Differentials
Asteatotic dermatitis (eczema craquele)
SIGNS / SYMPTOMS
Ichthyosis is not a specific diagnosis and is used more as a descriptive term describing scaling that is present in a number of different conditions. Scaling is also a finding in patients with severely dry skin, which, in certain instances, can become inflamed. When the skin takes on a 'dry river bed' appearance, with superimposed inflammation, this is referred to as eczema craquele, or asteatotic eczema.
INVESTIGATIONS
Clinical diagnosis.
Atopic dermatitis
SIGNS / SYMPTOMS
Inflamed, itchy skin that commonly occurs in patients who also demonstrate other features of epithelial hypersensitivity, such as asthma or environmental allergies.
Ichthyosis vulgaris often occurs in the setting of atopic dermatitis, so these 2 clinical conditions may exist together in the same patient.
INVESTIGATIONS
Clinical diagnosis.
Psoriasis
SIGNS / SYMPTOMS
Also may present with hyperkeratosis. However, it tends to be well circumscribed, with a fine, silvery scale, compared with the relatively larger scales that are seen in ichthyosis.
INVESTIGATIONS
Usually a clinical diagnosis.
If there is uncertainty, a skin biopsy may show classical features seen in psoriasis including intra-epidermal spongiform pustules and Munro's neutrophilic micro-abscess within the stratum corneum, parakeratosis, and epidermal acanthosis with dilated capillaries within dermal papillae.
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