the ichthyosis is severe, you may see deep cracks on the palms and soles. An infection may develop in the deep cracks.

• Itchy skin: The itch is often caused by dry skin.

• Rough bumps on the skin: These bumps can be mistaken for acne and usually develop on the arms, thighs, and buttocks. Many people who do not have ichthyosis get this. The medical name for this condition is keratosis pilaris.

• Unable to sweat enough: If the ichthyosis is very severe, a child (or adult) may not be able to sweat normally. Being aware of this can prevent the person from overheating.

The palms and soles tend not to develop scale, but they can have many lines, as shown here.

Ichthyosis vulgaris in adults

When ichthyosis vulgaris begins in adults, a disease or medicine is often the cause. While the cause is different in adults, the signs and symptoms are the same as in children.

Some adults notice changes to their skin before they are diagnosed with a condition like kidney disease, cancer, or human immunodeficiency virus (HIV). Signs and symptoms of ichthyosis can also begin years after the person is diagnosed with a disease like HIV or cancer.

Ichthyosis vulgaris can change with age

In some children, the scale becomes more noticeable until the child reaches puberty and then it lessens. It’s also possible for the signs and symptoms to disappear for a while and return during the teenage years.

If a child had a mild case that was mistaken for dry skin, it may seem that the ichthyosis is just beginning in the teenage years.

The disease can also return later in life when the person is an adult.

More obvious (worsens) in winter

The signs and symptoms tend to worsen in the winter when the air is cold and dry. During hot and humid weather, ichthyosis vulgaris may be barely noticeable or fade completely.

Watch for related conditions

Children who develop ichthyosis vulgaris also have a higher risk of developing the following conditions:

• Atopic dermatitis (Eczema)

• Asthma

• Hay fever

• Hives

Image
Image used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 2010; 63:607-41.

References
James WD, Berger TG, et al. “Genodermatoses and congenital anomalies.” In: James WD, Berger TG, et al. Andrews' Diseases of the Skin, Clinical Dermatology (tenth edition), Elsevier, Canada, 2006:560-1.

Patel N, Spencer LA, et al. “Acquired ichthyosis.” J Am Acad Dermatol. 2006;55(4):647-56.

Schwartz RA. “Hereditary and acquired ichthyosis vulgaris.” In: Elston DM, (chief editor) Medscape. Last updated June 22, 2016.