{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:25:46Z","timestamp":1767338746666,"version":"3.40.5"},"reference-count":11,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,7,1]]},"abstract":"<jats:p>Nutritional rickets has occasionally been described in children with lamellar ichthyosis, but their vitamin D endocrine status has not been described. We report 3 cases of vitamin D-deficiency rickets associated with ichthyosis in African children.<\/jats:p>\n               <jats:p>A 13-month-old Nigerian boy with lamellar ichthyosis had rib beading, elevated alkaline phosphatase, and rachitic changes on radiographs. His rickets did not resolve with calcium therapy, and his 25-hydroxyvitamin D level was low. His rickets resolved with parenteral vitamin D treatment, but his skin did not improve. Topical 0.005% calcipotriene (an analog of 1,25-dihydroxyvitamin D that has been useful in treating adults with psoriasis) was similarly ineffective in improving the child's skin condition.<\/jats:p>\n               <jats:p>An 8-year-old Nigerian boy with life-long skin findings consistent with lamellar ichthyosis had windswept deformity of the legs with rib beading and enlargement of the wrists and ankles. Radiographs showed active rickets, and the boy had an elevated alkaline phosphatase level and a decreased calcium level. Before knowing that his 25-hydroxyvitamin D level was low, he was treated with calcium and showed radiologic improvement. The skin did not improve with resolution of the rickets but did improve with unilateral topical application of 0.005% calcipotriene.<\/jats:p>\n               <jats:p>A 7-year-old South African girl presented with progressive windswept deformities of the legs and a 4-year history of skin disease (and a skin biopsy consistent with X-linked ichthyosis). Radiographs and biochemical data confirmed active rickets. Her rickets improved dramatically with vitamin D treatment.<\/jats:p>\n               <jats:p>Thus, 3 African children with ichthyosis developed vitamin D-deficiency rickets, probably because of a combination of impaired skin production and sunlight avoidance. This is consistent with previous findings of hypovitaminosis D in adults with ichthyosis and other disorders of keratinization. Measurement of 25-hydroxyvitamin D may be indicated in children with ichthyosis to identify those at risk for vitamin D-deficiency rickets, because it is possible that the cutaneous synthesis of vitamin D in such children is impaired.<\/jats:p>\n               <jats:p>Although the ichthyosis did not improve with resolution of vitamin D deficiency and rickets, 1 of 2 children treated with topical calcipotriene showed improvement in the treated areas of skin. Calcipotriene does not seem to be effective in reversing systemic vitamin D deficiency but can be effective in improving the severity of skin disease in children with ichthyosis.<\/jats:p>","DOI":"10.1542\/peds.114.1.e119","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:53:04Z","timestamp":1092444784000},"page":"e119-e123","source":"Crossref","is-referenced-by-count":31,"title":["Nutritional Rickets in Ichthyosis and Response to Calcipotriene"],"prefix":"10.1542","volume":"114","author":[{"given":"Tom D.","family":"Thacher","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Jos University Teaching Hospital, Jos, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip R.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Pettifor","sequence":"additional","affiliation":[{"name":"Medical Research Council, Mineral Metabolism Research Unit, Department of Paediatrics, University of the Witwatersrand and Chris Hani Baragwanath Hospital, Bertsham, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary L.","family":"Darmstadt","sequence":"additional","affiliation":[{"name":"Department of International Health, School of Hygiene and Public Health, The Johns Hopkins Medical Institutions, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2004,7,1]]},"reference":[{"key":"2021121006520557800_R1","doi-asserted-by":"crossref","unstructured":"Bhattacharyya AK. Nutritional rickets in the tropics. World Rev Nutr Diet.\u20081992;67:140\u2013197","DOI":"10.1159\/000419463"},{"key":"2021121006520557800_R2","doi-asserted-by":"crossref","unstructured":"Pettifor JM, Ross P, Wang J, Moodley G, Couper-Smith J. Rickets in children of rural origin in South Africa: is low dietary calcium a factor?Pediatrics.\u20081978;92:320\u2013324","DOI":"10.1016\/S0022-3476(78)80035-3"},{"key":"2021121006520557800_R3","doi-asserted-by":"crossref","unstructured":"Thacher TD, Fischer PR, Pettifor JM, et al. A comparison of calcium, vitamin D, or both for nutritional rickets in Nigerian children. N Engl J Med.\u20081999;341:563\u2013568","DOI":"10.1056\/NEJM199908193410803"},{"key":"2021121006520557800_R4","doi-asserted-by":"crossref","unstructured":"El Hag AI, Karrar ZA. Nutritional vitamin D deficiency rickets in Sudanese children. Ann Trop Paediatr.\u20081995;15:69\u201376","DOI":"10.1080\/02724936.1995.11747751"},{"key":"2021121006520557800_R5","unstructured":"Scott CI. X-linked icthyosis vulgaris. Birth Defects Orig Artic Ser.\u20081971;7:243\u2013244"},{"key":"2021121006520557800_R6","doi-asserted-by":"crossref","unstructured":"Torres CF, Forbes GB, Decancq GH. Muscle weakness in infants with rickets: distribution, course and recovery. Pediatr Neurol.\u20081986;2:95\u201398","DOI":"10.1016\/0887-8994(86)90063-9"},{"key":"2021121006520557800_R7","unstructured":"Devidayal, Kumar L, Singh M. Non-bullous ichthyosiform erythroderma with rickets [letter]. Indian Pediatr.\u20082002;39:207\u2013208"},{"key":"2021121006520557800_R8","doi-asserted-by":"crossref","unstructured":"Milstone LM, Ellison AF, Insogna KL. Serum parathyroid hormone level is elevated in some patients with disorders of keratinization. Arch Dermatol.\u20081992;128:926\u2013930","DOI":"10.1001\/archderm.128.7.926"},{"key":"2021121006520557800_R9","doi-asserted-by":"crossref","unstructured":"Milstone LM, Bale SJ, Insogna KL. Secondary hyperparathyroidism in patients with ichthyosis is not caused by vitamin D deficiency or ingestion of retinoids [letter]. Arch Dermatol.\u20081993;129:648","DOI":"10.1001\/archderm.1993.01680260120024"},{"key":"2021121006520557800_R10","doi-asserted-by":"crossref","unstructured":"Okano M, Kitano Y, Yoshikawa K. A trial of oral 1\u03b1-hydroxyvitamin D3 for ichthyosis [letter]. Dermatologica.\u20081988;177:23","DOI":"10.1159\/000248505"},{"key":"2021121006520557800_R11","doi-asserted-by":"crossref","unstructured":"Lucker GPH, Van de Kerkhof PCM, Van Dijk MR, Steijlen PM. Effect of topical calcipotriol on congenital ichthyoses. Br J Dermatol.\u20081994;131:546\u2013550","DOI":"10.1111\/j.1365-2133.1994.tb08558.x"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/114\/1\/e119\/1006477\/zpe0070400e119.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/114\/1\/e119\/1006477\/zpe0070400e119.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T15:52:42Z","timestamp":1639151562000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/114\/1\/e119\/64809\/Nutritional-Rickets-in-Ichthyosis-and-Response-to"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,7,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2004,7,1]]},"published-print":{"date-parts":[[2004,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.114.1.e119","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2004,7,1]]}}}