Complex Dermatological Manifestations of Poorly Controlled Diabetes: A Case of Acquired Ichthyosis

Acquired ichthyosis (AI) is a rare dermatological disorder characterized by dry, scaly skin. This case involves a 67-year-old Hispanic male with poorly controlled diabetes mellitus (DM) who presented with generalized dryness and itchiness after diabetic ketoacidosis. Examination revealed polygonal scales with erythema, and biopsy confirmed AI. Laboratory tests showed elevated glucose, dyslipidemia, hyponatremia, hyperkalemia, and Stage IIIb chronic kidney disease. Treatment included moisturizers, antihistamines, antifungal shampoo, topical corticosteroids, tacrolimus, and optimized DM management, leading to improvement. AI is often linked to systemic conditions like malignancy, autoimmune diseases, infections, and certain medications. Diagnosis is clinical and biopsy-supported, requiring a systemic workup to identify underlying causes. Poorly controlled DM was significant in this case, highlighting the importance of comprehensive assessment. Early recognition and understanding of AI's association with DM can optimize treatment and reduce morbidity.