This is the most common of the ichthyoses. It is inherited as an autosomal dominant trait and has an incidence of about 1 in 250 - 300. The condition occurs after the first year of life.
The skin is dry and scaly, and has small, fine white "cracks" like crazy paving. Scaling is prominent on the extensor surfaces of the extremities and the back, with the former more markedly involved and having larger scales. The forehead, cheeks and scalp may be affected. The limb flexures, especially the creases, appear normal.
Hyperkeratosis of the palms and soles are common. Keratosis pilaris on the arms, thighs and buttocks are present even in minor cases. Atopy is a common finding. The scaling may be most pronounced in the winter months and abate completely in the warm weather. The condition often improves in adult life and may even clear.
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