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Acquired ichthyosis in Adult
Other Resources UpToDate PubMed

Acquired ichthyosis in Adult

Contributors: Nkem Ugonabo MD, MPH, Marvin Turck MD, Susan Burgin MD
Other Resources UpToDate PubMed


Acquired ichthyosis (AI) is a rare condition with onset in adulthood that is usually associated with underlying disease. It is clinically similar to ichthyosis vulgaris, a benign hereditable disorder that manifests in childhood.

AI may be associated with underlying malignancies, infectious, inflammatory, or metabolic disorders, or with medications. The most common associated malignancy is Hodgkin disease. Other less frequent associations include multiple myeloma, cutaneous T-cell lymphoma and other lymphoproliferative disorders, leiomyosarcoma, Kaposi sarcoma, and carcinomas of the breast, lung, liver, and bladder. Skin changes are most often noted following the diagnosis of the malignancy.

AI is often seen in human immunodeficiency virus (HIV) infection, usually with a low CD4+ count, and not necessarily associated with malignancy. It has also been reported in the setting of active tuberculosis infection.

Acquired ichthyosis may be seen with chronic metabolic disturbances (malnutrition, malabsorption, renal failure, hyperparathyroidism, hypopituitarism, hypothyroidism, and diabetes). It also occurs on occasion with connective tissue disease (eg, systemic lupus and dermatomyositis) as well as with sarcoidosis, Hansen disease (leprosy), and post-bone marrow transplant.

Drug-induced acquired ichthyosis may be caused by cholesterol-lowering agents, isoniazid, acitretin, butyrophenones, dixyrazine, maprotiline, cimetidine, allopurinol, hydroxyurea, and clofazimine.

Coincident hair loss may occur, as may pruritus or a burning sensation. Symptoms usually improve in a warm, moist climate.

Disease severity may parallel the course of the associated disorder. Acquired ichthyosis often remits after treatment of underlying malignancy.


L85.0 – Acquired ichthyosis

8691004 – Acquired ichthyosis

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Last Reviewed:09/12/2019
Last Updated:09/15/2019
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Patient Information for Acquired ichthyosis in Adult
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Contributors: Medical staff writer


Acquired ichthyosis is a rare skin condition that appears in adulthood. It is usually caused by a medical condition or the use of certain medications. The affected skin is very dry, rough, and can look like fish scales.

Ichthyosis can be caused by systemic illnesses such as cancer, human immunodeficiency virus (HIV) infection, diabetes, kidney disease, thyroid disease, connective tissue disease, sarcoidosis, leprosy, and bone marrow transplant.

Acquired ichthyosis may also be brought on by drugs, including some cholesterol-lowering agents, antipsychotic medications, antidepressants, and cancer therapies. Cimetidine (used to treat acid reflex) and allopurinol (used to treat gout and kidney stones) may also cause these skin changes.

Symptoms usually go away after the underlying illness is treated or the medication is no longer being used.

Who’s At Risk

A person with a systemic illness, or taking medication for a systemic illness, is at risk of developing acquired ichthyosis. People with lowered immune systems, such as HIV-infected patients, are also at risk.

Signs & Symptoms

Acquired ichthyosis is very dry skin that appears in adulthood, especially after being diagnosed with a systemic illness. The affected skin has a "fish scale" appearance with rough patches that may be white, brown, or gray. Ichthyosis typically affects the trunk, limbs, and scalp.

Self-Care Guidelines

A daily skin care routine to keep your skin well-hydrated and exfoliated can ease symptoms. Frequent, regular use of moisturizing creams is recommended.

When to Seek Medical Care

Contact your health care provider if your skin splits or cracks, as that can lead to infection, or if your self-care is not providing adequate relief.


To reduce scale, your doctor might prescribe or recommend a cream or ointment that contains one of the following:
  • Alpha hydroxy acid
  • Salicylic acid
  • Urea
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Acquired ichthyosis in Adult
A medical illustration showing key findings of Acquired ichthyosis : Dry skin, Ichthyotic scaly plaque, Widespread distribution
Clinical image of Acquired ichthyosis - imageId=37823. Click to open in gallery.  caption: 'Diffuse xerosis and fine adherent scales on the legs of a patient with lymphoma.'
Diffuse xerosis and fine adherent scales on the legs of a patient with lymphoma.
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