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Hereditary ichthyosis : Causes, Skin Manifestations, Treatments and Quality of Life
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- Gånemo, Agneta, 1947- (author)
- Uppsala universitet,Dermatologi och venereologi
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- Svensson, Åke, Docent (opponent)
- Hudkliniken, Universitetssjukhuset MAS, Malmö
- (creator_code:org_t)
- ISBN 9155452469
- Uppsala : Acta Universitatis Upsaliensis, 2002
- English 68 s.
- Series: Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 0282-7476 ; 1125
- Doctoral thesis (other academic/artistic)
Abstract
Subject headings
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- Hereditary ichthyosis is a collective name for many dry and scaly skin disorders ranging in frequency from common to very rare. The main groups are autosomal recessive lamellar ichthyosis, autosomal dominant epidermolytic hyperkeratosis and ichthyosis vulgaris, and x-linked recessive ichthyosis. Anhidrosis, ectropion and keratodermia are common symptoms, especially in lamellar ichthyosis, which is often caused by mutations in the transglutaminase 1 (TGM1) gene. The aim of this work was to study patients with different types of ichthyosis regarding (i) the patho-aetiology (TGM1 and electron microscopy [EM] analysis), (ii) skin signs and symptoms (clinical score and subjective measure of disease activity), (iii) quality of life (questionnaires DLQI, SF-36 and NHP and face-to-face interviews) and (iv) a search for new ways of topical treatment. Patients from Sweden and Estonia with autosomal recessive congenital ichthyosis (n=83) had a broader clinical spectrum than anticipated, but a majority carried TGM1 mutations. Based on DNA analysis and clinical examinations the patients were classified into three groups, which could be further subdivided after EM analysis. Our studies indicate that patients with ichthyosis have reduced quality of life as reflected by DLQI and by some domains of SF-36, by NHP and the interviews. All the interviewees reported that their skin disease had affected them negatively to varying degrees during their entire lives and that the most problematic period was childhood. All patients with ichthyosis use topical therapy. In a double-blind study creams containing either 5% urea or 20% propylene glycol were found inferior to a cream formulation containing lactic acid 5% and propylene glycol 20% both regarding clinical improvement and thinning of the skin barrier. Improved topical therapy may reduce the need of more toxic, oral drugs. Future studies should elucidate whether this increases the quality of life of ichthyosis patients, especially if combined with more detailed information about the aetiology and inheritance of the diseases.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)
Keyword
- Dermatology and venereology
- Ichthyosis
- congenital ichthyosis
- genodermatoses
- skin disease
- quality of life
- topical treatment
- lactic acid
- propylene glycol
- Dermatologi och venerologi
- Dermatology and venerology
- Dermatologi och venerologi
- Dermatology and Venerology
- dermatologi och venereologi
Publication and Content Type
- vet (subject category)
- dok (subject category)
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