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Acquired ichthyosis in Adult
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Acquired ichthyosis in Adult

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Contributors: Nkem Ugonabo MD, MPH, Marvin Turck MD, Susan Burgin MD
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Synopsis

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.

Codes

ICD10CM:
L85.0 – Acquired ichthyosis

SNOMEDCT:
8691004 – Acquired ichthyosis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Rarer disorders:

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 09/13/2019
Last Updated: 09/16/2019
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Acquired ichthyosis in Adult
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Acquired ichthyosis : Dry skin, Ichthyotic scaly plaque, Widespread
Clinical image of Acquired ichthyosis
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