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Article
November 1987

Ichthyosis Induced by Cholesterol-Lowering DrugsImplications for Epidermal Cholesterol Homeostasis

Author Affiliations

From the Departments of Dermatology (Drs Williams, Grubauer, and Elias), Pediatrics (Dr Williams), and Medicine (Dr Feingold), University of California School of Medicine, San Francisco, and the Dermatology (Drs Williams, Grubauer, and Elias) and Metabolism (Dr Feingold) Services, Veterans Administration Medical Center, San Francisco.

Arch Dermatol. 1987;123(11):1535-1538. doi:10.1001/archderm.1987.01660350135030
Abstract

• Ichthyosis and other disorders of cornification may occur as side effects of treatment with several hypocholesterolemic agents. Recent progress in understanding of the functional role of lipids in stratum corneum provides a new pathophysiologic basis for these earlier clinical observations. In stratum corneum, lipids are segregated within intercellular membranes, where they appear to regulate permeability barrier function and desquamation. Cholesterol is an important constituent of these membranes and may be essential to both of these functions. Perturbation of barrier function induces cholesterologenesis locally within the epidermis. Polar sterol metabolites, such as cholesterol sulfate, may also regulate epidermal sterologenesis under normal or pathologic circumstances. Cholesterol homeostasis may also modulate desquamation. For example, hairless mice fed azacosterol hydrochloride (20,25-diazacholesterol) develop a generalized scaling disorder without loss of barrier function. In these mice, total stratum corneum sterol content is markedly decreased, and topical or systemic repletion with cholesterol can correct the scaling abnormalities.

(Arch Dermatol 1987;123:1535-1538)

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