Congenital ichthyosis linked to elevated risk of allergic disorders
People with congenital ichthyosis, the group of rare inherited disorders that impair the skin barrier, may face a substantially increased risk of food allergy, allergic rhinitis, and allergic asthma, according to a new study published in the Journal of Allergy and Clinical Immunology.
The cross-sectional survey by researchers at Northwestern University in Chicago included 115 children and adults with physician-confirmed congenital ichthyosis. Overall, 68.2% reported at least one physician-diagnosed atopic disorder, including 64.3% of children and 72.5% of adults.
They found significantly higher rates of allergic rhinitis, food allergy, and allergic asthma among participants than in age-matched data from the 2021 National Health Interview Survey. More than one-half of respondents reported allergic rhinitis, about one-third reported food allergies, and one-quarter reported allergic asthma.
The disparity was particularly pronounced for food allergy. Among children ages six to 11 years, 48% reported a food allergy, compared with about 6% of children in the general U.S. population. Approximately 23% of adult respondents reported food allergies, compared with about 6% of American adults.
“Clinicians think about ichthyosis as being only a skin disease, but it’s not,” said the study’s senior author, Dr. Amy Paller, in a press release. She is chair of dermatology at Northwestern University Feinberg School of Medicine.
The highest rates of allergic disease were observed not only among participants with erythrodermic forms of ichthyosis, including Netherton syndrome, ichthyosis with confetti, and harlequin ichthyosis, but also among those with X-linked ichthyosis. The pattern was consistent with the greater degree of epidermal barrier impairment associated with these conditions, the researchers reported.
The findings support evidence from atopic dermatitis research suggesting that environmental allergens may penetrate more readily through a damaged skin barrier, contributing to sensitization and subsequent allergic disease.
“Having asthma, food allergies, and seasonal allergies can all impact quality of life and sleep. We need to approach allergic disorder with treatments that go beyond the moisturizers that are the mainstay of treatment for ichthyosis—and be more holistic in our care of ichthyosis patients,” Dr. Paller said.
The researchers concluded that clinicians should routinely ask patients with congenital ichthyosis about possible comorbid allergic conditions.
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