Wearable Devices Are Unlocking New Insights for Men with X-Linked Ichthyosis

Researchers at Cardiff University have recently shown that males with X-linked ichthyosis, and female carriers, are at increased risk of heart rhythm abnormalities (either erratic, or excessively slowed or rapid beating of the heart) [1,2]. The reasons for this elevated risk are currently unclear, but it may arise due to abnormal development of the cardiac septum, the tissue separating the two sides of the heart and preventing oxygenated and deoxygenated blood from mixing [3]. When the heart beats abnormally there is a risk of blood clots forming within it; should these clots travel to the brain, they can block blood vessels and cause complications such as stroke and cognitive decline. There is therefore a need to identify any abnormal heart rhythms (arrhythmias) early in high-risk populations (such as XLI-carriers) to allow regular monitoring and clinical intervention where required. The use of wearable devices, such as smartwatches, could allow continuous screening to be performed in a non-invasive, convenient, cheap and effective manner.

In their latest paper [4], the Cardiff researchers, working together with the Ichthyosis Support Group UK and with cardiologists at University Hospital of Wales, tested the feasibility of using Apple Watches to monitor heart rhythms over a prolonged period in a small number of men with XLI. This study indicated that use of such watches is viable for this purpose, and importantly, does not exacerbate the skin issues associated with XLI. While watches appeared reasonably effective at picking up persistent heart rhythm problems, their ability to detect sporadic, transient, arrhythmias is still unclear, and a larger trial of this technology is planned to address this question. Greater use of reliable wearable technologies over the next few years should help to identify arrhythmias early in life, and to limit their long-term adverse impacts on patients and healthcare systems.

[1] https://jmg.bmj.com/content/57/10/692.long
[2] https://jmg.bmj.com/content/60/7/636.long
[3] https://portlandpress.com/essaysbiochem/article/68/4/423/234273/Cardiac-arrhythmia-in-individuals-with-steroid
[4] https://link.springer.com/article/10.1007/s00403-025-03884-x