[Acquired ichthyosis-like skin disease. A challenge for diagnostic evaluation]

We report on four patients with acquired ichthyosis-like skin lesions seen in our out-patients' clinic in the last 6 years. Emphasis is placed on the case of a 25-year-old patient who suffered from mycosis fungoides with the clinical features of an acquired ichthyosis-like condition. Three further observations illustrate the broad clinical spectrum of acquired ichthyosis-like dermatoses. In these patients renal insufficiency, HIV infection or an extreme diet were the cause of the skin lesions. Our observations emphasise that an acquired ichthyosis-like condition should be regarded as a challenge to make a definite diagnosis. Guidelines for a step-by-step diagnostic procedure are proposed.