Ichthyosis vulgaris, commonly known as fish scale disease or fish scale disease, is an inherited and rare skin disease. Fish scale disease, which is the most common type among a group of skin diseases with more than 20 subtypes called ichthyosis, accounts for approximately 95% of all ichthyosis cases. This disease, which causes the appearance of thick, dry and scaly skin, usually manifests itself from the first years of life. Mild cases of ichthyosis vulgaris may not be detected because they can be mistaken for very dry skin. However, in severe cases, there is the appearance of scaly skin with accumulation of dead skin, which shows the disease more clearly. The current treatment methods in this disease, which has no definite treatment due to its genetic disease, are generally aimed at improving the appearance of the skin and alleviating the symptoms.
What is Fish Scale Disease?
The question of what is fish scale disease or ichthyosis vulgaris? It can be answered as a genetic disease that causes a fish scale-like appearance on the skin. Although the majority of fish scales are genetically inherited, it may rarely develop later. It is thought that the main cause of acquired fish skin diseases is the mutation of the related genes.
The main feature of the disease is that the entire surface of the skin is covered with flake-like skin layers formed by dead skin. The layers in question are mostly brown in color. However, in some patients, an appearance in white or gray tones may also be encountered. There is severe itching on the thickened and dried skin. In addition, because the air is colder and drier, fish scale disease affects the person much more severely in winter.
Sweating is not possible in patients with fish scales due to skin lesions. Most of the cases of ichthyosis vulgaris are mild. Therefore, it can be confused with skin diseases such as allergies or eczema. While flake-like layers of dead skin are commonly seen on the legs, patients may also experience scaling on the arms, hands, and other parts of the body. In most patients, the palm It is seen that there are deep lines in it.
Causes of Fish Scale Disease
The most common cause of ichthyosis vulgaris is heredity. However, fish scale disease may occur due to subsequent genetic mutations. Although the cells in the skin multiply at a normal rate in fish scale patients, they cannot be removed from the skin surface in a healthy way.
As a result, dead skin that is not shed fast enough becomes layers and forms flake-like structures on the skin surface. Fish scale disease genes, which can be genetically inherited from both parents, do not require the mother or father to be sick. Children of parents with carriers of this gene are more likely to develop the disease.
The disease is autosomal semidominant, that is, semi-dominant inherited. Inclusion of a single disease gene in a chromosome pair results in a mild version of the disease. If the disease is present or mutation is seen in both genes, a moderate or severe version of the disease is encountered. Because it is a rare disease, the probability of inheriting the fish scaly gene from both parents is very low, except for consanguineous marriage, so mild forms of the disease are much more common.
Another factor thought to be among the potential causes of ichthyosis vulgaris is mutations in the uterus. With the occurrence of such a situation in the mother's womb, it is thought that the protein called filagrin, which is used to form the outermost layer of the skin and to shed dead skin, is missing. Fish scale diseases caused by such genetic origin causes manifest themselves from the first years of life.
Fish scale disease seen in adults, on the other hand, has a later development (acquired) feature. There are studies showing that some diseases such as various types of cancer, kidney failure, leprosy, sarcoidosis, HIV and AIDS can lead to developing fish scaling. It is also emphasized that some drugs that are used, albeit rarely, can cause fish scale disease.
Symptoms of Fish Scale Disease
Symptoms in both acquired and genetic fish skin disease are almost non-existent. are the same as each other. The main symptoms include:
- Rough and dry skin texture (xerosis)
- Skin itching
- Onset between the second month and five years of age, not usually present at birth , disease-specific appearance
- Chicken skin appearance of the skin (follicular hyperkeratosis)
- Layers of dead skin concentrated on the legs, arms, scalp, various parts of the face and trunk
- Most too much is evident on the outer surface of the arms and legs, and the folds of the arms and legs are preserved
- Hard swellings similar to acne spots on the arms, thighs and buttocks
- Inability to sweat enough, resulting in problems with the body's heat balance in severe cases
- Distinctive skin lines (hyperlinearity) on the palms and soles
- The formation of cracks in the skin and related infections
Treatment of Fish Scale Disease
Fish scale Patients with a skin appearance similar to the disease may have simple skin dryness and consequent flaking problem. Since these two conditions can cause very similar symptoms, dry skin is usually treated before genetic testing is resorted to. If no improvement can be achieved with the use of a suitable moisturizer twice a day in the fish scale appearance seen in children, the physician may refer to genetic tests with the suspicion of ichthyosis vulgaris.
If there is an individual with fish scale disease in the family, the physician should be informed about this issue. In addition, information such as other diseases the patient has, the drugs used and how long the symptoms have been going on can be very decisive for diagnosis and treatment. Therefore, it is very important to take a detailed medical history of the patient. If deemed necessary by the physician, a small sample of the skin can be obtained by biopsy. A sample can be taken and sent to the laboratory for examination under a microscope. Unfortunately, there is no definitive treatment to prevent the condition in patients diagnosed with genetic ichthyosis vulgaris as a result of these studies. However, with some medical treatments and home care practices, the symptoms and complaints related to the disease can be alleviated significantly.
Some drugs and creams may be prescribed by the physician to moisturize the skin, remove dead skin and alleviate the itching problem. Their regular use helps to reduce skin lesions. However, practices such as frequent bathing, using a bath sponge or scrub to purify the skin from dead skin, and applying moisturizing cream to the skin after bathing are very effective in combating dead skin layers caused by the disease.
Using air humidifiers at home, especially in winter months and in arid regions, can be effective in reducing skin dryness. If symptoms such as eczema and allergies are observed in addition to the disease, a separate treatment plan should be established. For this reason, if you or your child are experiencing skin lesions that resemble fish scales, it is useful to consult a dermatologist and get an opinion on the causes of this condition. You can use the contact form on our website to reach us.
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