If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Pediatr Dermatol. No worries! The most common types of bacteria that can cause infection include: These types of bacteria grow and thrive in warm and moist conditions, which is why it commonly affects your feet if youre wearing tight socks and shoes with minimal airflow. The differential diagnosis of keratolysis exfoliativa includes the following entities: 1. Australas J Dermatol. Picture 2: Palm with Exfoliative Keratolysis. The peroxide solution should be no more than one part hydrogen peroxide to three parts warm water. Often misdiagnosed as psoriasis, eczema, or chronic contact dermatitis, exfoliative keratolysis is more common in children and young adults, in those with sweaty hands, and during the summer months. Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. Another sign of the condition is the appearance of skin tags. The first indication of Keratolysis Exfoliativa in Indians is peeling of the skin. A diagnosis of Keratolysis Exfoliativa may involve the following exams and procedures: A differential diagnosis may be necessary to eliminate other conditions that present similar signs and symptoms such as: Many clinical conditions may have similar signs and symptoms. (1895). It usually comes about in the summer triggered by humid conditions. The application of cucumber juice, aloe vera gel, witch hazel, or pineapple juice can also help improve exfoliative keratolysis. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. Lifelong desquamation of the hands and feet. doi: 10.1111/jdv.16881. The infection is characterised by craterlike pits on the surface of the feet and toes. The condition often causes air-filled blisters that eventually peel, and leaves the skin looking reddish, tender, dry, and cracked. However, this is not generally itchy in contrast to eczema. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. Peeling skin can be a menace to treat in India. Keratolysis exfoliativa (KE) is a palmoplantar eruption of air-filled bullae on an erythematous base, which results in lamellar peeling with hallmark superficial collarettes of scale. Washing your feet and hands with soap and water when you remove your shoes and socks. If you wish to read unlimited content, please log in or register below. Keratolysis exfoliativa is also characterized by a lack of inflammation. 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. Dermatology Made Easybook. 10 Ways to Control Blood Sugar without Medication, What Is Exfoliative Keratolysis? 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. The peeling off the skin in keratolysis exfoliativa worsens when the peeling skin will be associated with harsh chemical irritants. The possible complications due to Keratolysis Exfoliativa include: Mild and localized cases of Keratolysis Exfoliativa may not require any medical intervention since the exfoliated areas are generally replaced by normal skin. While eczema and exfoliative keratolysis look very similar, the difference is that exfoliative keratolysis will peel and shed, whereas eczema also produces itchy skin. The .gov means its official. From now on, be watchful towards your health and try these remedies if you ever have exfoliative keratolysis. In such cases, the cracked skin on fingertips takes longer to peel off and heal. Using quality lotions and moisturizers that can prevent infection. Because of this, the skins ability to heal is compromised. The epidermis is made up of several layers of keratin, a type of protein which helps the skin to remain flexible, strong and waterproof. This approach has been present since 1976 and uses ultraviolet rays to treat the condition. Lee YC, Rycroft RJ, White IR, McFadden JP. However, the condition is recurrent sometime after the skin returns to normal. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. Young adult people are mostly victims of this disease. Summer is the period when it attacks. Topical corticosteroids-usually not of much benefit. Exfoliative keratolysis will hibernate beneath the skin once the redness and scales have healed. Neri I, Patrizi A, Gabrielli L, Virdi A, Veronesi G, Corsini I, Lazzarotto T, Lanari M, Misciali C, Guglielmo A. J Eur Acad Dermatol Venereol. Dermatologists recommend that one maintains good personal hygiene and avoids spending too much time in the sun. Advertising on our site helps support our mission. To the best of our knowledge, this report is the first that documents the efficacy of the use of systemic acitretin in KE. And, a less confirmed theory says that this is somewhat related to the genetic inheritance. What causes keratolysis exfoliativa in Indians? No, pitted keratolysis isnt contagious and cant spread from person to person. It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. 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. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. 1. It is best to stay away from such irritants. Your skin pits or forms small indentations because the bacteria (protease enzyme) destroys layers of your skin cells that continuously shed dead skin cells (stratum corneum or the horny layer). In most cases the condition subsides on its own. 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. Peeling skin syndrome (PSS), or keratolysis exfoliativa congenita, is an unusual autosomal recessive disease characterized by life-long, spontaneous superficial peeling of the skin that may be persistent or periodic.104-106 The Nikolsky sign tends to be positive. 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. Bookshelf Exfoliative keratolysis A CASE OF CONGENITAL EXFOLIATION OF THE SKIN.(KERATOLYSIS EXFOLIATIVA?). 102-6. As there is no known remedy for this disease, one can try the precautions and home remedies to get rid of this problem. However, they are not generally itchy. However, the cause of the constant skin shedding in exfoliative keratolysis remains a mystery. Provides a good description of the clinical features of recurrent focal palmar peeling and how to differentiate it from other conditions. Want to know more about exfoliative keratolysis? Wear shoes and/or socks that are too tight (occlusive) and have limited airflow. Dry skin flakes blister and slough off, leaving behind . Persistent itching. Wende, G. W. (1919). This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. White patch of skin or a patch thats lighter than your natural skin tone. After a long day on your feet, you might notice a foul odor coming from your feet, shoes and socks. There is no definitive cure for exfoliative keratolysis. 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 condition rarely goes away on its own without treatment from your healthcare provider. Red spots arise on the skin that turn into blisters and finally into ulcers. Pompholyx or dyshidrotic eczema (differentiated by its chronic nature, associated pruritus, fissures, and lichenification seen on examination), 2. Copyright and all rights reserved. Pitted keratolysis is a bacterial infection that affects the skin on your feet. 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. So, how long does exfoliative keratolysis last? The best material to improve airflow to your feet through your socks is cotton. 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. In most cases, it starts with the advent of summer and ends when simmer departs. Lee, YC, Rycroft, RJ, White, IR, McFadden, JP. References Hausauer AK, Cohen DE. Any one of these can be applied up to twice daily. In other words, treatment can only deal with the symptoms and signs associated with the condition. If possible, use drugs which can reduce sweating excessively. For this procedure, the patient is contained in a cabinet consisting 24 UVA fluorescent bulbs. When the weather is so hot, it can cause skin peeling that may eventually lead to lamellar dyshidrosis and to prevent that it is strongly advised to apply lotion in the sensitive prone areas such as the fingers and the feet. 8600 Rockville Pike The cause of development of Keratolysis Exfoliativa is currently unknown. arrow-right-small-blue b. Any one of these can be applied up to twice daily. These ointments and lotions will help reduce the discomfort that causes itching in the skin. The condition requires no medical test and is detected by a well experienced dermatologist. Your healthcare provider will offer treatment to make the bacteria that cause pits in your feet go away, which will ease your fear. Seborrheic dermatitis Symptoms of pitted keratolysis affect your feet, specifically the web spaces between your toes and the ball, heel and soles of your foot. Its becausepeople dont consult a doctor or go to the clinic with this type of minor sickness. The skin may swell and become red due to inflammation. Exfoliative keratolysis is such a problem that gives a bad feeling to the beholders of the affected hands. Some risk factors are more important than others. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. A beautiful hand with nice and thin fingers can add personality to ones style. Still, it will reappear weeks and even months later. Inquire about any history of atopic dermatitis. This oral Soriatane (Acitretin) has been reported as the only one effective drug that has shown improvementwhen used to treat this disease. 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. Scarlet fever For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. The following may be helpful: Protection from irritants Emollient hand creams especially those containing urea, lactic acid, or silicone Acitretin Photochemotherapy. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. In addition to amino acids and lactic acids, urea is a natural moisturizing factor (NMF) that is commonly found in the outermost layer of . It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. Enjoying our content? Atopic dermatitis (eczema) 10 Most Common Nail Diseases And Disorders. Oakley, A., Exfoliative keratolysis, DermNet New Zealand; How Long Does Exfoliative Keratolysis Last? This problem is more prevalent in younger age groups. Keratolysis exfoliativa is a condition that is treatable at home. The condition is diagnosed when your dermatologist notices peeling skin on palms of hands and cracked skin on fingertips. They might ask questions about the type of shoes and socks you wear, especially around the time you noticed your symptoms. It is important to note that prolonged healing occurs when the blisters centers on the base of the fingers due to consistent shredding and peeling of the skin. Contact dermatitis Palmoplantar pustulosis or palmoplantar psoriasis (distinguished by occasional involvement of typical psoriasis on other locations of the body, observation of pustules on exam, and the chronic nature of this disease), 3. A diet rich in Vitamin B may aid in avoiding the condition in India. One of the more common forms of treatment for exfoliative keratolysis is the application of a lactic acid-infused hand cream. arrow-right-small-blue Keratolysis exfoliativa is distinct from the following conditions. These lesions burst later to reveal a new layer of skin. 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. Acne pitted scar treatment. Skin shedding (keratolysis exfoliativa congenita): report of a case. Keratolysis exfoliativa. How to treat keratolysis exfoliativa? Cutaneous T-cell lymphoma And because of that, the condition is recurrent as the root problem of the disorder isnt directly addressed. So extra attention should be drawn to the sweaty parts of the body. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. When the blisters present around the palms burst, they cause circular marks leaving cracked skin on fingertips. Keratolysis exfoliativa and the mosaic fungus. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. Chang YY, van der Velden J, van der Wier G, et al. On physical examination there are symmetrical, irregular circumscribed annular or circinate patches of superficial scaling on the palms and, less often, the soles (Figure 1). American Osteopathic College of Dermatology. 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. 1. Differential diagnosis. The scales are also tender and dry after the skin has peeled off. Exfoliative keratolysis treatment. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.aocd.org/page/PittedKeratolysis), (https://dermnetnz.org/topics/pitted-keratolysis), (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?bookid=2585§ionid=211767935). It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. The etiology of keratolysis exfoliativa is unknown, but the condition appears to be worsened by heat or sweating. As use of PUVA can be costly sometimes, some dermatologists recommend exposure to sunlight as it is safer compared to methoxsalen. If you are struggling with exfoliative keratolysis or another skin condition, visit a dermatologist or a natural health practitioner familiar with skin problems to learn more about the best treatment approaches available for you. 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. Consult Indias top dermatologists online to get suitable skin treatment from the comfort of your home.
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