Impaired Dermatoscopic Visualization in a Patient With Ichthyosis Vulgaris Undergoing Complete Skin Examination

Ichthyosis vulgaris is an inherited disease caused by loss of function mutations in the filaggrin encoding gene. This mutation results in decreased skin hydration, elevated skin surface pH, and increased transepidermal water loss. This leads to the characteristic xerosis and scaling seen with the disease. Patients with ichthyosis vulgaris may be at a greater risk for skin cancer, which emphasizes the importance of complete skin examinations in this patient population. Prior literature has not addressed potential challenges that arise when performing complete skin examinations in patients with ichthyosis vulgaris - primarily, that dermatoscopic visualization can be obscured by hyperkeratosis. This case highlights the importance of keratolytic use before skin examinations in patients with ichthyosis vulgaris.