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Because of the multiplicity of genes involved in the ichthyoses, it is not surprising that there are differences in outward appearance. Sometimes the entire body surface is involved (e.g., LI/CIE), while in others (IV, XLI) the face and folds of the body may not be involved. The scales tend to be dark and coarse in some (e.g., LI), while in others (e.g., CIE, IV) they may be finer and lighter in color. In EHK the scales often have a ridged or even spiny character, and this can be especially apparent in body folds or over joints. Skin fragility and formation of blisters can also occur in EHK. Sometimes the skin under the scales is very red (erythrodermic); this is especially common in Harlequin Ichthyosis and CIE, but may also be seen in EHK and Netherton syndrome, and others.