A 9-year-old boy presented with black scales all over the body sparing the flexures. There was a history of consanguineous parentage and prolonged labor. Scaling started from three weeks of age with exacerbations in the winter and remission in summer. On examination, there was coarse hyper pigmented scaling over the whole body (Fig. 1) with sparing of flexures. Right sided cryptorchidism was present till the age of four years. Ophthalmological examination, blood counts, chest X-ray and urine examination were normal. Patient was diagnosed as X-linked ichthyosis based on clinical features, history of prolonged labor and cryptorchidism. He was prescribed emollients and 10% urea; he showed improvement in scaling after four weeks.

Fig. 1 Generalised dark scaling over trunk with sparing of flexures.