Epub 2020 Sep 10. There has been no conventional drug proven to be effective to heal exfoliative keratolysis. There may be an association with underlying atopic dermatitis, thus one may also see a combination of asthma and allergies more frequently. Meaning, the signs are symptoms are treated but the underlying cause is not addressed. Unfortunately, what causes exfoliative keratolysis is relatively unknown. No matter how small and trivial an organ is, we should take good care of that. Applying lactic acid hand cream to the skin is one of the more common exfoliative keratolysis treatments. The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. 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 occurs as a result of a bacterial infection that causes smelly and itchy feet. Another is to be extra careful during outbreaks particularly summer season. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you This further hardens and numbs the skin. 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. Acral Peeling Skin Syndrome: A Case Report and Literature Review. If you take an antibiotic and dont see an improvement in your symptoms after a week, talk to your healthcare provider. 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. It is triggered by allergic reactions to substances, food or even air. Updated by Dr Oakley, December 2018. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. The scales are also tender and dry after the skin has peeled off. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. Causes and Treatment. Treat hyperhidrosis if present. Erythromycin. Microscopy reveals cleavage within the outside horny layer of skin, the stratum corneum. Skin peeling on hands is the first thing your general physician may notice before diagnosing you with Keratolysis Exfoliativa. 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: Because of this prevalent condition, the disease is sometimes mistaken for eczema. Exfoliative Keratolysis (Causes,Symptoms,Treatment) Arch Dermatol, 3(202), 11. Jock itch The disease is thought about as seasonal as this usually affects young adults during summer. Also, be sure to clean your hands to keep bacteria from getting inside the cracks on your hands and fingers. Supportive investigations may be undertaken. Youll be sure from this test whether this is due to an allergic problem or other underlying problems which should be determined. Another reason for skin peeling off is excessive Vitamin A in the body. Firstly, exposure to allergens can cause the condition to develop as it can sometimes be a result of an allergic reaction. Any one of these can be applied up to twice daily. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. Lets take a brief look at the possible exfoliative keratolysis causes below: One of the first key exfoliative keratolysis symptoms is air-filled blisters that later peel in a circular pattern, or split and form skin tags. , 1999. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. 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. The peroxide solution should be no more than one part hydrogen peroxide to three parts warm water. Foot skin peeling Chiriac, A., & Solovan, C. (2013). 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. Keratolysis exfoliativa. MeSH 102-6. 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. Interference with other drugs you take, which prevents the medication from working effectively. Exposure to irritants such as washing powder, soap, detergent etc. 2.ICD-10-CM classification code L08.89 5. But, people spend a whole bunch of years without knowing that they are having this disease. 2021 Mar;72(3):215-224. doi: 10.1007/s00105-021-04765-w. Epub 2021 Feb 12. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. 1996. pp. Pitted keratolysis home treatment | HealthTap Online Doctor Policy. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis.). 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. The usage of lotions that are rich in Salicylic Acid and Lactic Acid may prevent infection The first sign of keratolysis exfoliativa is one or more superficial air-filled blisters on the fingers or palms. Wende, G. W. (1919). 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. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. 1. Usually, a skin test can determine the real disease. Superficial Cutaneous Infections and Pyodermas. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. Usually the condition subsides with the use of an ointment as prescribed by the general physician. This problem is more prevalent in younger age groups. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. ), Close more info about Keratolysis exfoliativa (Lamellar dyshidrosis, Recurrent focal palmar peeling, Recurrent palmar peeling). What Is Exfoliative Keratolysis? Fifthly, prolonged exposure to salt water and the bacteria present on sea creatures contributes to skin peeling. 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. 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. Use of topical steroids and cortisone cream and even increased levels of prednisone is also effective in treating the problem. 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. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. Keratolysis exfoliativa or hand eczema? - Mitchell Center for Natural Work or participate in activities where youre outdoors and on your feet for most of the day. #1 Protect from Irritants. Hautarzt. Mupirocin. Another cause of the skin peeling is sweating in your shoes. 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. These ointments and lotions will help reduce the discomfort that causes itching in the skin. Psychiatry 27 years experience. Adverts are the main source of Revenue for DoveMed. (2020). Thirdly, detergents, irritating soaps and sometimes solvents can cultivate exfoliation reactions. Pitted Keratolysis and its treatment in Homoeopathy:case Report Stevens-Johnson syndrome Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. From now on, be watchful towards your health and try these remedies if you ever have exfoliative keratolysis. 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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. Youre most at risk of developing pitted keratolysis if you have sweaty feet and wear shoes with limited airflow. If the skins of the palms and the soles start to peel off, thats the first sign of exfoliative keratolysis. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. Federal government websites often end in .gov or .mil. The skin peeling associated with the condition can affect the palms of the hands, the tips of the fingers, and even the soles of the feet. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. Dermatologie, U. M. C. G., & Jonkman, M. F. (2013). Br J Dermatol. Thus, the skin peels off and sometimes cause pain too. 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. Changing your shoes and socks when they get wet. 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. At times it may affect the tips of the fingers; cracks formed due to the skin condition could go deeper into the skin. Recent histopathologic and molecular studies have linked KE to premature corneo-desmosomal disruption. Exfoliative keratolysis is the medical term of what we have commonly known as skin peeling disease. This is common among fishermen but no significant evidence has been correlated to this incident. Keratolysis - an overview | ScienceDirect Topics Kawasaki disease As now we know that exfoliative keratolysis is not sever or dangerous. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Enjoying our content? The latest research on exfoliative keratolysis suggests that there is a link between corneocytes and exfoliative keratolysis. 100 Jaar Leerstoel Dermatologie Rijksuniversiteit te Groningen. Epub 2012 Oct 5. This can ensure that exfoliative keratolysis will not be exacerbated by secondary infections. This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. Keratolysis exfoliativa Approved by: Krish Tangella MD, MBA, FCAP. Psoriasis: Psoriasis is a chronic condition that affects the skin. After you start taking an antibiotic, it will begin working within your body to rid it of bacteria. It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. The condition causes discomfort in the skin that leads to persistent itching. The condition can be treated at home by taking necessary precautions: Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. - Drug Monographs Dermatology Made Easybook. 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. Keratolysis Exfoliativa Ozark Dermatology What is the treatment for keratolysis exfoliativa? And, a less confirmed theory says that this is somewhat related to the genetic inheritance. Keratolysis exfoliativa - PubMed List of photos, images and pictures ofExfoliative Keratolysis: The health information provided on this web site is for educational purposes only and is not to be used as a substitute for medical advice, diagnosis or treatment. It is always important to discuss the effect of risk factors with your healthcare provider. It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. Acne pitted scar treatment. Eating a healthy diet can be a good source of natural components which may heal the skin. Another medical approach to treat the disorder is photochemotherapy (PUVA). 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. Common symptoms that accompany skin peeling are rashes, itching, dryness and other irritants. 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. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. When it comes to skin conditions, exfoliative keratolysis is, at times, harmless but also sometimes quite painful. 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. Photochemotherapy can be applied if the disease goes beyond control. This process also involves the application of psoralensplant compounds that include trisoralen, 5-methoxypsoralen, and methoxsalen. 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. There can be multiple layers of peeling skin (lamellae). pii: 13030/qt6mv338nx. Generally, the condition does not require any lab tests to be performed. Exfoliative Keratolysis - Treatment, Pictures, Causes, Symptoms This is likely a common condition that rarely presents to physicians because it is largely asymptomatic. Eating different kinds of nuts is good for skin. Your body isnt able to stop future infections (. Once the scales and the redness heals, the condition hibernates. Fourthly, although unproven, medical researchers believe that extremely hot climate during summer increases episodes of perspiration. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. Australas J Dermatol. Br J Dermatol. Advertising on our site helps support our mission. Although treatments are available, it is more of palliative. Dont miss out on todays top content on Dermatology Advisor. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. In some cases, the blisters leave a deeper split in the skin that makes the skin around the fingers hard and numb. No worries! This should include protecting the hands from any physical or chemical irritants and encouraging the patient to wear gloves when possible. However, after a few months or sometimes even after a few weeks the condition recurs again. In addition to the lactic acid content, hand creams used to treat the condition oftentimes also contain urea and silicone as well.. Drysol, applied to dry skin at bedtime, or oral glycopyrrolate, starting at a dosage of 1mg by mouth 2-3 times daily, may be helpful. Keratolysis Exfoliativa isnt a condition that is of grave concern in India. That being said, there are certain scenarios that make someone more susceptible to exfoliative keratolysis. Keratolysis Exfoliativa in India may arise due to sunburns or infections that directly cause damage to the skin. Pompholyx or dyshidrotic eczema (differentiated by its chronic nature, associated pruritus, fissures, and lichenification seen on examination), 2. Learn how we can help. Please remove adblock to help us create the best medical content found on the Internet. On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. Exfoliative Keratolysis - DermaTalk If you still have an odor coming from your feet after you wash your feet at the end of the day, its a sign that you have pitted keratolysis. 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. A patient does not feel any pain with dry skin. How can you prevent exfoliative keratolysis? Consult Indias top dermatologists online to get suitable skin treatment from the comfort of your home. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC.