A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing) – appearance depends on the form of ichthyosis (see “Symptoms – Complaints” below).
- Skin
- Blistering?
- Erythroderma (redness of the skin)?
- Rhagades? (fissures; narrow, cleft-shaped tear that cuts through all layers of the epidermis (epidermal layer)); infections can develop in the cracks
- Scales: Appearance, size, color, texture, infestation pattern.
- Dry and rigid (rigid) skin.
- Coarsened hand line pattern (“ichthyosis hand”)?
- Hornification of the epidermis (epidermis).
- Predilection sites
- Extremities extensor sides, palms, soles of feet?
- Articular flexors?
- Generalized skin infestation? (affecting the whole body)
- Hair and nails
- Distinct defect of the hair shaft? (Trichorrhexis invaginata (TI); bamboo hair).
- Hair loss?
- Growth disorders?
- Face
- Skin
- Inspection (viewing) – appearance depends on the form of ichthyosis (see “Symptoms – Complaints” below).
- Cancer screening – in the context of secondary ichthyosis as paraneoplasia.
- Dermatological examination [due topossible atopic diathesis (predisposition to hypersensitivity reactions)] – depending on the form of ichthyosis (see below “Symptoms – complaints”).
- Endogenous eczema?
- Neurodermatitis?
- Ophthalmological examination [due topossible accompanying symptoms] – depending on the form of ichthyosis (see below “Symptoms – complaints”).
- Corneal changes?
- Urological examination [due topossible accompanying symptoms] – depending on the ichthyosis form (see below “Symptoms – complaints”).
- Cryptorchidism? (20% of cases) – absence of one or both testes in the scrotum (not palpable) or the testis has an intra-abdominal location (retentio testis abdominalis; abdominal testis) or is absent (anorchia).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.