Causes and Treatment. Clinical evaluation of atopic hand-foot dermatitis. Keratolysis exfoliativa generally presents in young active adults. When your hands are covered in ruptured blisters, the first thing you want to know is the cause of this irritating skin condition. Contact Dermatitis:Contact Dermatitis is a condition that causes acute inflammation of the skin. Exfoliative keratolysis is mostly a seasonal disease. If the patients condition worsens or becomes symptomatic, then the diagnosis should be questioned and it may be important to review the differential diagnosis and re-evaluate the patient to rule out other etiologies. National Library of Medicine The condition is diagnosed when your dermatologist notices peeling skin on palms of hands and cracked skin on fingertips. Exfoliative keratolysis treatment is available; however, the treatment is more of a palliative solution. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. 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. This site needs JavaScript to work properly. Keratolysis exfoliativa is also characterized by a lack of inflammation. The latest research on exfoliative keratolysis suggests that there is a link between corneocytes and exfoliative keratolysis. On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. Your healthcare provider will offer treatment to make the bacteria that cause pits in your feet go away, which will ease your fear. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis, Tinea manuum (fungal infection of the hand), Avoiding known irritants, chemicals, and friction, where possible, Application of topical agents such as lactic acid or silicone cream. 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. Exfoliative keratolysis mainly attacks and is common during the summer months. The .gov means its official. Often times, these creams also contain silicone and urea. Keratolysis exfoliativa. The latter isnt seasonal as well and happens all year round and is also common for people who have skin asthma. The condition is recurring causing the skin to harden and become rough. 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. This process also involves the application of psoralensplant compounds that include trisoralen, 5-methoxypsoralen, and methoxsalen. And because of that, the condition is recurrent as the root problem of the disorder isnt directly addressed. Stevens-Johnson syndrome For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. 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. Youll be sure from this test whether this is due to an allergic problem or other underlying problems which should be determined. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. Acute exfoliative keratolysis: It is a primary stage of skin peeling of hands. 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. Interference with other drugs you take, which prevents the medication from working effectively. pii: 13030/qt6mv338nx. , 1999. Medication side effects DermNet provides Google Translate, a free machine translation service. 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Some individuals have a family history of the disorder. Keratolysis exfoliativa is diagnosed clinically. 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. However, the condition is recurrent sometime after the skin returns to normal. PubMed. The difference between the two is that the former only peels and shreds while the latter has an accompanying itchy feeling on the skin. Policy. Treatment for exfoliative keratolysis typically involves the use of antibiotics or antifungal medications. The condition arises to allergens or irritants that come in contact with the patient. Prevent the bacteria from returning by changing your shoes and socks when they get wet and wearing shoes with good airflow. Changing your shoes and socks when they get wet. This oral Soriatane (Acitretin) has been reported as the only one effective drug that has shown improvementwhen used to treat this disease. Keratolysis exfoliativa treatment. Lee YC, Rycroft RJ, White IR, McFadden JP. Once the scales and the redness heals, the condition hibernates. Tenia pedis. The symptoms are aggravated by exposure to irritants including water, soap, detergents and solvents. Most patients deny any itching, but may rarely complain of slight tenderness. The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. Keratolysis exfoliativa is a condition that is treatable at home. The most affected areas of the body are usually the fingers and the soles. Although there has not been any studies to confirm it, it is very rampant around that time of the year. The condition may also be a sign of immune system disorders. fix microsoft teams not displaying images and gifs. British Journal of Dermatology,7(2), 37-39. One common mistake while doing the diagnosis of this disease is, some doctor confuses it with the following diseases. Just another site Once the skin is completely peeled off has healed, normal skin reforms, but Keratolysis Exfoliativa usually recurs in the following weeks. The condition causes discomfort in the skin that leads to persistent itching. Careers. vol. 18. A bacterial infection causes pitted keratolysis. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. 5.3k views Answered >2 years ago. Cutaneous T-cell lymphoma Keratolysis exfoliativa also known as focal palmar peeling is a common disorder that is rarely reported and often overlooked as hand eczema. Tests arent always necessary, as pitted keratolysis has a distinct appearance on your skin, but your healthcare provider might offer tests to rule out similar conditions, which could include: Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. British Journal of Dermatology, 167(5), 1076-1084. Can my diet help in avoiding peeling skin? (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. - Drug Monographs Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. What is the treatment for keratolysis exfoliativa? While eczema and exfoliative keratolysis look very similar, the difference is that exfoliative keratolysis will peel and shed, whereas eczema also produces itchy skin. No advanced study has been carried out about what might be the cause of exfoliative keratolysis. Urea is a natural moisturizing factor found in the outer epidermis. Chang, Y. Y., Van der Velden, J., Van der Wier, G., Kramer, D., Diercks, G. F. H., van Geel, M., & Jonkman, M. F. (2012). PMC Additionally, numbing sensations of the skin are marked accompanied by hardening of the skin as well. Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. Picture 1: Fingers affected withExfoliative Keratolysis. It is triggered by allergic reactions to substances, food or even air. How often should I apply topical antibiotics to my skin? These hollow spaces are actually the peeked areas. Fans and air conditioning equipments are readily available to neutralize the heating process as lengthened periods of treatment tend to get very hot sometimes. The number of cases for the condition of skin peeling off the body rises during the summer months and is usually seen in patients who have sweaty palms. Ringworms Choosing socks and shoes that fit your feet and arent too tight. How do I avoid peeling skin? In others, the following treatment measures may be considered: Regular follow up visits with the healthcare provider is important and recommended. Chang YY, van der Velden J, van der Wier G, Kramer D, Diercks GF, van Geel M, Coenraads PJ, Zeeuwen PL, Jonkman MF. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. Australas J Dermatol. 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. Acral skin eruption observed during SARSCoV2 pandemic: possible keratolysis exfoliativa with red palms and soles. Chang YY, van der Velden J, van der Wier G, et al. The infection caused by wearing tight or restricting footwear and due to excessive sweating. First, lets take a look at how the outer layer of the skin, the epidermis, is involved in the development of exfoliative keratolysis. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. The condition is typically caused by an overgrowth of bacteria on the skin or by a reaction to a medication. Keratolysis exfoliativa MedGen UID: 575367 Concept ID: C0343064 Congenital Abnormality; Disease or Syndrome Recent clinical studies Etiology Clinical evaluation of atopic hand-foot dermatitis. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. vol. 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. 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. 2020 Dec;34(12):e783-e785. This is common among fishermen but no significant evidence has been correlated to this incident. In some cases, the blisters leave a deeper split in the skin that makes the skin around the fingers hard and numb. Also, not having a risk factor does not mean that an individual will not get the condition. One of the more common forms of treatment for exfoliative keratolysis is the application of a lactic acid-infused hand cream. The epidermis is made up of several layers of keratin, a type of protein which helps the skin to remain flexible, strong and waterproof. doi: 10.1111/j.1365-2133.2012.11175.x. When the condition affects the lower body, it causes foot skin peeling. Another sign of the condition is the appearance of skin tags. Washing your feet and hands with soap and water when you remove your shoes and socks. Any one of these can be applied up to twice daily. 143-4. Eating a healthy diet can be a good source of natural components which may heal the skin. Pitted keratolysis and athletes foot are both conditions that affect your feet. Some believe that it is more frequently associated with underlying atopic dermatitis, while others report an association with primary hyperhidrosis. Epub 2012 Oct 5. This can be done by applying the medical ointments like OTC moisturizer on the affected area and then avoiding any water or moisture contact with that affected region. Exfoliative Keratolysis Treatment Picture 2: Palm with Exfoliative Keratolysis The best way to treat the condition is to avoid the causative factors. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. Our body demands special care from us. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. The following may be helpful: Protect the affected area from irritants Please remove adblock to help us create the best medical content found on the Internet. Topical psoralen emollients such as gels or lotions are typically applied to the affected areas for 10 minutes before skin is exposed to UVA. Exfoliative keratolysis at the fingers base will often take longer to heal due to frequent skin peeling. The scales are also tender and dry after the skin has peeled off. Contact dermatitis In cases like this, it would be recommended to consult a physician for extensive treatment and care but their management can only be limited too as it is best to treat the condition on its early episodes. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. 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. A few cases witness skin peeling on face as well. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. 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. Psychiatry 27 years experience. Physical and mental stress can affect the skin sometimes. 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. If you have any concerns with your skin or its treatment, see a dermatologist for advice. How long does Exfoliative Keratolysis last? Fox, H. (1921). Wearing shoes with good airflow; avoid rubber boots. I experience it twice in a year. The condition isnt constricted to the skin on the hands and face, one may even notice skin peeling on the face. Fifthly, prolonged exposure to salt water and the bacteria present on sea creatures contributes to skin peeling. Keratolysis Exfoliativa is usually seen in young Indian adults who are active throughout the day. The disease is thought about as seasonal as this usually affects young adults during summer. Work or participate in activities where youre outdoors and on your feet for most of the day. 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. It usually comes about in the summer triggered by humid conditions. Treating Exfoliative Keratolysis at Home Keratolysis can be treated at home if it is in the nascent stages. Skin shedding (keratolysis exfoliativa congenita): report of a case. Copyright and all rights reserved. Others may associate it with hyperhidrosis. Sometimes, it lasts for only a few weeks and sometimes a number of months pass by without any relief. 3. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. Take Care Of Your Nails At Home: Easy Pro Guide. Exfoliative keratolysis is a common skin condition characterized by recurrent focal palmar peeling that often affects the palms of the hands, the focal surface of the fingers and the soles of the feet.Exfoliative keratolysis is also known by other names such as keratolysis exfoliativa, recurrent palmar peeling and lamellar dyshidrosis. arrow-right-small-blue 2. J. Cutan. Disclaimer. There are also forms of exfoliative keratolysis natural treatment that may help relieve the condition. To the best of our knowledge, this report is the first that documents the efficacy of the use of systemic acitretin in KE. Firstly, exposure to allergens can cause the condition to develop as it can sometimes be a result of an allergic reaction. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. Please enable it to take advantage of the complete set of features! (2020). It tends to show up on thumbs, hands or the soles of the feet. But this method is rarely recommended as psoralen activation works best with UVA. 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. These ointments and lotions will help reduce the discomfort that causes itching in the skin. This further hardens and numbs the skin. Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Keratolysis exfoliativa and the mosaic fungus. While there are no known causes for Keratolysis Exfoliativa, the following are probably what caused skin peeling: A few other conditions that also cause peeling of the skin are: It can also fortify the epidermal barrier that may prevent future exfoliative keratolysis outbreaks.
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