Indian Journal of Dermatology
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Year : 2022  |  Volume : 67  |  Issue : 5  |  Page : 579-582

Could “islets of sparing” be a clue for neutral lipid storage disease with ichthyosis in patients with congenital ichthyosiform erythroderma?

1 Medipol University, Faculty of Medicine, Dermatology Clinic, Istanbul, Turkey
2 Basaksehir Cam and Sakura City Hospital, Dermatology Clinic, Istanbul, Turkey
3 Bakırköy Dr. Sadi Konuk Education and Research Hospital, Pathology Clinic, Istanbul, Turkey
4 Istanbul University, Faculty of Medicine, Pathology Clinic, Istanbul, Turkey
5 Basaksehir Cam and Sakura City Hospital, Hematology Clinic, Istanbul, Turkey
6 Haseki Education and Research Hospital, Medical Genetics Clinic, Istanbul, Turkey
7 Bezmialem Vakıf University, Faculty of Medicine, Medical Genetics Clinic, Istanbul, Turkey

Correspondence Address:
Baran Cayhan
Basaksehir Cam and Sakura City Hospital, Basaksehir/Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijd.ijd_1154_20

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The prevalent form of ichthyosis in neutral lipid storage disease (NLSDI) is nonbullous congenital ichthyosiform erythroderma (CIE) characterized by fine, whitish scales on erythematous skin over the whole body. Here, we report a late-diagnosed, 25-year-old woman with NLSDI presenting with diffuse erythema and fine whitish scales throughout the body with patches of apparently normal skin, “islets of sparing” on her lower extremities. We observed that the size of the normal skin islets changed with time, and even the entire lower extremity was covered with erythema and desquamation like the rest of the body. Frozen section histopathological examinations were made from lesional skin and normal-looking skin; no difference was observed in terms of lipid accumulation. The only noticeable difference was the thickness of the keratin layer. In CIE patients, observation of patches of apparently normal skin or “islets of sparing” might be a clue for NLSDI to be distinguished from other CIE conditions.

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