Ichthyosis in Unani Medicine: A Comprehensive Review of Disorders of Cornification and their Modern Dermatological Correlates

Ichthyosis is a heterogeneous group of hereditary and acquired disorders of cornification, which is characterised by generalised dry, scaly skin that develops from impaired epidermal barrier function. The condition is derived from the Greek word ichthys, meaning fish, representing the characteristic fish-scale appearance of the skin. The prevalence of ichthyosis varies widely, with ichthyosis vulgaris affecting approximately 1 in 3, 000 individuals, while rare autosomal recessive congenital ichthyoses (ARCI) occur in nearly 1 in 300, 000 births and show higher prevalence in regions with consanguineous marriages, particularly in parts of South India. This article comprehensively discusses the classification, aetiology, pathophysiology, clinical features, diagnosis, and management of both inherited and acquired ichthyoses, with salient emphasis on corresponding modern molecular and genetic mechanisms with traditional Unani medical concepts. Inherited ichthyoses emerge due to mutations in genes responsible for epidermal protein and lipid synthesis, which results due to defective keratinocyte differentiation, abnormal desquamation, and compromised skin barrier integrity. Acquired ichthyosis is kindred with systemic conditions such as autoimmune disorders, endocrine abnormalities, malignancies, infections, nutritional deficiencies, and drug exposure. The Unani perspective represents ichthyosis as Jild ki khushki aur taqashur, attributed predominantly to abnormal black bile (Sauda-e-ghair-?abi'i), pathological combustion (i?tiraq), and excessive dryness (ghalba-e-yubusat). A correlation is drawn between Unani concepts of defective quwwat-e-mughayyirah and the modern understanding of genetic and metabolic dysfunction influencing epidermal transformation. The article further outlines contemporary dermatological management strategies along with Unani principles of treatment, emphasizing detoxification, humoral balance, emollient therapy, and holistic patient care. This integrative approach highlights the importance of Unani medicine in understanding and managing ichthyosis in relation to modern medical science.