Ichthyosis

The ichthyoses are a group of dermatological disorders characterized by generalized scaly, erythematous skin, accompanied by epidermal barrier function disruptions. This Primer by Gutierrez-Cerrajero and colleagues summarizes the epidemiology, mechanisms, diagnosis and treatment of ichthyosis, and discusses patient quality of life and open research questions for this condition. The ichthyoses are a large, heterogeneous group of skin cornification disorders. They can be inherited or acquired, and result in defective keratinocyte differentiation and abnormal epidermal barrier formation. The resultant skin barrier dysfunction leads to increased transepidermal water loss and inflammation. Disordered cornification is clinically characterized by skin scaling with various degrees of thickening, desquamation (peeling) and erythema (redness). Regardless of the type of ichthyosis, many patients suffer from itching, recurrent infections, sweating impairment (hypohidrosis) with heat intolerance, and diverse ocular, hearing and nutritional complications that should be monitored periodically. The characteristic clinical features are considered to be a homeostatic attempt to repair the skin barrier, but heterogeneous clinical presentation and imperfect phenotype-genotype correlation hinder diagnosis. An accurate molecular diagnosis is, however, crucial for predicting prognosis and providing appropriate genetic counselling. Most ichthyoses severely affect patient quality of life and, in severe forms, may cause considerable disability and even death. So far, treatment provides only symptomatic relief. It is lifelong, expensive, time-consuming, and often provides disappointing results. A better understanding of the molecular mechanisms that underlie these conditions is essential for designing pathogenesis-driven and patient-tailored innovative therapeutic solutions.

Automated summary

This article summarizes the epidemiology, mechanisms, diagnosis, and treatment of ichthyosis, a group of dermatological disorders characterized by scaly, erythematous skin and epidermal barrier function disruptions. It also discusses the impact on patient quality of life and open research questions. Ichthyosis severely affects patient quality of life and currently available treatment options only provide symptomatic relief.