Brief Answer: Ichthyosis; send more details Detailed Answer: Hi XXXX, Welcome to the forum. I can very well understand your feelings and your sufferings, for any young female it is quite bothersome to get even a single skin problem. After getting your short query I can make out a possibility of "Ichthyosis". It is an inborn condition which is present right from the birth. It is basically due to dry skin condition due to various causes. to confirm the same and to rule out exact type Irequest you to kindly let me know some important points: 1. Is it present all over body or some of the parts are spared such as face, elbow or knee folds. 2. Have you felt more aggravation since you know the problem or you see bit of improvement. 3. What are the type of scales (the rough surface coming out from skin): are these small or large. Do you feel this rough skin is giving a stucked on apppearance. 4. Anybody in yur family having same type of complaint. 5. Have you visited a dermatologist or taken any treatment. I request you to kinldy send some pictures of teh areas so that I can help you better. regards, Dr Sanjay

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Brief Answer: Not appear as psoriasis; go for biopsy Detailed Answer: Hi XXXX, Thanks for uploading the important information and most helpful of all a good resolution picture. Now after getting most of the information and correlating the facts with the picture, I can not make a diagnosis of Psoriasis in yourself. In the first query itself there were certain important points which were making negate possibility of psoriasis. And, the picture which I can see it confirms more about no possibility of psoriasis. There are certain points in favor of my opinion: 1. The condition is present since birth (18 years). 2. There is improvement of psoriasis after sun exposure. In yourself there is more aggravation. 3. Psoriasis manifest itself as well defined, sharply marginated red plaques with visible scales (mica like ) on the skin surface. In yourself I can see that the plaques are neither well marginated, nor these are red and the scales are fine one with rather rough surface of the plaques distributed in a pattern. So, all these things are not in favor of psoriasis. I can get that previously of dermatologist had diagnosed it as psoriasis but have you gone for any skin biopsy (a small piece of skin is taken by punch and then analyzed under microscope) to confirm the same. If you have gone for biopsy previously then let me know the report of the same. Even then I suggest you to go for biopsy of the skin again and get it analyzed from one of the best centers in India. In my opinion as I said preiosly it appears to an ichthyosiform disorder present since birth. TO confirm the same – biopsy is the ultimate answer. For the part of treatment – applying coconut oil is not the solution in your case. If I were your treating dermatologist then would have opted for a medium to high potency steroid with salicylic acid combination cream (such as dipsalic) to be applied over the plaques ( the areas of very rough surface). It is to be applied very thinly after a warm compression of affected part in water for 15- 20 minutes. Additionally a keratolytic cream and emollient cream combination to be applied for multiple times over affect ted areas. If itching is present then would have prescribed laoratadine (Dazit ) twice daily. Once the confirmation of diagnosis done then I would have opted for treatment accordingly. IF you have any further queries I will be glad to help. With regards, Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)

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