'Confetti' skin disease spoils the party for bad genes

Science Express

Itchthyosis with confetti leaves sufferers with red, scaly skin sprinkled with spots of normal pigment. Scientists hope it will help solve the riddle of other genetic disorders.

A rare skin disease that leaves victims with red, scaly flesh mottled with tiny patches of normal pigment just might hold the secret to curing other genetic disorders, scientists say.

Called “ichthyosis with confetti” because of a random sprinkling of normal skin cells, the disease is so unusual it might affect only “a couple dozen” people worldwide, said Dr. Keith Choate, a Yale University dermatologist and research scientist.

But the strange ailment may one day show scientists how to silence certain genes that cause disease, said Choate, who with colleagues reported findings in the latest issue of the journal Science Express. In effect, the confetti gene double-crosses the disease gene, forcing it to reverse itself to good health.

“One could envision dealing with other conditions caused by dominant gene functions like cancer and imagine taking the defective copy and causing the disease to go away by the same mechanism,” Choate said.

First, though, a little about ichthyosis. Named after the Greek word for fish, ichthyosis is usually characterized by the development of extremely thick, scaly skin, or, sometimes, very thin skin. It can lead to severe medical problems like calorie loss, water loss, overheating, blistering and psychological issues related to disfigurement and skin color changes. About 16,000 babies are born who either have or will develop the general condition, far more than ever develop the confetti variety.

But it’s the “confetti” in ichthyosis with confetti that intrigued one of Choate’s Yale mentors, Dr. Leonard Millstone, who, Choate recalled, “called me over and said ‘You should see this patient, see what’s happening.’ Practically before his very eyes, he saw a white spot developing."

In a study released last week, Choate and colleagues described how they unlocked the secret. In some skin cells, an entire chunk of chromosome 17 that contains the defective gene inherited from one’s parents is replaced from the spot of the bad gene all the way to the end of that arm of the chromosome. The replacement section contains a good copy of the gene, also inherited from parents.

Patients with the confetti tend to grow more and more normal patches of skin the longer they live, but while those patches could be called “cured,” and while the increase in normal patches does lessen ichthyosis symptoms somewhat, patients still have ichthyosis and Choate said the benefits are “relatively mild.”

Still, Choate said the strange disease offers hope that somehow, other genetic diseases – such as muscular dystrophy or cancer – may be forced to become self-correcting, too. One day, that could be a big payoff of the research.

Do you grapple with an annoying skin issue? Do tell.

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Discuss this post

Ichthyosis is a skin condition, not a disease. It is genetic and not contagious.

I have a version of Ichthyosis. Mine is Lamellar Ichthyosis, and I'm very lucky that I have a mild case of it. My skin produces itself faster than it can slough off. I get overheated easily and my sweat and oil glands don't work as they should. On the upside, I heal much faster than someone with "plain" skin. :)

I had issues growing up, and still do, because of my appearance. My skin condition has gotten better as I've gotten older, though. I still get comments and/or questions about my red face. Most people assume (incorrectly) that I have a sunburn.

To learn more about ichthyosis and the various types (as well as varying degrees of severity), please visit FIRST (Foundation for Icthyosis and Related Skin Types) at http://www.firstskinfoundation.org/

    Reply#1 - Tue Aug 31, 2010 6:08 PM EDT

    My dermatologist asked me if I had a certain dry, scaly skin  pattern when I was a child, and I did. So did my mother. I have suffered from extremely dry skin all my life. When people tell me they have dry skin, it is nothing like as dry as mine. Anyway, she told me I have ichthiosis. Not the confetti type but the fish scale type. Very frustrating as, no matter what I do, I have dry skin even in the summer when the humidity used to help a bit. As I have gotten older, even that no longer helps. Any treatment out there?

      Reply#2 - Tue Aug 31, 2010 6:12 PM EDT

      Thank you for excellent coverage of our very rare skin disorder. The first commenter is correct, that it is a disorder, not a disease, but your article is otherwise excellent. 4 members of my family have this particular type, and I am elated that it is getting attention and has such a potential for helping others with unrelated genetic problems. Dr. Choate and Dr. Milstone are amazing people and we owe them much both as a family and as a society.

      More information can be found at www.ichthyosis.com and also at www.firstskinfoundation.org

      • 1 vote
      #2.1 - Tue Aug 31, 2010 10:47 PM EDT

      I use Eucerin or Hydrocerin 2 times a day. Some of the other skin products, were either to heavy or too light. The heavier creams like DermaCerin do not soak in, and stay on top and make a rubbery coating on the skin, and get on clothing.

      • 1 vote
      #2.2 - Thu Sep 2, 2010 2:05 PM EDT
      Reply

      Ichtyosis is a skin condition, which is inherited, it sometimes skippes 2 or 3 generation. The condition is caused, due to the skin not holding water. It is so dry, that the skin breaks down and crumbles. It is exremely itchy and easely irritated.

      • 1 vote
      Reply#3 - Thu Sep 2, 2010 1:45 PM EDT

      Thank you for bringing attention to Ichthyosis! the work that they are doing at Yale is certainly incredible. It brings hope to those that live with this rare skin disorder. My granddaughter who is 4 has EHK. Our hope is that through research a cure can be discovered for those whose lives are effected by Ichthyosis. Like other rare disorders, funding for research is always an issue. In addition to the work that they are doing at Yale, the FIRST foundation provdes wonderful support.

        Reply#4 - Wed Sep 12, 2012 6:04 PM EDT
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