It is also known as Focal Palmar Peeling and is typically observed in young adults, The cause of the condition is generally unknown, but it may be aggravated by contact with irritants, such as chemicals and solvents, and is more common in summers. The symptoms are aggravated by exposure to irritants including water, soap, detergents and solvents. Keratolysis exfoliativa is diagnosed clinically. Exposure to irritants such as washing powder, soap, detergent etc. Psoriasis: Psoriasis is a chronic condition that affects the skin. Another reason for skin peeling off is excessive Vitamin A in the body. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you Secondly, genetic predisposition may also expose someone to this condition as certain environmental or external factors can trigger the disease to develop. Antibiotics treat the infection to remove the bacteria from your body. This painful or harmless skin problem also goes by names such as keratolysis exfoliativa, lamellar dyshidrosis, dyshidrosis lamellosa sicca, and recurrent palmar peeling. 4. How to treat keratolysis exfoliativa? Acute exfoliative keratolysis: It is a primary stage of skin peeling of hands. 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. Treatment for exfoliative keratolysis typically involves the use of antibiotics or antifungal medications. Want to talk to an expert regarding your diet? It is periodic. Epub 2020 Sep 10. References Hausauer AK, Cohen DE. arrow-right-small-blue Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. This should include protecting the hands from any physical or chemical irritants and encouraging the patient to wear gloves when possible. - Full-Length Features Intravenous steroids may be given in severe cases, but steroids usage has its own side effects, when used for a long time. On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. Disclaimer: Results are not guaranteed*** and may vary from person to person***. A 21-year-old male asked: . 2020 Dec;34(12):e783-e785. The lower body may also see such signs of flaking in the form of skin peeling on legs. 1. Skin peeling happens when the outer layer of the skin called as epidermis; which is made up of keratin, breaks down, loses its strength and exfoliates. No advanced study has been carried out about what might be the cause of exfoliative keratolysis. Lee HJ, Ha SJ, Ahn WK, Kim D, Park YM, Byun DG, Kim JW Pediatr Dermatol 2001 Mar-Apr;18 (2):102-6. doi: 10.1046/j.1525-1470.2001.018002102.x. Topical steroids are not known to be helpful, Phototherapy may be considered for severe cases, Avoid using soaps, detergents, and harsh chemicals, If seawater aggravates the condition, then minimizing or avoiding exposure to the same, Where possible, avoid activities that cause friction in the affected palms or soles, Try to use suitable gloves to protect the hands, where necessary, The prognosis of Keratolysis Exfoliativa is generally good as a majority of the cases are self-limited and a spontaneous resolution is noted, In some individuals, the condition may be severe with frequent recurrences being noted. If possible, use drugs which can reduce sweating excessively. Use of topical steroids and cortisone cream and even increased levels of prednisone is also effective in treating the problem. Keratolysis exfoliativa and the mosaic fungus. The best material to improve airflow to your feet through your socks is cotton. In some cases, the following steps may be considered: The following DoveMed website link is a useful resource for additional information: https://www.dovemed.com/healthy-living/skin-disorders/, American Academy of Dermatology930 E. Woodfield Road Schaumburg, IL 60173Phone: (866) 503-SKIN (7546)Fax: (847) 240-1859Website: http://www.aad.org, https://dermnetnz.org/topics/keratolysis-exfoliativa/(accessed on 05/20/2021), https://en.wikipedia.org/wiki/Keratolysis_exfoliativa (accessed on 05/20/2021). 2.ICD-10-CM classification code L08.89 5. While eczema and exfoliative keratolysis look very similar, the difference is that exfoliative keratolysis will peel and shed, whereas eczema also produces itchy skin. American Osteopathic College of Dermatology. (Provides a description of the microscopic pattern of splitting seen in keratolysis exfoliativa and contrasts these finding with that of familial continual peeling of the skin), Lee, HJ, Ha, SJ, Ahn, WK, Kim, D, Park, YM, Byun, DG. It is also known as Focal Palmar Peeling and is typically observed in young adults 23-31. 18. The condition often causes air-filled blisters that eventually peel, and leaves the skin looking reddish, tender, dry, and cracked. Sometimes on the ends of the fingers, the split in the skin is deeper, in which case the skin feels hard and numb and takes longer to peel off. One of the more common forms of treatment for exfoliative keratolysis is the application of a lactic acid-infused hand cream. Acral skin eruption observed during SARSCoV2 pandemic: possible keratolysis exfoliativa with red palms and soles. Keratolysis exfoliativa is more common during the summer months in about 50% of affected individuals. Peeling skin on fingers near nails This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. Created for people with ongoing healthcare needs but benefits everyone. Epub 2012 Oct 5. Zinia is an SEO specialist born and raised in Bangladesh. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. Keratolysis exfoliativa is a condition that is treatable at home. 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. The peeling may be painful in some cases and it is best to get it treated immediately. Mupirocin. Eczema is also a quite painful condition, whereas exfoliative keratolysis doesnt hurt as much. Applying lactic acid hand cream to the skin is one of the more common exfoliative keratolysis treatments. You can reduce your risk of pitted keratolysis by: Pitted keratolysis causes your feet to smell bad. Keratolysis exfoliativa. Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. The cause of development of Keratolysis Exfoliativa is currently unknown. Pits or tiny indentations in the patch of skin that look like small holes. There are different ways to do the treatment. Key Takeaway: Your healthcare provider will diagnose pitted keratolysis after reviewing your complete medical history and performing a physical exam to learn more about your symptoms. MacKee, G. M., & Lewis, G. M. (1931). Generally, skin peeling on fingers is a common symptom in Indians. Topics AZ Copyright and all rights reserved. Instead, eat plenty of anti-inflammatory, essential fatty acid-rich foods like flaxseed oil and wild-caught fish, and other foods that assist with wound healing like vitamin A-rich foods, probiotic-rich foods, and pumpkin seeds and chia seeds. Optimal Therapeutic Approach for this Disease, Unusual Clinical Scenarios to Consider in Patient Management. There is no definitive cure for exfoliative keratolysis. 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. Dis., 37, 223. If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Exfoliative keratolysis. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. The disruption and premature separation of corneocytes are responsible for this disease. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. A dermatologist may notice these signs and up on further investigation recommend the right treatment for the patient. Coconut oil is the best natural moisturizer due to its antimicrobial, antifungal, and antibacterial properties that may speed healing and soothe the skin. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. Dermatologica. Registration is free. Keratolysis exfoliativa is thought to be a very common condition with limited epidemological data available since it rarely presents itself to physicians because of its asymptomatic nature. keratolysis exfoliativa has no known causes in Indians but the condition is found in young adults who are active throughout the day. In turn, the loss of strength causes the skin to exfoliate. The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. Keratolysis exfoliativa LAST UPDATED: Jul 14, 2021 Introduction Refer to the chapter Peeling skin conditions Disclaimer - the author PCDS cannot accept responsibility for any misleading or incorrect statements, and the management of individual patients remains the direct responsibility of the individual doctor. It can be treated with an application of coconut oil and keep your hand moist. The diagnosis of keratolysis exfoliativa is made based on history and clinical examination. 8600 Rockville Pike Around half of the individuals present the condition in summer months, Individuals with sweaty palms have a higher risk, Exposure to saltwater (especially seawater), Air-filled blister formation on the finger or palm of the hand. If you have a condition that causes excessive sweating, like hyperhidrosis, your healthcare provider will offer additional treatment for your sweating to prevent pitted keratolysis from returning in the future. A few cases witness skin peeling on face as well. 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. 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. The condition is also accompanied by a few blisters around the palms of the hand. However, this is not generally itchy in contrast to eczema. 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. Although effective, PUVA treatment can also have some negative side effects such as: As previously mentioned above, there is no definitive cure for this disorder. Use this soak for a few minutes. It is performed to examine the change in skin pigmentation, Skin biopsy, if necessary: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. Would you like email updates of new search results? Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). doi: 10.1111/j.1365-2133.2012.11175.x. That being said, there are certain scenarios that make someone more susceptible to exfoliative keratolysis. In other words, treatment can only deal with the symptoms and signs associated with the condition. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. The soles of the feet may also be affected, These break (exfoliate) to leave behind raw red and tender skin beneath, The lesions are mostly circular/oval in shape with a rim of peeling edges (termed collarettes of scale), The tender red skin may turn dry, crack, and even rarely bleed, following which normal skin appearance is noted, Ends of digits may become hard and numb with thickened skin, which may take time to peel, There may be pain and discomfort depending on the severity, but Itchiness is not observed, Physical examination of the individual and medical history evaluation; a visual examination of the palms may help the healthcare provider diagnose the condition, Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens, Woods lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. Some Observations on Keratolysis Exfoliativa. If you have pitted keratolysis, that odor will still be present after you wash your feet and change your socks and shoes. Pitted keratolysis home treatment. Usually, a skin test can determine the real disease. When keratin breaks down, it impairs the skins strength and elasticity. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. Psoralens Another way to treat the condition is the use of PUVB ( this is a mixture of psoralens and short wave ultraviolet radiation). The example can be best explained by skin asthma. Antibiotics could include: Clindamycin. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. HHS Vulnerability Disclosure, Help Synthetic materials or blended materials in socks can restrict airflow to your feet. A patient does not feel any pain with dry skin. Treating Exfoliative Keratolysis at Home Keratolysis can be treated at home if it is in the nascent stages. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. 2. Another sign of the condition is the appearance of skin tags. Maintaining good personal hygiene and avoiding overexposure to the sun. Youve viewed {{metering-count}} of {{metering-total}} articles this month. Consult Indias top dermatologists online to get suitable skin treatment from the comfort of your home. Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. There is no definitive cure for exfolaitive keratolysis; however, the right treatments can help control symptoms of the condition, such as lactic acid application, ultraviolet radiation treatment, or home remedies like certain essential oils or a coconut oil moisturizer. In het boek wordt de geschiedenis beschreven van de Groningse leerstoel huid-en geslachtziekten van 15 september 1913, toen prof. dr. RA Reddingius bij Koninklijk Besluit werd, 466. When this is the case, it is best to consult your doctor for exfoliative keratolysis treatment. The condition may also be a sign of immune system disorders. The following may be helpful: Protection from irritants Emollient hand creams especially those containing urea, lactic acid, or silicone Acitretin Photochemotherapy. Stevens-Johnson syndrome Another is to be extra careful during outbreaks particularly summer season. Peeling skin can be a menace to treat in India. PDF | An 8 year-old boy, previously healthy, presented on the emergency department, during the summer, with air-filled blisters on the volar aspect of. 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. What is the treatment for keratolysis exfoliativa? There are no associated systemic implications or complications seen in patients with keratolysis exfoliativa. 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. I experience it twice in a year. In some cases, the blisters leave a deeper split in the skin that makes the skin around the fingers hard and numb. Cutaneous T-cell lymphoma It is also wise to eat a healthy anti-inflammatory diet and maintain proper hygiene by cutting your nails on a regular basis and washing your hands and feet. The condition requires no medical test and is detected by a well experienced dermatologist. For example, rubber boots dont offer sufficient airflow. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. Although treatments are available, it is more of palliative. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. The https:// ensures that you are connecting to the Keratolysis exfoliativa treatment. Ultraviolet radiation treatment is also called photochemotherapy (PUVA), and uses ultraviolet rays to treat exfoliative keratolysis. Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. are preferable. Contact dermatitis 37. It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. Treatments are mainly anecdotal and may or may not lead to improvement. Visit your healthcare provider if you experience anxiety related to your phobia, as well as symptoms of pitted keratolysis. Supportive investigations may be undertaken. While Indian home remedies may give fruitful results, some cases are too severe to be treated with these remedies. It is also known as exfoliative keratolysis, dyshidrosis lamellosa sicca, and focal palmar peeling. How can you prevent exfoliative keratolysis? 2. Pompholyx or dyshidrotic eczema (differentiated by its chronic nature, associated pruritus, fissures, and lichenification seen on examination), 2. Worldwide, there is no racial or ethnic preference observed, A positive family history of the condition is observed sometimes, Keratolysis Exfoliativa is more common during the warm summers. ), Close more info about Keratolysis exfoliativa (Lamellar dyshidrosis, Recurrent focal palmar peeling, Recurrent palmar peeling). The following methods are Listed below: Oral for this method, methoxsalen capsules are ingested orally a few hours before the procedure usually 2-3 hours. Keratolysis exfoliativa is distinct from the following conditions. Initially, it doesnt cause any pain or abnormality but gradually some air-filledblisters take over the skin of palms and/or soles. And, a less confirmed theory says that this is somewhat related to the genetic inheritance. Want to know more about exfoliative keratolysis? The blisters burst to leave expanding collarettes of scale and circular or oval, tender, erythematous peeled areas. It can also fortify the epidermal barrier that may prevent future exfoliative keratolysis outbreaks. The formation of numerous skin tags will look like the skin from the hand is peeling. Advertising on our site helps support our mission. Enjoying our content? Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Superficial Cutaneous Infections and Pyodermas. Also, be sure to clean your hands to keep bacteria from getting inside the cracks on your hands and fingers. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. How is keratolysis exfoliativa treated in India? In extreme cases, a doctor may recommend photochemotherapy, which is a combination of Psoralen and Ultraviolet. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. However, there are situations that local approach is utilized. Exfoliative keratolysis is mostly a seasonal disease. Seborrheic dermatitis These hollow spaces are actually the peeked areas. Picture 2: Palm with Exfoliative Keratolysis. British Journal of Dermatology, 167(5), 1076-1084. So extra attention should be drawn to the sweaty parts of the body. If you work in an environment where youre on your feet all day, choose shoes with good ventilation to improve how much air reaches your feet. Exfoliative keratolysis is a skin condition that causes the shedding of the top layer of skin. The peroxide solution should be no more than one part hydrogen peroxide to three parts warm water. Contact Dermatitis:Contact Dermatitis is a condition that causes acute inflammation of the skin. The first sign of the condition in India is generally flaky dry skin around the fingers and skin peeling on palms. Same-day slots available, Low waiting time, At-home care programs & blood tests, Easy access to doctors & dietitians, Our AI will help you assess your health status in 5 minutes, Understand your menstrual cycles & reproductive health better, Our presence identified by the fourth pillar of democracy, Cardiac Risk Assessment Test in Ahmedabad, Allergy Risk Assessment Test in Ahmedabad, Smoker's Risk Assessment Test in Ahmedabad, Bhakare Super Speciality Hospital and Research Institute. Keratolysis exfoliativa codes and concepts. The Licensed Content is the property of and copyrighted by DSM. Any exacerbating factors should be controlled. Most patients deny any itching, but may rarely complain of slight tenderness. Neri, I., Patrizi, A., Gabrielli, L., Virdi, A., Veronesi, G., Corsini, I., & Guglielmo, A. Exfoliative Keratolysis often called keratolysis exfoliativa or focal palmar peeling is an integumentary disease wherein peeling of the skin occurs, it usually affects the distal parts of the fingers and the palmar toes.
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