Acquired Ichthyosis: Causes and Underlying Conditions

By SWA

Introduction

Ichthyosis is a broad term used to describe a group of skin disorders characterized by dry, thickened, and scaly skin. While hereditary ichthyosis is caused by genetic mutations that affect the skin’s natural process of shedding and renewal, there is another form—acquired ichthyosis—which occurs as a result of various underlying conditions. Unlike its genetic counterpart, acquired ichthyosis develops later in life, often as a symptom or side effect of other diseases, conditions, or medications.

In this article, we will explore the primary causes of acquired ichthyosis, including its association with cancer, autoimmune diseases, chronic inflammation, infections, metabolic disorders, drug reactions, and nutritional deficiencies.

1. Malignant Neoplasms (Cancer)

Acquired ichthyosis has been observed in association with various forms of cancer, particularly as a paraneoplastic syndrome, where the presence of cancer triggers systemic effects throughout the body, including the skin. Certain types of cancer have been most frequently associated with acquired ichthyosis:

  • Hodgkin's lymphoma is one of the most common cancers linked to acquired ichthyosis. The exact mechanism is not fully understood, but it is believed that the cancer cells may release factors that interfere with normal skin cell function.
  • Other cancers, such as non-Hodgkin's lymphoma, leukemia, lung cancer, breast cancer, and gastrointestinal carcinomas, have also been linked to the development of ichthyosis in affected individuals.

The symptoms of ichthyosis may be one of the first signs of an underlying malignancy. In such cases, treating the cancer may lead to improvement or resolution of the skin condition.

2. Autoimmune Diseases

Autoimmune diseases occur when the body’s immune system mistakenly attacks its own tissues, causing widespread inflammation and tissue damage. Several autoimmune diseases have been associated with acquired ichthyosis:

  • Systemic lupus erythematosus (SLE), a chronic disease that affects multiple organ systems, including the skin, can sometimes lead to ichthyosis-like symptoms. Inflammation in lupus may affect skin regeneration and cause dryness and scaling.
  • Sjogren’s syndrome, another autoimmune condition affecting moisture-producing glands, may also lead to skin dryness, which can resemble ichthyosis.
  • Sarcoidosis, a disease marked by the formation of inflammatory granulomas, can affect many organs, including the skin, causing ichthyosis-like patches in some patients.

The underlying immune dysfunctions in these conditions can disrupt normal skin turnover and barrier function, leading to thickened, dry, and scaly skin.

3. Chronic Inflammatory Diseases

Prolonged inflammation can have systemic effects on the body, including the skin. Certain inflammatory diseases have been associated with acquired ichthyosis:

  • Rheumatoid arthritis (RA) is a chronic inflammatory disorder primarily affecting the joints but can also cause secondary skin changes, including dry and scaly skin resembling ichthyosis.
  • Dermatomyositis, an inflammatory disease that affects both the skin and muscles, may also lead to ichthyosis-like skin changes as a secondary effect of the ongoing inflammation.

Inflammatory diseases can disrupt the normal processes of skin shedding and regeneration, leading to a build-up of dead skin cells and the characteristic scaling seen in ichthyosis.

4. Infectious Diseases

Infectious diseases, particularly chronic infections, can sometimes trigger the development of acquired ichthyosis. Some infections known to cause this condition include:

  • HIV/AIDS: Individuals with advanced HIV/AIDS are at increased risk for various skin conditions, including ichthyosis. The virus’s effect on the immune system and the body’s inability to properly maintain the skin barrier likely play a role.
  • Leprosy: Caused by Mycobacterium leprae, leprosy can damage the skin and nerves, leading to patches of dry, scaly skin that resemble ichthyosis.
  • Tuberculosis: In some cases, tuberculosis can cause systemic effects that lead to ichthyosis-like symptoms.
  • Syphilis (late stage): Chronic infections like syphilis may also cause secondary ichthyosis due to its systemic effects on the body.

Infections may interfere with the skin's ability to shed old cells, causing a build-up of thick, scaly skin.

5. Metabolic Disorders

Metabolic diseases affect the body's ability to process and utilize nutrients, and these imbalances can have wide-ranging effects, including on the skin. Common metabolic causes of acquired ichthyosis include:

  • Hypothyroidism: When the thyroid gland is underactive, the body’s metabolism slows down, including the turnover of skin cells. This can result in dry, flaky, and thickened skin, resembling ichthyosis.
  • Renal failure: Individuals with chronic kidney disease can develop uremic pruritus, a condition where the accumulation of waste products in the blood (due to reduced kidney function) leads to dry and itchy skin. This can evolve into ichthyosis in severe cases.
  • Cholestasis: Conditions where bile flow from the liver is impaired (e.g., liver cirrhosis or bile duct obstruction) can cause ichthyosis-like scaling due to the build-up of bile salts in the skin.

Treating the underlying metabolic disorder can sometimes resolve the ichthyosis-like symptoms.

6. Drug Reactions

Certain medications can induce ichthyosis-like symptoms as a side effect, particularly if they interfere with skin cell turnover, hydration, or lipid production. Some drugs known to cause acquired ichthyosis include:

  • Nicotinic acid (niacin): Used for managing cholesterol, niacin can cause skin flushing and, in some cases, ichthyosis-like scaling.
  • Cimetidine, a medication used to treat acid reflux, and hydroxyurea, used to treat some cancers, have been associated with ichthyosis as an adverse effect.
  • Retinoids, often prescribed for acne or psoriasis, can sometimes dry out the skin excessively, leading to ichthyosis-like scaling.
  • Clofazimine, an antibiotic used in treating leprosy, can cause ichthyosis-like symptoms with long-term use.

In most cases, discontinuing the medication will result in an improvement of skin symptoms.

7. Nutritional Deficiencies

Proper nutrition is essential for maintaining healthy skin. Certain nutrient deficiencies can lead to skin conditions resembling ichthyosis:

  • Vitamin A deficiency: Vitamin A is crucial for skin health and cell turnover. A deficiency can cause hyperkeratosis, a condition where the skin becomes thick, dry, and scaly.
  • Zinc deficiency: Zinc is essential for a wide range of biological processes, including skin repair and renewal. A lack of zinc can result in dry, scaling skin.
  • Essential fatty acid deficiency: Fatty acids are necessary for maintaining the integrity of the skin barrier and preventing water loss. A deficiency can lead to ichthyosis-like dryness and scaling.
  • Protein deficiency: Malnutrition, particularly a lack of protein, can impair the skin’s ability to regenerate, leading to scaly and dry skin.

Correcting the nutritional deficiency can often resolve or significantly improve ichthyosis symptoms.

Conclusion

Acquired ichthyosis is a skin disorder that can arise from a variety of underlying conditions, ranging from cancer and autoimmune diseases to chronic inflammation, infections, metabolic disorders, drug reactions, and nutritional deficiencies. Unlike hereditary ichthyosis, which is genetic, acquired ichthyosis develops later in life as a symptom of other health issues. Identifying and treating the underlying cause is often key to managing and potentially resolving the skin condition.

For individuals experiencing sudden or unexplained changes in their skin, especially if accompanied by other symptoms, seeking medical advice is important. A thorough evaluation can help determine whether an underlying condition may be responsible for the skin changes, allowing for appropriate treatment and management.

Below are key references for the article:

References:

  1. Hodak, E., David, M., & Hazaz, B. (1993). Acquired ichthyosis. Journal of the American Academy of Dermatology, 28(1), 55-60.

    • Available through PubMed: Link

  2. Roth, D. I., & Felsenstein, D. (1983). Acquired ichthyosis associated with malignant neoplasms. Archives of Dermatology, 119(1), 53-56.

    • Available through JAMA Network: Link

  3. McLean, W. H., & Irvine, A. D. (2007). Heritable filaggrin disorders: the paradigm of atopic dermatitis. Journal of Investigative Dermatology, 127(6), 1283-1294.

    • Available through Nature Publishing Group: Link

  4. Elgart, M. L. (1987). Acquired ichthyosis. Seminars in Dermatology, 6(4), 278-282.

    • Available through ScienceDirect: Link

  5. Hoffmann, R., & Brix, E. (2012). Acquired ichthyosis in patients with malignancies and chronic diseases. Dermatology Online Journal, 18(12).

    • Available through University of California: Link

  6. Goldsmith, L. A., Katz, S. I., Gilchrest, B. A., Paller, A. S., Leffell, D. J., & Wolff, K. (Eds.). (2012). Fitzpatrick's Dermatology in General Medicine. 8th ed. McGraw-Hill Education.

    • Available through AccessMedicine: Link

  7. Ryan, T. J. (1986). The metabolism of the epidermis in health and disease. Clinical Dermatology, 4(1), 66-72.

    • Available through ScienceDirect: Link

  8. Marinkovich, M. P., & O’Malley, J. T. (2008). Ichthyosis and related disorders of cornification. Dermatologic Therapy, 21(2), 121-131.

    • Available through Wiley Online Library: Link

  9. DiGiovanna, J. J., & Robinson-Bostom, L. (2003). Ichthyosis: etiologic heterogeneity and common pathomechanisms. Journal of the American Academy of Dermatology, 48(2), 220-242.

    • Available through PubMed: Link

  10. Proksch, E., Brandner, J. M., & Jensen, J. M. (2008). The skin: an indispensable barrier. Experimental Dermatology, 17(12), 1063-1072.

    • Available through Wiley Online Library: Link

 
Skin after BioNTech mRNA vaccine


 © 2000-2025 Sieglinde W. Alexander. All writings by Sieglinde W. Alexander have a fife year copy right.
Library of Congress Card Number: LCN 00-192742 ISBN: 0-9703195-0-9

Comments

Post a Comment

Popular posts from this blog

Is ME CFS connected to Spinal Muscular Atrophy (SMA) or Post Polio?

By SWA
Image
Today, I understand why Spinal Muscular Atrophy (SMA) received little attention, particularly in the mid-50s. This complex and debilitating genetic illness was poorly understood, and patients' symptoms were often minimized or even dismissed. For more information, please visit the Spinal Muscular Atrophy (SMA) page on MalaCards . Even now, many neurologists lack detailed knowledge of SMA, and comprehensive examinations mentioned in research are rarely pursued. In 2008, while investigating permanent adrenal insufficiency, an MRI ordered by my endocrinologist unexpectedly revealed Chiari Malformation II. However, surgery in 2009 brought no improvement. In 2010, a DNA test showed a genetic marker in the ACTN3 gene: https://www.malacards.org/search/results?q=ACTN3%20gene%20and%20Spinal%20Muscular%20Atrophy%20(SMA) A 2015 MRI revealed ankylosing spondylitis, multiple Tarlov cysts, stenosis at L4 and L5, spinal canal narrowing, and widespread degenerative changes. Surgery on L4 and L5 ...
Read more

Cytokine Storm, Mast Cell Activation Syndrome (MCAS), Endothelial Dysfunction and microclots/thrombosis?

By SWA
Could a virus be the stimulus for cytokine production?   It is well established, but rarely  tested, that a cytokine storm is an overactive immune response characterized by the excessive release of pro-inflammatory cytokines. ( ANA, CRP, and CBC tests are necessary) It can occur in various conditions, such as severe infections (e.g., COVID-19), (and other viruses), autoimmune diseases, and after certain treatments.  Serositis and lymphopenia are common features of systemic lupus erythematosus following SARS-CoV-2 infection: A case report and literature review These cells are called NKG2D+CD8+ T cells and researchers say their aggressive response is responsible for neurological damage suffered from infections beyond just Zika, like COVID-19 and even septic shock. The aggressive response is the result of the body producing large amounts of inflammatory proteins called cytokines, which in moderation help to coordinate the body’s response in battling an infection...
Read more

Toxic Skin Condition Post-mRNA COVID-19 Vaccination

By SWA
Image
Identifying Severe Skin Conditions Post-Vaccination Following administration of the BioNTech mRNA vaccine, a small subset of individuals may develop severe and complex reactions. These reactions are often misdiagnosed or misunderstood due to their rarity and diverse presentation. This essay examines a case characterized by severe skin conditions, systemic symptoms, and complications such as hypercalcemia and crystal formation. It highlights the need for accurate diagnosis, holistic management, and increased awareness of these rare but significant vaccine-related adverse events. Initial Symptoms and Misdiagnoses Severe symptoms began shortly after the first dose of the BioNTech vaccine, initially presenting as petechiae, diagnosed by a rheumatologist. However, following the second dose, symptoms rapidly escalated, resulting in intense burning pain and thinning of the skin. The skin on the legs and thighs became paper-thin and could tear with the slightest touch, with the affected area e...
Read more