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November 1982

Measuring Scale Steroid Sulfatase and ß-Lipoprotein Mobility in Ichthyosis

Arch Dermatol. 1982;118(11):875-876. doi:10.1001/archderm.1982.01650230003003

To the Editor.—  X-linked ichthyosis, as pointed out by Epstein et al in a recent editorial in the December Archives (1981;117:761-763) is a genetic disorder with a specific biochemical defect—an absence of steroid sulfatase activity associated with an accumulation of cholesterol sulfate in the skin. A simple, noninvasive assay was reported by Baden et al,1 involving measurement of steroid sulfatase in scale or callus samples scraped from the feet. Epstein and Leventhal2 described a technique (available in most clinical laboratories) to demonstrate increased electrophoretic mobility of low-density lipoproteins due to a greater cholesterol-sulfate content. Our extensive experience with patients with ichthyosis has made us realize that the value of these tests has not been fully appreciated by the practicing dermatologist.

Report of a Case.—  We recently saw a 56-year-old man with apparent sex-linked ichthyosis, whose condition was diagnosed by the referring physician on the basis of his clinical

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