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Dermatology · Genodermatoses: X-linked ichthyosis
Sample itemA boy has dark, large, adherent scales on the neck and trunk beginning in infancy, with comma-shaped corneal opacities, and his maternal uncle is affected. Which enzyme is deficient?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Steroid sulfatase
X-linked recessive ichthyosis results from deletion of the STS gene at Xp22.3 encoding steroid sulfatase, so cholesterol sulphate accumulates and stratum corneum desquamation is impaired. Cryptorchidism and prolonged labour in carrier mothers are associated.
Option by option
A. Tyrosinase
Tyrosinase deficiency causes oculocutaneous albinism.
B. Filaggrin
Filaggrin deficiency causes ichthyosis vulgaris.
C. Steroid sulfatase (correct)
Correct. Steroid sulfatase deficiency is the cause.
D. Transglutaminase 1
Transglutaminase 1 deficiency causes lamellar ichthyosis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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