Avoid certain bathroom products: Stay away from products with substances that may contribute to exfoliative keratolysis, including solvents, antibacterial soaps, and certain fabrics. Most patients deny any itching, but may rarely complain of slight tenderness. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. If you wish to read unlimited content, please log in or register below. The etiology of keratolysis exfoliativa is unknown, but the condition appears to be worsened by heat or sweating. Exfoliative Keratolysis Treatment Picture 2: Palm with Exfoliative Keratolysis The best way to treat the condition is to avoid the causative factors. The skin may swell and become red due to inflammation. Differential diagnosis. While Indian home remedies may give fruitful results, some cases are too severe to be treated with these remedies. The condition is diagnosed when your dermatologist notices peeling skin on palms of hands and cracked skin on fingertips. Flaky dry skin around the affected area A dermatologist may recommend the use of keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Hausauer, A. K., & Cohen, D. E. (2015). As they do so, new skin is born out of the process. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. There may be an association with underlying atopic dermatitis, thus one may also see a combination of asthma and allergies more frequently. Exfoliative Keratolysis Treatment Topical steroids are often given exfoliative keratolysis. Educating the patient on the benign nature of this condition is imperative, as often the patient merely wants a diagnosis and does not desire any further treatment. It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. Although there has not been any studies to confirm it, it is very rampant around that time of the year. So, you can say it lasts during the summer. Although treatments are available, it is more of palliative. 1.clinical diagnosis- Pitted keratolysis. Unable to load your collection due to an error, Unable to load your delegates due to an error. Picture 2: Palm with Exfoliative Keratolysis. We do not endorse non-Cleveland Clinic products or services. Kawasaki disease In such situations, one may consult a doctor and use medication that is prescribed by them. Often times, these creams also contain silicone and urea. What Is Exfoliative Keratolysis? Acral Peeling Skin Syndrome: A Case Report and Literature Review. After the soak, you can use a pumice stone to remove dry skin from your feet. It usually comes about in the summer triggered by humid conditions. 4. It is also known as Focal Palmar Peeling and is typically observed in young adults How to treat keratolysis exfoliativa? It is its own thing. This approach has been present since 1976 and uses ultraviolet rays to treat the condition. The first sign of the condition in India is generally flaky dry skin around the fingers and skin peeling on palms. Getting oneself rehydrated is a good condition as well as well hydrated cells arent easily affected by extremely hot weather conditions. (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?bookid=2570§ionid=210430286), Visitation, mask requirements and COVID-19 information. Exfoliative Keratolysis Treatment The ideal treatment is avoiding the risk factors that are its primary causes. 1996 Aug;37(3):1434. government site. What Are These Tiny Red Spots on My Skin (Petechiae)? PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. Keratolytic creams containing urea, lactic acid, ammonium lactate or salicyclic acid. Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. 2014 Jun;150(6):647-8. doi: 10.1001/jamadermatol.2013.9190. Another sign of the condition is the appearance of skin tags. There is usually no need for further diagnostic testing, as this is typically a clinical diagnosis; however, in more difficult cases, a potassium hydroxide (KOH) scraping or fungal culture to rule out tinea should be negative and patch testing to rule out allergic contact dermatitis should also be negative. Arch Dermatol, 3(202), 11. Then, the blisters burstand it leaves a hollow and blank space underneath the skin. Dermatologists recommend that one maintains good personal hygiene and avoids spending too much time in the sun. Unauthorized use of these marks is strictly prohibited. Although rare, it can also affect the palm of your hand. Erythromycin. Synthetic materials or blended materials in socks can restrict airflow to your feet. Once the scales and the redness heals, the condition hibernates. In other words, treatment can only deal with the symptoms and signs associated with the condition. Eczema is also a quite painful condition, whereas exfoliative keratolysis doesnt hurt as much. Another is to be extra careful during outbreaks particularly summer season. Initially, it doesnt cause any pain or abnormality but gradually some air-filledblisters take over the skin of palms and/or soles. Last modified on March 2021With inputs from Dr.Vedalatha Kakani, General Physician. 24/7 visits - just $44! Visit the emergency room if you have symptoms of an allergic reaction from taking antibiotics, including: If you have a fear of patterns with a lot of holes (trypophobia), a pitted keratolysis diagnosis can be a trigger for your fear. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. Eat the proper diet: It is best to eliminate processed foods and additives, fried foods, high-sugar foods, and common food allergens from the diet. 166. MeSH There are a number of preventative tips that can help you decrease the risk of exfoliative keratolysis symptoms. The first sign of this condition is constant discomfort on the skin that provokes itching. renowned by other titles, such as Lamellar dyshidrosis, recurrent focal palmar peeling and recurrent palmar peeling, keratolysis exfoliativa afflicts the palms of the hands and tender soles of the feet. Normally, its not painful but swelling blisters or inflamed layer of skins can cause pain to the body. We hope youre enjoying the latest clinical news, full-length features, case studies, and more. It is also a good idea to avoid the warm weather during the summer, since this can lead to skin peeling that may eventually develop into exfoliative keratolysis. Before that, we should know what it really is. Lifelong desquamation of the hands and feet. SANGSTER, A. Keratolysis exfoliativa (dyshidrosis lamellosa sicca), een aparte peelingentiteit. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Normal skin will develop in due time, although it is common for exfoliative keratolysis to return within a few weeks after normal skin has formed. 2015 Dec 16;21(12). Cutaneous T-cell lymphoma There has been no conventional drug proven to be effective to heal exfoliative keratolysis. Another is to be extra careful during outbreaks particularly summer season. European Journal of Pediatric Dermatology, 23(2), 125-125. Normal skin gradually develops as the blisters split and new skin forms. The diagnosis of keratolysis exfoliativa is made based on history and clinical examination. These hollow spaces are actually the peeked areas. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. The risk factors for Keratolysis Exfoliativa include: It is important to note that having a risk factor does not mean that one will get the condition. DermNet provides Google Translate, a free machine translation service. arrow-right-small-blue The condition requires no medical test and is detected by a well experienced dermatologist. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. There are different ways to do the treatment. The condition may also be a sign of immune system disorders. Topical corticosteroids-usually not of much benefit. All rights reserved. Although PUVA can be effective, it can also have various side effects, like itching, burning, eye damage, and skin cancer. However, one has to take psoralen by mouth or apply topical psoralen before exposing oneself to the sun as it is difficult to calibrate the correct amount of exposure. When this is the case, it is best to consult your doctor for exfoliative keratolysis treatment. This is a very common disease where the skin starts to peel off automatically causing eruptions and dryness to the palms of hands and, sometimes, to the soles of feet. In case you come into contact with any allergens, use lotions that will soothe the skin and reduce the itching that is associated with peeling. Please remove adblock to help us create the best medical content found on the Internet. Clipboard, Search History, and several other advanced features are temporarily unavailable. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. 10 Most Common Nail Diseases And Disorders. Still, it will reappear weeks and even months later. How often should I apply topical antibiotics to my skin? Also, not having a risk factor does not mean that an individual will not get the condition. As you already know there are no fixed reasons behind exfoliative keratolysis. This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. Talk to a doctor now . In most cases the condition subsides on its own. Psychiatry 27 years experience. 2021 Mar;72(3):215-224. doi: 10.1007/s00105-021-04765-w. Epub 2021 Feb 12. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. Photochemotherapy can be applied if the disease goes beyond control. The skin thickens, hardens into a callus, dries out, and peels off. There are some texts that mention the use of photochemotherapy with hand/foot psoralen and ultraviolet A light (PUVA) for severe cases. However, they are not generally itchy. (2020). There are possible side effects of taking antibiotics, which could include: Before starting any treatment, talk to your healthcare provider about side effects and discuss the current medications you take to avoid drug interactions. Keratolysis exfoliativa is a common skin condition in which there is focal peeling of the palms and less often the soles. Persistent itching. This disorder doesnt respond to any drugs except an oral Soriatane. For example, rubber boots dont offer sufficient airflow. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. Using quality lotions and moisturizers that can prevent infection. J Cutan Dis, 37, 174-175. It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. The same also occurs when the condition affects the palm or the soles of the feet. The following factors may have a role to play in its formation and/or exacerbation: The signs and symptoms of Keratolysis Exfoliativa may include: Recurrence of the localized condition is observed within a few weeks. The pathologist examines the biopsy under a microscope. 37. Keratolysis Exfoliativa is a fairly common skin condition that is characterized by localized peeling (exfoliation) of the outer layers of skin of the palms and soles. Staph infections Because of this prevalent condition, the disease is sometimes mistaken for eczema. The peeling may be painful in some cases and it is best to get it treated immediately. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks. How do I avoid peeling skin? They might ask questions about the type of shoes and socks you wear, especially around the time you noticed your symptoms. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. Keratolysis exfoliativa is a condition that is treatable at home. Topics AZ Disclaimer: Results are not guaranteed*** and may vary from person to person***. The lower body may also see such signs of flaking in the form of skin peeling on legs. The condition isnt constricted to the skin on the hands and face, one may even notice skin peeling on the face. Your healthcare provider will diagnose pitted keratolysis after reviewing your complete medical history and performing a physical exam to learn more about your symptoms. It most often affects the skin on your feet. There is also some suggestion that it is incited by low-grade physical or chemical damage to the stratum corneum of the volar skin, leading to a superficial separation of the stratum corneum. This is a very common disease where the skin starts to peel off automatically causing eruptions and dryness to the palms of hands and, sometimes, to the soles of feet. Treatment for exfoliative keratolysis typically involves the use of antibiotics or antifungal medications. We present a 55-year-old woman with extensive disease on the hands and feet, who failed to respond to standard topical therapy but showed a marked dose-response improvement with the use of oral acitretin. How can I prevent this condition from returning in the future? Books about skin diseasesBooks about the skin Acne pitted scar treatment. A trial of potent (betamethasone dipropionate 0.05% or equivalent) or ultrapotent (clobetasol 0.05% or equivalent) topical corticosteroid applied twice daily for no more than 2 weeks could be attempted; however, these are typically not found to be very beneficial as this disease is characterized by a lack of inflammation. For this scenario, only the affected hands or feet are soaked in methoxsalen solution for half an hour before it is being exposed to UVA rays. Intravenous steroids may be given in severe cases, but steroids usage has its own side effects, when used for a long time.
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