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American Journal of  
Life Science and Innovation (AJLSI)

Advancements in Ichthyosis Treatment in Pediatric Patients: Evaluating the Impact of  
Immune System Inhibitors Targeting TNF-alpha, IL-17A, IL-4, and IL-12

Eiman Hamza Ahmed Elsayed1*, Rabab Elsayed Ali Hassan Khater2

Volume 3 Issue 1, Year 2024
ISSN: 2833-1397 (Online)

DOI: https://doi.org/10.54536/ajlsi.v3i1.2730
https://journals.e-palli.com/home/index.php/ajlsi

Article Information ABSTRACT

Received: May 01, 2024

Accepted: May 31, 2024

Published: June 04, 2024

Lamellar, X-linked recessive, and Vulgaris ichthyosis represent rare genetic variants 
distinguished by abundant dry surface scales. The etiology of  childhood ichthyosis involves 
a combination of  acquired and inherited factors. Children with Ichthyosis have a Th17-
dominant immune profile, similar to psoriasis, with a correlation between ichthyosis severity, 
erythema, Trans Epidermal Water Loss (TEWL), and immunological markers. In order to 
examine the safety and effectiveness of  immune system inhibitors that target TNF-alpha, 
IL-17A, IL-4, and IL-12 in the treatment of  pediatric Ichthyosis, a retrospective research 
study was conducted on 30 pediatric patients aged 6-12 years at tertiary care pediatric 
dermatology hospitals in UAE, for a time duration of  5 months. IL-17-A is a key cytokine of  
Ichthyosis, and its specific suppression is considered necessary in contrast to other cytokines. 
Consequently, the choice of  treatment was dictated by elements unique to the condition and 
the intensity of  symptoms, focusing on using Secukinumab as an IL-17-A inhibitor. The 
findings showed that, following five months of  treatment, patients receiving secukinumab 
showed positive outcomes, with their ichthyosis area severity index score declining by 45 
to 50%. Additionally, the proinflammatory rate of  cytokines was significantly lower in this 
group of  patients compared to the placebo-treated control group. The safety and Efficacy 
of  Secukinumab compared to Ixekizumab and Brodalumab vs placebo were examined 
using t-tests, with statistical significance determined at P< 0.05. The present research study 
concludes that Secukinumab effectively enhances skin texture and reduces scaling severity 
in Ichthyosis, suggesting clinical relevance. The findings underscore Secukinumab’s potential 
as a beneficial agent for various ichthyosis types, such as lamellar, X-linked, and vulgaris. The 
study’s comparison with placebo and other IL-17A inhibitors like Ixekizumab and Brodalumab 
provides valuable insights into Secukinumab’s Efficacy and potential clinical uses.

Keywords

Ichthyosis, Secukinumab, 
Pediatrics, IL-17, TNF-alpha, 
IL-4, IL-12

INTRODUCTION
Lamellar Ichthyosis, X-linked recessive Ichthyosis, and 
Ichthyosis vulgaris are among the rare genetic variations 
of  this rare skin illness characterized by excessively dry 
surface scales. Both acquired and inherited factors can 
contribute to the etiology of  childhood ichthyosis. Most 
cases of  Ichthyosis are caused by inherited ichthyosis 
vulgaris, caused by an inherited gene from one or both 
parents (Pontello et al., 2020). 
Another potential cause could be a genetic mutation that 
transpires in the womb, depriving the child’s skin of  a 
vital protein known as filaggrin. Adults with acquired 
ichthyosis vulgaris may develop the condition as a result 
of  many medical conditions, including kidney failure, 
clofazimine, nicotinic acid deficiency, sarcoidosis, leprosy, 
and HIV (Lilly & Bunick, 2023).
Children’s Ichthyosis is caused by epidermal development 
and metabolism anomalies, which result in severe skin 
dryness and scaling. Mutations in particular genes 
involved in skin barrier function and cornification result 
in inherited forms of  Ichthyosis, such as autosomal 
recessive congenital Ichthyosis (ARCI) and X-linked 
recessive Ichthyosis (XLI). 
Impaired breakdown of  cholesterol sulfate leads to 

hyperkeratosis and generalized brown scales in XLI, 
which is associated with mutations in the steroid sulfatase 
(STS) gene. Conversely, ARCI comprises several subtypes, 
such as congenital ichthyosiform erythroderma (CIE) and 
lamellar Ichthyosis (LI), andpresents with with clinical 
symptoms , including rough scaling, erythroderma and 
collodion membrane after birth (Joosten et al., 2022).
Skin cornification processes, such as desquamation, 
keratin synthesis, cornified envelope synthesis, and stratum 
corneum structure, are disrupted in Ichthyosis. Increased 
transepidermal water loss (TEWL), a compromised skin 
barrier, and altered epidermal differentiation result from 
these disturbances. 
Extensive skin scaling, hyperkeratosis, and inflammation 
are the hallmarks; erythroderma frequently follows. While 
acquired Ichthyosis in children is linked to underlying 
illnesses or drugs that disrupt the establishment of  the 
skin barrier, resulting in fishlike scales concentrated on 
the extremities, hereditary types such as XLI and ARCI 
are essentially genetic in origin (Dyer et al., 2013).
Studies on children with Ichthyosis reveal a Th17-
dominant immune profile with elevated expression of  IL-
17/TNFα-synergistic/additive genes. This immunological 
profile is comparable to that of  the inflammatory 

1 Pediatric specialist in UAE
2 Dermatology specialist in UAE
* Corresponding author’s e-mail: dr_eh2412@yahoo.com



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condition psoriasis. The severity of  Ichthyosis, erythema, 
and transepidermal water loss (TEWL) is significantly 
linked to immunological markers, suggesting a potential 
link between inflammation and skin barrier abnormalities. 
(Czarnowicki et al., 2018; Kim et al., 2022; Paller, 2019).
Targeting TNF-alpha, IL-17A, IL-4, and IL-12, immune 
system inhibitors have demonstrated potential in treating 
Ichthyosis by treating immunological dysregulation and 
inflammation. While IL-17A inhibitors may provide a 
specific treatment for the pathophysiology of  Ichthyosis, 
TNF-alpha inhibitors have been shown useful in treating 
inflammatory skin conditions. Moreover, inhibitors 
that target IL-4 and IL-12 appear to have therapeutic 
applications (Huangfu et al., 2023; Paller, 2019; Wang et 
al., 2021).
Drugs that inhibit factors related to the immune 
system, such as TNF-alpha, IL-17A, IL-4, and IL-12, 
are often considered as potential treatments, including 
Etanercept, Adalimumab, Infliximab (TNF-alpha 
inhibitors), Secukinumab, Ixekizumab, Brodalumab 
(IL-17A inhibitors), Dupilumab (IL-4 inhibitors) and 
Ustekinumab (IL12 and 23 inhibitors) (Paller et al., 2017; 
Peña-Corona et al., 2023; Zaenglein et al., 2021). 
The present research study aimed to improve the quality 
of  life by examining the safety and Efficacy of  immune 
system inhibitors that target TNF-alpha, IL-17A, IL-4, 
and IL-12 in pediatric ichthyosis treatment.

LITERATURE REVIEW
Ichthyosis is a common skin ailment that impairs 
perspiration, causes itching, and causes recurrent 
infections. It also negatively affects the quality of  life for 
those who have it. Although diagnosis is hampered by 
diverse clinical presentation and inadequate phenotype–
genotype association, the distinctive clinical symptoms 
represent a homeostatic attempt to restore the epidermal 
barrier. Comprehending the molecular pathways is 
essential for creating novel therapy approaches that target 
the underlying causes of  various ailments (Gutiérrez-
Cerrajero et al., 2023).
Ichthyoses and cornification disorders often require long-
term retinoid treatment. However, it was found that long-
term use of  retinoids in ichthyoses may cause potential 
negative effects on the eyes, bones, heart, and psyche, 
requiring careful clinical considerations (Zaenglein et al., 
2021).
Based on the etiology of  the skin disorder, gene therapy, 
and protein substitution are used as treatments for 
Ichthyosis. It was identified that biological therapy has 
been effectively used to treat Netherton syndrome and 
autosomal recessive congenital ichthyosis (Joosten et al., 
2022).
In a pediatric patient with severe erythrodermic autosomal 
recessive congenital Ichthyosis (ARCI), secukinumab was 
found to exhibit clinical Efficacy and safety, resulting 
in a 48% reduction in the baseline score, a reduction in 
proinflammatory cytokines, and an abrogation of  Th17-
skewing (Yogarajah et al., 2021).

There is no particular treatment for Ichthyosis; it is 
managed with systemic therapy, which includes UV 
radiation, moisturizing medicines, keratolytics, vitamin A 
derivatives, and therapeutic baths (Takhtarova et al., 2021).
Alpha-hydroxy acids (AHAs) like lactic, glycolic, or 
pyruvic acids are used to hydrate skin in children with 
Ichthyosis by disintegrating corneocytes in the stratum 
corneum, improving moisture and decreasing thickness. 
Particularly, lactic acid has demonstrated Efficacy over 
petrolatum-based creams in treating ichthyosis vulgaris. 
It can be obtained as a 12% ammonium lactate lotion 
or compounded in a 5–10% concentration. AHAs also 
help to improve desquamation and decrease corneocyte 
adhesion, which makes them useful for treating children’s 
ichthyosis symptoms (Palmer & Dunwell, 2022).
Salicylic acid, a keratolytic agent, is frequently used to 
treat Ichthyosis because it softens keratin, loosens scaly, 
dry skin, and facilitates removal. Although it is usually 
well tolerated, it may result in mild hives, irritation, rash, 
dryness, peeling, itching, redness, and skin swelling. 
Adverse effects might be quite serious in certain instances. 
Preparations of  salicylic acid with concentrations ranging 
from 0.5% to 30% and 6%, particularly in pediatrics, are 
used to treat particular ailments of  Ichthyosis in children 
(Cortés et al., 2020). 
Vitamin B5 in Dexpanthenol is a helpful treatment for 
children with ichthyosis vulgaris. It is a good alternative 
to use as a first-line therapy to enhance skin moisture and 
lessen dryness and scaling (Cortés et al., 2020).
Children with Ichthyosis are treated with emollient 
lotions such as Dexeryl, which contains glycerol. Based 
on studies, Dexeryl improves skin condition by lessening 
the severity of  xerosis and its associated symptoms. In 
80% of  treated youngsters, it is both effective and well-
tolerated. Thick, scaly, dry, and cracked skin are the signs 
this treatment targets (Blanchet‐Bardon et al., 2012).
Propylene glycol is a useful treatment for several 
conditions that cause the skin to become scaled. Because 
it keeps the skin free of  scales and removes them from the 
skin, it is very effective in treating ichthyosis (Hernández-
Martin et al., 2013).
Congenital ichthyosis patients may benefit greatly from 
vitamin D treatment, as it has demonstrated a strong 
ability to ameliorate the skin condition of  those afflicted. 
Studies have demonstrated the high incidence of  rickets 
and severe vitamin D insufficiency in children with 
congenital Ichthyosis. Short-term high-dose vitamin D 
treatment provided a notable clinical response in children 
with congenital Ichthyosis. During the treatment, 400–
600 IU of  cholecalciferol a day was advised after 60,000 
IU of  oral cholecalciferol was given daily for 10 days. The 
results showed that vitamin D treatment had a beneficial 
effect on the symptoms of  congenital Ichthyosis, as 
evidenced by the decrease in skin scaling and stiffness of  
the extremities (Sethuraman et al., 2016).
Research revealed that congenital Ichthyosis could be 
successfully treated when acitretin therapy was used 
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the baby’s skin condition had not improved with liquid 
Vaseline treatment (Gulasi, 2016).
If  congenital Ichthyosis is treated, acitretin 0.5 mg/kg/
day should be administered initially and 1 mg/kg/day 
after two months. As the highest doses do not exceed 1 
mg/kg/day, its short plasma half-life minimizes negative 
effects (Zaenglein et al., 2021).
Immune system inhibitors such as Etanercept (TNF-
alpha Inhibitors) have no adverse effects when used to 
treat juvenile idiopathic arthritis and Harlequin ichthyosis 
in children (Baldo et al., 2021). On the other hand, 
studies indicated that Adalimumab is also used to treat 
Ichthyosis in children; it targets the cytokine TNF-alpha, 
which is linked to inflammation. It helps to improve skin 
conditions and manage symptoms (Sticherling, 2020).
It has been demonstrated that infliximab treatment is 
beneficial in lowering skin inflammation in children with 
Ichthyosis, including Netherton syndrome. Studies have 
demonstrated that infliximab can improve skin lesions by 
reducing the expression of  several inflammatory markers, 
such as TSLP, IL-6, and IL-8. Clinical investigations have 
shown that infliximab treatment significantly improves 
the skin signs of  Netherton syndrome, including itching, 
scaling, dry skin, and eczematous lesions (Barbati et al., 
2021; Cicek et al., 2021; Roda et al., 2017).
IL-17 A inhibitors Secukinumab, which resembles 
the inflammatory profile of  Ichthyosis, have been 
demonstrated in clinical trials to be a safe and efficacious 
treatment for children with psoriasis. In particular, 
secukinumab resulted in a 48% decrease in the Ichthyosis-
Area-Severity-Index score following a 6-month therapy 
term in a young patient with severe erythrodermic 
Ichthyosis associated with ABCA12 deficiency in a 
therapeutic trial. Treatment was well tolerated, and the 
patient’s blood cytokine profile consistently changed, 
showing a decrease in proinflammatory cytokines and a 
Th17-skewing (Albela et al., 2024; Narbutt et al., 2023; 
Yogarajah et al., 2021).
In treating approximately 95% of  patients with pediatric 
ichthyosis vulgaris, Ixekizumab has demonstrated long-
term safety and Efficacy in decreasing dry scales. Changes 
in profilagrin expression tackle the underlying pathology 
(Pontone et al., 2022).
Dupilumab reduces inflammation and pruritus in 
patients with Ichthyosis by inhibiting interleukin-4 and 
interleukin-13 signaling. Studies indicate that Netherton 
syndrome and bullous congenital ichthyosiform 
erythroderma BCIE can be treated well and that managing 
Ichthyosis in children may be possible (Afshan & Kelbel, 
2019; Almuhanna, Alrashidi, et al., 2023; Martin-García et 
al., 2023; Olbrich et al., 2023).
Ustekinumab has been investigated for the treatment of  
Ichthyosis in pediatric patients, particularly in the case of  
a 15-year-old boy with Harlequin ichthyosis (HI). After 
one month of  treatment, the off-label Ustekinumab trial 
revealed a little improvement in erythema. Ustekinumab 
was removed from the regimen after a year since it did not 
result in a meaningful response to treatment. However, 

Ustekinumab may be a viable therapeutic option for other 
ichthyotic disorders (Almuhanna, Alasmari, et al., 2023).

MATERIALS AND METHODS
Study Design
The present research study was retrospective to examine 
the safety and Efficacy of  immune system inhibitors that 
target TNF-alpha, IL-17A, IL-4, and IL-12 in pediatric 
ichthyosis treatment.

Study Setting Duration 
The current study was conducted on 30 pediatric 
patients (ages 6-12 years) diagnosed with different types 
of  ichthyosis skin diseases at tertiary care pediatric 
dermatology hospitals in UAE for 5 months from 
November to February 2024. 

Participants 
Inclusion Criteria 

➢ Patients with Ichthyosis between the ages of  6 and 
12 who satisfied the study’s criteria and were verified by 
the patients’ database were included. 

➢ Subjects with a recent diagnosis or those with a 
previous diagnosis were included in the follow-up.

➢ Clinical information included key ichthyosis 
conditions such as lamellar, X-linked recessive, and 
vulgaris Ichthyosis.

Exclusion Criteria 
➢ The present research study eliminated patients who 

declined to participate or had missing data.

Intervention 
➢ Previous research studies found that TNF-alpha 

was elevated in Netherton syndrome compared to 
psoriasis and atopic dermatitis, but it was still lower 
than in Ichthyosis. Together, TNF-alpha and IL-17 
activate genes and markers connected to IL-17, so the 
main cytokine of  the Th17 pathway, IL-17A, sharply 
increases during Ichthyosis. IDH-related Th2 cytokine 
IL-4 expression levels are comparable to controls in 
Ichthyosis. Furthermore, engaged in the immunological 
profile of  Ichthyosis, IL-12 also impacts Th1 immune 
responses.

Key Cytokine of  Ichthyosis IL-17-A Inhibition
➢ IL-17 A is the primary cytokine responsible for 

inducing an immune response by activating genes and 
infectious or inflammatory markers. 

➢ The primary focus of  this study was to inhibit IL-
17-A in order to lessen the inflammatory and allergic 
symptoms associated with all three types of  pediatric 
Ichthyosis.

➢ IL-17A inhibitors, including Secukinumab, 
Ixekizumab, and Brodalumab, were administered to 
patients 6 to 12 years old, according to their body mass 
index, who had been diagnosed with multiple types of  
Ichthyosis, such as vulgaris, lamellar, and X linked. 



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Outcome Measures
➢ In the result, it was found that after 5 months of  

therapy, the patients who were given secukinumab 
provided positive results, and the patient’s ichthyosis area 
severity index score decreased by 45 to 50 percent, and it 
significantly reduced the proinflammatory rate of  cytokines 
against the control group, which was given with placebo.

➢ On the other hand, Secukinumab is FDA-approved 
safe and effective therapy even for severe erythrodermic 
Ichthyosis.

Primary Outcomes of  Secukinumab 
Improvements in skin texture and a decrease in the 
production of  scales were observed. Furthermore, there 
was a noteworthy decrease in inflammation, as seen by a 
45% improvement in the Ichthyosis Area Severity Index 
score within 6 months of  treatment.

Secondary Outcomes of  Secukinumab 
Secukinumab is safe and effective in treating children with 
severe Ichthyosis, significantly improving the severity of  
their symptoms. Remarkably, the cytokine profile returns 
to normal after treatment, and proinflammatory cytokines 
drop. Gastrointestinal problems, hypersensitivity 
reactions, and musculoskeletal pain have been linked 
to fewer side effects in conjunction with this good 
response. These results demonstrate the safety profile 
of  secukinumab and suggest it as a viable therapy for 
pediatric patients with severe Ichthyosis.

Statistical Analysis
T-tests were used to analyze associations between 
Secukinumab’s effectiveness and safety profile and that of  
Ixekizumab and Brodalumab against placebo. Employing 
an Area severity index score assessment of  Secukinumab. 
At P< 0.05, statistical significance was determined.

RESULTS AND DISCUSSION
Treatment Outcomes 
Efficacy of  Secukinumab in Comparison with Other 
Immune System Inhibitors
The Efficacy of  the IL-17-A inhibitor, Secukinumab, 
was evaluated by comparing its treatment outcomes with 
TNF-alpha, IL-4, and IL-12/13 inhibitors. Given that IL-
17-A is a key cytokine in various forms of  Ichthyosis, its 
targeted inhibition is deemed essential compared to other 
cytokines. Therefore, treatment selection was based on 
disease-specific factors and symptom severity, prioritizing 
using Secukinumab as an IL-17-A inhibitor. 
Secukinumab demonstrated rapid and effective symptom 
reduction, surpassing other IL-17 inhibitors like 
Ixekizumab and Brodalumab. Specifically, Secukinumab 
achieved a 45% faster decrease in area severity index score 
and notable improvements in skin scaling and texture 
against the placebo-treated control group. These results 
underscore the efficiency of  Secukinumab as a treatment 
for Ichthyosis, particularly in addressing symptom severity 
and enhancing skin quality. 

Safety Profile and Adverse Events in Comparison 
with Other IL-17-A Inhibitors
Secukinumab demonstrated high effectiveness and 
a lower incidence of  hypersensitivity reactions and 
gastrointestinal issues than Ixekizumab and Brodalumab. 
However, it is important to note that Brodalumab carries 
a risk of  affecting mental health by potentially causing 
depression and generating suicidal ideation. Additionally, 
there is a risk of  malignancies in patients using Ixekizumab 
and Brodalumab for the treatment of  Ichthyosis.

DISCUSSION
Childhood ichthyosis is a rare skin condition characterized 
by extremely dry surface scales. It is also known by the 
names Lamellar ichthyosis, X-linked recessive Ichthyosis, 
and ichthyosis vulgaris. A prenatal mutation or hereditary 
genes may impact the filaggrin protein in the skin. 
Acquired ichthyosis vulgaris in adults can result from 
several different illnesses.
Research on children with Ichthyosis reveals a Th17-
dominant immune profile with elevated expression of  IL-
17/TNFα-synergistic/additive genes, similar to psoriasis. 
Immune system inhibitors targeting TNF-alpha, IL-
17A, IL-4, and IL-12 have shown potential in treating 
immunological dysregulation and inflammation. These 
drugs, including Etanercept, Adalimumab, Infliximab, 
Secukinumab, Ixekizumab, Brodalumab, Dupilumab, and 
Ustekinumab, may improve quality of  life in pediatric 
ichthyosis treatment.
Long-term retinoid therapy is necessary for ichthyoses 
and cornification problems, although it can have 
detrimental consequences on the eyes, bones, heart, and 
brain. Netherton syndrome and autosomal recessive 
congenital Ichthyosis treatments include gene therapy 
and protein substitution.
The present research study involved 30 pediatric patients 
diagnosed with ichthyosis skin diseases in UAE from 
November to February 2024. Participants included 
those aged 6-12 with recent or previous diagnoses. Key 
ichthyosis conditions were included. The study found 
that TNF-alpha and IL-17 activate genes and markers 
related to IL-17, leading to increased Th17A cytokine 
levels. IDH-related Th2 cytokine IL-4 expression levels 
were comparable to controls. IL-12 also impacts Th1 
immune responses.
This research study focused on key cytokine IL-17-A 
to reduce inflammatory and allergic symptoms in 
pediatric ichthyosis patients aged 6-12. IL-17A inhibitors 
Secukinumab, Ixekizumab, and Brodalumab were 
administered to patients with various ichthyosis types. 
After 5 months, patients with secukinumab showed 
positive results, decreased ichthyosis severity index 
scores by 45-50%, and significantly reduced cytokine 
proinflammatory rate.
Compared to IL-17 inhibitors such as Ixekizumab and 
Brodalumab, secukinumab showed faster and more 
significant symptom reduction. Secukinumab specifically 
produced a 45% quicker reduction in the area severity 



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index score and appreciable changes in the scale and 
texture of  the skin. These outcomes highlight how well 
secukinumab treats Ichthyosis, especially when improving 
skin quality and symptom severity. 
Compared to Ixekizumab and Brodalumab, 
Secukinumab showed great Efficacy and a decreased 
rate of  hypersensitivity responses and gastrointestinal 
problems against a control group. However, it is crucial 
to remember that Brodalumab poses a risk of  harming 
mental health, as it may lead to suicidal thoughts and 
sadness. Furthermore, those treated for Ichthyosis with 
Ixekizumab and Brodalumab run the risk of  developing 
cancers.

LIMITATIONS
➢ The study has a limited sample size, which could 

affect the generalizability of  the findings to a broader 
population. 

➢ The cost of  Secukinumab and its accessibility to 
all patients, especially in regions with limited healthcare 
resources, could impact its applicability in real-world 
settings.

CONCLUSION
In conclusion, this study demonstrated the ability 
to effectively improve the skin texture scaling area 
severity index via Secukinumab, which may have clinical 
applications. These results highlight the potential of  
Secukinumab to serve as an efficient and protective agent 
against all types of  Ichthyosis, including lamellar, X-linked, 
and vulgaris. This study provides valuable information 
regarding the effects of  Secukinumab relative to placebo 
and over the already studied outcomes of  other IL-17-A 
inhibitors, including Ixekizumab and Brodalumab, and its 
potential clinical applications.

Clinical Implications
The results obtained from the present research study 
could be valuable for clinical practitioners in public health 
care, particularly pediatricians, as they may consider 
incorporating secukinumab into the treatment regimen 
for Ichthyosis, leading to improved area severity index 
scores and enhanced safety for pediatric patients. 

Future Directions
➢ Conduct longitudinal research to evaluate the long-

term effectiveness and safety profile of  secukinumab in 
pediatric patients with Ichthyosis. A minimum 12-month 
follow-up period should be a part of  this study to assess 
the treatment’s long-term effectiveness and any possible 
side effects.

➢ Recommended to Examine if  it would be 
advantageous to treat pediatric patients with Ichthyosis 
with secukinumab in addition to other therapies like 
topical corticosteroids, emollients, or phototherapy. 
Optimizing treatment outcomes using a combined 
strategy could result in synergistic effects.

REFERENCES
Afshan, T., & Kelbel, T. (2019). M501 An Adolescent 

Patient With Krt10 Mutation-Associated Ichthyosis 
Successfully Treated With Dupilumab. Annals of  
Allergy, Asthma & Immunology, 123(5), S139. 

Albela, H., Ingrid Pao Lin, T., Lee, T. S., Ooi, D., & Leong, 
K. F. (2024). Secukinumab therapy for paediatric 
patients with various phenotypes of  congenital 
ichthyosis. Clinical and experimental dermatology, 
llae082. 

Almuhanna, N., Alasmari, B. S., Alhamazani, R., Alkhezzi, 
S., Alhomida, F. A., Alasmari, B., & Alshammari, R. 
(2023). Assessing the Use of  Ustekinumab in a Pediatric 
Patient With Harlequin Ichthyosis. Cureus, 15(4). 

Almuhanna, N., Alrashidi, A. R., Shaheen, E. A., Alanazi, 
Y., Alfawzan, A., Alharthi, R., & Alhomida, F. A. 
(2023). Assessing the use of  dupilumab in a pediatric 
patient with bullous congenital ichthyosiform 
erythroderma. JAAD case reports, 39, 17-20. 

Baldo, F., Brena, M., Carbogno, S., Minoia, F., Lanni, 
S., Guez, S., Petaccia, A., Agostoni, C., Cimaz, R., 
& Filocamo, G. (2021). Juvenile idiopathic arthritis 
in Harlequin ichthyosis, a rare combination or the 
clinical spectrum of  the disease? Report of  a child 
treated with etanercept and review of  the literature. 
Pediatric Rheumatology, 19(1), 80. 

Barbati, F., Giovannini, M., Oranges, T., Lodi, L., Barni, 
S., Novembre, E., Baldo, E., Cristofolini, M., Stagi, S., 
& Ricci, S. (2021). Netherton syndrome in children: 
management and future perspectives. Frontiers in 
Pediatrics, 9, 645259. 

Blanchet‐Bardon, C., Tadini, G., Machado Matos, M., 
& Delarue, A. (2012). Association of  glycerol and 
paraffin in the treatment of  ichthyosis in children: an 
international, multicentric, randomized, controlled, 
double‐blind study. Journal of  the European Academy of  
Dermatology and Venereology, 26(8), 1014-1019. 

Cicek, F., Cekic, S., & Kilic, S. S. (2021). Infliximab 
therapy in an infant with Netherton syndrome. 
Pediatric dermatology, 38(3), 714-716. 

Cortés, H., Del Prado-Audelo, M. L., Urbán-Morlán, 
Z., Alcalá-Alcalá, S., González-Torres, M., Reyes-
Hernández, O. D., González-Del Carmen, M., & 
Leyva-Gómez, G. (2020). Pharmacological treatments 
for cutaneous manifestations of  inherited ichthyoses. 
Archives of  Dermatological Research, 312, 237-248. 

Czarnowicki, T., He, H., Leonard, A., Malik, K., Magidi, 
S., Rangel, S., Patel, K., Ramsey, K., Murphrey, M., & 
Song, T. (2018). The major orphan forms of  ichthyosis 
are characterized by systemic T-cell activation and Th-
17/Tc-17/Th-22/Tc-22 polarization in blood. Journal 
of  Investigative Dermatology, 138(10), 2157-2167. 

Dyer, J. A., Spraker, M., & Williams, M. (2013). Care of  
the newborn with ichthyosis. Dermatologic Therapy, 
26(1), 1-15. 

Gulasi, S. (2016). Congenital ichthyosis: a case treated 
successfully with acitretin. Iranian Journal of  Pediatrics, 26(5). 



Pa
ge

 
74

https://journals.e-palli.com/home/index.php/ajlsi

Am. J. Life Sci. Innov. 3(1) 69-74, 2024

Gutiérrez-Cerrajero, C., Sprecher, E., Paller, A. S., 
Akiyama, M., Mazereeuw-Hautier, J., Hernández-
Martín, A., & González-Sarmiento, R. (2023). 
Ichthyosis. Nature Reviews Disease Primers, 9(1), 2. 

Hernández-Martin, A., Aranegui, B., Martin-Santiago, 
A., & Garcia-Doval, I. (2013). A systematic review 
of  clinical trials of  treatments for the congenital 
ichthyoses, excluding ichthyosis vulgaris. Journal of  the 
American Academy of  Dermatology, 69(4), 544-549. e548. 

Huangfu, L., Li, R., Huang, Y., & Wang, S. (2023). The IL-
17 family in diseases: From bench to bedside. Signal 
Transduction and Targeted Therapy, 8(1), 402. 

Joosten, M., Clabbers, J., Jonca, N., Mazereeuw-Hautier, 
J., & Gostyński, A. (2022). New developments in 
the molecular treatment of  ichthyosis: review of  the 
literature. Orphanet journal of  rare diseases, 17(1), 269. 

Kim, M., Mikhaylov, D., Rangel, S. M., Pavel, A. B., He, 
H., Renert-Yuval, Y., Del Duca, E., Malik, K., Huynh, 
T., & Ibler, E. (2022). Transcriptomic analysis of  
the major orphan ichthyosis subtypes reveals shared 
immune and barrier signatures. Journal of  Investigative 
Dermatology, 142(9), 2363-2374. e2318. 

Lilly, E., & Bunick, C. G. (2023). Congenital Ichthyosis: A 
Practical Clinical Guide on Current Treatments and 
Future Perspectives. Clinical, Cosmetic and Investigational 
Dermatology, 2473-2479. 

Martin-García, C., Godoy, E., Cabrera, A., Cañueto, 
J., Muñoz-Bellido, F. J., Perez-Pazos, J., & Dávila, I. 
(2023). Report of  two sisters with Netherton syndrome 
successfully treated with dupilumab and review of  the 
literature. International Journal of  Immunopathology and 
Pharmacology, 37, 03946320231172881. 

Narbutt, J., Niedźwiedź, M., Lesiak, A., Ceryn, J., & 
Skibińska, M. (2023). Secukinumab for the treatment 
of  psoriasis in pediatrics: patient selection and 
acceptability. Patient preference and adherence, 421-431. 

Olbrich, H., Sadik, C. D., Ludwig, R. J., Thaçi, D., & Boch, 
K. (2023). Dupilumab in inflammatory skin diseases: 
a systematic review. Biomolecules, 13(4), 634. 

Paller, A. S. (2019). Profiling immune expression to 
consider repurposing therapeutics for the ichthyoses. 
Journal of  Investigative Dermatology, 139(3), 535-540. 

Paller, A. S., Renert-Yuval, Y., Suprun, M., Esaki, H., 
Oliva, M., Huynh, T. N., Ungar, B., Kunjravia, N., 
Friedland, R., & Peng, X. (2017). An IL-17–dominant 
immune profile is shared across the major orphan 
forms of  ichthyosis. Journal of  Allergy and Clinical 
Immunology, 139(1), 152-165. 

Palmer, V., & Dunwell, P. (2022). A Case of  Ichthyosis 

Vulgaris and the Use of  70% Glycolic Acid Chemical 
Peels for Management. Cureus, 14(9). 

Peña-Corona, S. I., Echeverria, M. d. l. D. C., Cortés, H., 
Carmen, G.-D., & Leyva-Gómez, G. (2023). Advances 
in the treatment of  autosomal recessive congenital 
ichthyosis, a look towards the repositioning of  drugs. 
Frontiers in pharmacology, 14, 1274248. 

Pontello, E., Battajon, N., Tormena, F., Giovannini, 
M., Buffo, M., Mainini, N., Visintin, G., Favero, V., 
Vendramin, S., & Galeazzo, B. (2020). Congenital 
ichthyosis in newborns. A case-series and review of  
the literature. European Journal of  Pediatric Dermatology, 
30(2), 104-110. 

Pontone, M., Giovannini, M., Filippeschi, C., Oranges, T., 
Pedaci, F. A., Mori, F., Barni, S., Barbati, F., Consonni, 
F., & Indolfi, G. (2022). Biological treatments for 
pediatric Netherton syndrome. Frontiers in Pediatrics, 
10, 1074243. 

Roda, Â., Mendonça-Sanches, M., Travassos, A. R., 
Soares-de-Almeida, L., & Metze, D. (2017). Infliximab 
therapy for Netherton syndrome: a case report. 
JAAD case reports, 3(6), 550-552. 

Sethuraman, G., Marwaha, R. K., Challa, A., Yenamandra, 
V. K., Ramakrishnan, L., Thulkar, S., & Sharma, V. 
K. (2016). Vitamin D: a new promising therapy for 
congenital ichthyosis. Pediatrics, 137(1). 

Sticherling, M. (2020). Dermatology Part 2: Ichthyoses 
and Psoriasis. Pediatric Pharmacotherapy, 153-175. 

Takhtarova, T. G., Khismatullina, Z. R., Panova, L. 
D., & Panova, A. N. (2021). Ichthyosis (concept, 
pathohistology, clinical picture, treatment). Vestnik 
dermatologii i venerologii, 97(3), 6-13. 

Wang, M., Zhai, X., Li, J., Guan, J., Xu, S., Li, Y., & 
Zhu, H. (2021). The role of  cytokines in predicting 
the response and adverse events related to immune 
checkpoint inhibitors. Frontiers in immunology, 12, 
670391. 

Yogarajah, J., Gouveia, C., Iype, J., Häfliger, S., Schaller, 
A., Nuoffer, J.-M., Fux, M., & Gautschi, M. (2021). 
Efficacy and safety of  secukinumab for the treatment 
of  severe ABCA12 deficiency‐related ichthyosis in a 
child. Skin Health and Disease, 1(2), e25. 

Zaenglein, A. L., Levy, M. L., Stefanko, N. S., Benjamin, 
L. T., Bruckner, A. L., Choate, K., Craiglow, B. G., 
DiGiovanna, J. J., Eichenfield, L. F., & Elias, P. (2021). 
Consensus recommendations for the use of  retinoids 
in ichthyosis and other disorders of  cornification in 
children and adolescents. Pediatric dermatology, 38(1), 
164-180.


