Bathing Suit Ichthyosis

A 10-year-old girl, born of nonconsanguineous parents, presented with a history of scaling over the trunk, scalp, and buttocks since birth. There was no family history of similar complaints. A history of exacerbation of scaling during summers accompanied by heat intolerance was present. On examination, large brown scales were observed over the trunk, extending upward to the neck and shoulders, and downward to the mid-thigh, with relative sparing of the buttocks, flanks, upper limbs, and legs resembling a bathing suit distribution [Figure 1a and b]. Lamellar scaling was also noted on the forehead and scalp [Figure 1c]. Her hair, teeth, and nails were normal. A diagnosis of bathing suit ichthyosis (BSI) was considered based on the history and characteristic clinical appearance. Genetic analysis could not be performed due to financial constraints. BSI is a rare autosomal recessive congenital ichthyosis caused by mutation in transglutaminase 1 gene and characterized by restriction of lesions to sites of relatively higher temperature such as the trunk with typical sparing of the central face, buttocks, and limbs.[1] BSI generally has a good prognosis due to limited skin involvement and fewer complications.Figure 1: Clinical image showing the characteristic distribution of thick large brownish scales in a bathing suit distribution over the anterior (a) and posterior trunk (b); Thick brownish scales over the scalp and forehead with sparing of the face (c)Declaration of consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.