Ichthyosis Hystrix is a confusing term which has been applied to patients with ichthyotic lesions varying from mild to severe whorled and linear hyperkeratoses (thickenings of skin). The lesions may be thick enough to resemble porcupine quills. The appearance of skin under the microscope may resemble that of bullous congenital ichthyosiform erythroderma, but ichthyosis hystrix is not a blistering problem. Because the skin is so thick it can be difficult to treat with peeling agents applied to the skin, but these can be helpful. For more severe cases, orally administered retinoids or full surgical excision with grafting or tissue expansion may be necessary.
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