PMC6332984_01
Clinical presentation of patient 1 and 2. (a, c). Patient 1 shows a lamellar type of ichthyosis involving the forehead, external auditory meatus, and neck, but sparing the centrofacial area by additional involvement of the bathing suit area. (b, d) Patient 2 shows a mild ichthyosis confined to bathing suit area with involvement of the axilla, but sparing of ears and face. The patient has been seen in winter.
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fig1
On examination, patient 1 had large brownish, lamellar scales involving the bathing suit area of the trunk including the neck, forehead, axillae, external auditory meatus, and thick scales on the scalp (Figures 1(a) and 1(c)). Patient 2 was seen in winter, and she had mild ichthyosis confined to the bathing suit area (Figures 1(b) and 1(d)).
Histopathology of the ichthyotic area in patient 2 shows hyperkeratosis with follicular plugging and hyperplasia of the epidermis with well-preserved stratum granulosum. (HE: haematoxylin & eosin; SG: stratum granulosum; scale bare = 100 mum).
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fig2
Skin biopsy from her ichthyotic area showed hyperkeratosis with follicular plugging, mild hyperplasia of the epidermis with well-preserved granular layer, no parakeratosis, and patchy perivascular infiltrates of lymphohistiocytes (Figure 2).