Inquire about any history of atopic dermatitis. 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. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks, Hausauer AK, Cohen DE. So extra attention should be drawn to the sweaty parts of the body. The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. How can you prevent exfoliative keratolysis? The cause of keratolysis exfoliativa is unknown. These ointments and lotions will help reduce the discomfort that causes itching in the skin. 5.3k views Answered >2 years ago. When keratin breaks down, it impairs the skins strength and elasticity. There are different ways to do the treatment. 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. Sometimes, allergic reactions may cause peeling of the skin. But, people spend a whole bunch of years without knowing that they are having this disease. are preferable. What Are These Tiny Red Spots on My Skin (Petechiae)? (2020). As a result, the skin begins to shred. The condition can be treated at home by taking necessary precautions: Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. 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. Treat hyperhidrosis if present. Exfoliative keratolysis. How can I prevent this condition from returning in the future? National Library of Medicine Dermatologie, U. M. C. G., & Jonkman, M. F. (2013). Exfoliative keratolysis will hibernate beneath the skin once the redness and scales have healed. 2. The condition requires no medical test and is detected by a well experienced dermatologist. Dry skin Journal of the European Academy of Dermatology and Venereology. What Is Exfoliative Keratolysis? DermNet does not provide an online consultation service.If you have any concerns with your skin or its treatment, see a dermatologist for advice. When the condition affects the lower body, it causes foot skin peeling. Hautarzt. Lets take a deeper look at some of the other exfoliative keratolysis treatments available. 1.clinical diagnosis- Pitted keratolysis. HHS Vulnerability Disclosure, Help Keratolysis Exfoliativa is the condition of peeling of the skin around the palms and soles. 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. Youll be sure from this test whether this is due to an allergic problem or other underlying problems which should be determined. Symptoms of pitted keratolysis affect your feet, specifically the web spaces between your toes and the ball, heel and soles of your foot. Keratolysis exfoliativa is a condition that is treatable at home. The best material to improve airflow to your feet through your socks is cotton. The https:// ensures that you are connecting to the Atopic dermatitis (eczema) Wende, G. W. (1919). This situation is linked to destruction of keratin layers in the epidermis resulting to unwarranted skin exfoliation. Applying lactic acid hand cream to the skin is one of the more common exfoliative keratolysis treatments. Clipboard, Search History, and several other advanced features are temporarily unavailable. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. 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. British Journal of Dermatology, 167(5), 1076-1084. Pemphigus The first indication of Keratolysis Exfoliativa in Indians is peeling of the skin. Keratolysis Exfoliativa in India may arise due to sunburns or infections that directly cause damage to the skin. Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Tenia pedis. Topical psoralen emollients such as gels or lotions are typically applied to the affected areas for 10 minutes before skin is exposed to UVA. However, they are not generally itchy. How long does Exfoliative Keratolysis last? Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. A person suffering from exfoliative keratolysis could experience sores and peeling skin; skin peeling occurs gradually over time resulting in formation of very dry and itchy skin. Try to prevent sweating by using topical agents. Careers. 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. Antibiotics effectively treat the condition to make the odor go away. Most patients deny any itching, but may rarely complain of slight tenderness. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. The exact cause of exfoliative keratolysis is not known. Then, the blisters burstand it leaves a hollow and blank space underneath the skin. When the whole hand and foot peel off it gone for next six months. Thus, the skin peels off and sometimes cause pain too. Dont miss out on todays top content on Dermatology Advisor. Sign Up for the Latest Health News and Tips, Home Skin Care What Is Exfoliative Keratolysis? Still, it will reappear weeks and even months later. 2015 Dec 16;21(12). In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. 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 pitted keratolysis focuses on removing the bacterial infection from your body. Dis., 37, 223. (A study that characterizes the clinical characteristics of 108 atopic dermatitis patients with hand-foot dermatitis. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. The best way to treat the condition is to avoid the causative factors. Exfoliative keratolysis can also be called "focal palmar peeling" or "keratolysis exfoliativa." In generic terms it's known as the "skin peeling disease." The odor caused by the infection occurs because the bacteria release a stinky sulfur compound. Split Fingernails (Onychoschizia): Symptoms, Causes & Remedies, Beaus Lines 101: Causes, Treatments & Whos At Risk, Black Spot on Toenails: Symptoms, Causes & Treatments, 11 Practical Ways to Stop Biting Your Nails, Subungual Melanoma Addressing All Your Concerns, White Superficial Onychomycosis: Types, Symptoms, Causes & Treatment, 22 Vacation Nail Designs for Your Next Getaway, Black & Gold Nail Designs: 51 Fabulous Ways To Rockem, 18 Best Tropical Nail Designs Try These Trends, 33 Stylish Patriotic Nail Designs to Celebrate, 21 Trendiest Red and Silver Nail Designs for 2023, 35 Trendy Ways to Wear Navy Blue Nails in 2023, How To Use Cuticle Remover Tool: Step-by-Step Guide. For example, rubber boots dont offer sufficient airflow. Urea is a natural moisturizing factor found in the outer epidermis. The hand cream can prevent the excessive scales and dryness that lead to peeling from forming. Keratolysis exfoliativa and the mosaic fungus. Presently, it is not known to occur from genetic factors, even though a family history is occasionally noted. Another reason for skin peeling off is excessive Vitamin A in the body. In case it doesn't, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions in India. Speak to a dietician on MFine to know how changes in your food can help you address your situation today! Another sign of the condition is the appearance of skin tags. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Picture 2: Palm with Exfoliative Keratolysis. Any exacerbating factors should be controlled. Keratolysis exfoliativa is more common during the summer months in about 50% of affected individuals. Red spots arise on the skin that turn into blisters and finally into ulcers. A doctor can diagnose any disease by studying the history and symptoms of a patient keeping in mind that there might be some other risk factors too. Want to talk to an expert regarding your diet? 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. The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. Dont apply bleach or apple cider vinegar to your skin to make the odor from pitted keratolysis go away. J. Cutan. The condition is typically caused by an overgrowth of bacteria on the skin or by a reaction to a medication. Wear shoes and/or socks that are too tight (occlusive) and have limited airflow. Natural hand soak: Soak your hands in an oatmeal bath for about 15 to 20 minutes daily to help improve exfoliative keratolysis symptoms like dry skin. Oatmeal bath this gains improvement when practiced daily, Taking daily Vitamin supplements as weakened immune system predisposes someone to the disorder, Mint application on affected area; mint contains healing properties and has moisturizing effects as well, Pineapple juice applied over to damaged skin, Eating protein rich foods such as meat, liver, carrots as they aid in cell repair, Drinking apple cider vinegar pills and olive extracts, Frequent cutting of fingernails and toenails to maintain hygiene, Avoidance of eating egg as it is a known allergen as well as crustaceans or seafoods. If you have pitted keratolysis, that odor will still be present after you wash your feet and change your socks and shoes. Tinea (typically seen with associated changes in the fingernails or toenails, occasionally pruritic, does not wax and wane, positive fungal scraping or culture, and responds to treatment with antifungal agents). It most commonly occurs in young adults and is typically worse in the summer months or with warm weather. The condition arises to allergens or irritants that come in contact with the patient. ), (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), (A study that characterizes the clinical characteristics of 108 atopic dermatitis patients with hand-foot dermatitis. Changing your shoes and socks when they get wet. This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. A few cases witness skin peeling on face as well. It is possible that sweaty palms are to blame, as hyperhidrosis in the palms is more common. Antibiotics could include: Clindamycin. PMC 4. In addition, exfoliative keratolysis treatment will include topical steroids and cortisone creams; topical emollients that contain lactic acid, silicone, and urea; photochemotherapy; and a number of home remedies and natural treatments. Photograph of keratolysis exfoliativa on the hand. Youre most at risk of developing pitted keratolysis if you have sweaty feet and wear shoes with limited airflow. Initially, it doesnt cause any pain or abnormality but gradually some air-filledblisters take over the skin of palms and/or soles. Pompholyx or dyshidrotic eczema (differentiated by its chronic nature, associated pruritus, fissures, and lichenification seen on examination), 2. Dermatology Made Easybook. SANGSTER, A. Br J Dermatol. Skin shedding (keratolysis exfoliativa congenita): report of a case. It is its own thing. Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. - Drug Monographs Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. The treatment process in India does not require any surgery or frequent doctor visits. Keratolysis exfoliativa. Visit your healthcare provider if your symptoms dont improve after taking antibiotics for one week. There are some texts that mention the use of photochemotherapy with hand/foot psoralen and ultraviolet A light (PUVA) for severe cases. Eczema can be painful too unlike the aforementioned which doesnt have accompanying pain. The first sign of the condition in India is generally flaky dry skin around the fingers and skin peeling on palms. Pitted keratolysis is a bacterial skin infection that causes a foul odor and itchiness. Dermatologists recommend that one maintains good personal hygiene and avoids spending too much time in the sun. Recurrent focal palmar peeling. 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. Fusidic acid. Disclaimer. Clinical evaluation of atopic hand-foot dermatitis. This further hardens and numbs the skin. From now on, be watchful towards your health and try these remedies if you ever have exfoliative keratolysis. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. They are also advised to take on protective goggles to shield the eyes from being exposed to the harmful radiation. Secondly, genetic predisposition may also expose someone to this condition as certain environmental or external factors can trigger the disease to develop. The condition rarely goes away on its own without treatment from your healthcare provider. In such situations, one may consult a doctor and use medication that is prescribed by them. 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. 24/7 visits - just $44! Once the scales and the redness heals, the condition hibernates. 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. That being said, there are certain scenarios that make someone more susceptible to exfoliative keratolysis. Exfoliative keratolysis at the fingers base will often take longer to heal due to frequent skin peeling. vol. The condition causes discomfort in the skin that leads to persistent itching. How do I avoid peeling skin? Keratolysis exfoliativa. It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. DermNet does not provide an online consultation service. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. Dr. Heidi Fowler answered. No genetic abnormality has been detected to date (2018). 102-6. Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. When it comes to skin conditions, exfoliative keratolysis is, at times, harmless but also sometimes quite painful. The peeling skin on hands and feet usually occurs when the temperature is hotter than normal. As they do so, new skin is born out of the process. 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. Eczema is also a quite painful condition, whereas exfoliative keratolysis doesnt hurt as much. Using quality lotions and moisturizers that can prevent infection. Recent histopathologic and molecular studies have linked KE to premature corneo-desmosomal disruption. In some cases, the blisters leave a deeper split in the skin that makes the skin around the fingers hard and numb. A beautiful hand with nice and thin fingers can add personality to ones style. The formation of numerous skin tags will look like the skin from the hand is peeling. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. Pediatr Dermatol. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. 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). Keratolysis exfoliativa is a condition that is treatable at home. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. As you already know there are no fixed reasons behind exfoliative keratolysis. She spends her free time reading books and watching TV series. 1983. pp. The application of cucumber juice, aloe vera gel, witch hazel, or pineapple juice can also help improve exfoliative keratolysis. Some risk factors are more important than others. The hands and feet should also always be well cleaned. (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?bookid=2570§ionid=210430286), Visitation, mask requirements and COVID-19 information. official website and that any information you provide is encrypted Patients should be aware that this treatment is purely anecdotal and data to support its benefit is lacking. Lee YC, Rycroft RJ, White IR, McFadden JP. American Osteopathic College of Dermatology. It has been regarded as a subtype of dyshidrotic eczema, a fungal infection or a dermatophytid reaction. Home remedies or preventions are more effective with respect to this problem. 8600 Rockville Pike Just another site Copyright 2017, 2013 Decision Support in Medicine, LLC. Superficial Cutaneous Infections and Pyodermas. Recurrent focal palmar peeling. There can be multiple layers of peeling skin (lamellae). 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. 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. Having said all that, we want to enumerate some risk factors that intrigue this disease. So, you can say it lasts during the summer. A patient does not feel any pain with dry skin. Epub 2012 Oct 5. Normal skin gradually develops as the blisters split and new skin forms. Also, not having a risk factor does not mean that an individual will not get the condition. An official website of the United States government. Psoriasis: Psoriasis is a chronic condition that affects the skin. Antibiotics treat the infection to remove the bacteria from your body. The condition causes a foul odor and itchiness. It may not be possible to prevent Keratolysis Exfoliativa in many cases. Fourthly, although unproven, medical researchers believe that extremely hot climate during summer increases episodes of perspiration. Athletes foot I need to mention after peeling it gives me very shiny,healthy and soft hands. Photochemotherapy can be applied if the disease goes beyond control. Protection from irritants, wear gloves, good moisturization. Eating different kinds of nuts is good for skin. For this procedure, the patient is contained in a cabinet consisting 24 UVA fluorescent bulbs. The differential diagnosis of keratolysis exfoliativa includes the following entities: 1. There may be an association with underlying atopic dermatitis, thus one may also see a combination of asthma and allergies more frequently. The majority of patients, with only mild disease, can be treated with topical moisturizers or keratolytics and followed up as needed. 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. 18. It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. Keratolysis Exfoliativa is a common skin condition in India that can be noticed around the palms and soles. 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). (1895). Speak to a doctor on MFine to know more about its causes and risk factors today! Key Takeaway: First, lets take a look at how the outer layer of the skin, the epidermis, is involved in the development of exfoliative keratolysis. Fifthly, prolonged exposure to salt water and the bacteria present on sea creatures contributes to skin peeling. Do the antibiotics interfere with any of the medications I currently take? 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. 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. Lane, J. E. (1919). Exfoliative keratolysis is such a problem that gives a bad feeling to the beholders of the affected hands. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. Oakley, A., Exfoliative keratolysis, DermNet New Zealand; How Long Does Exfoliative Keratolysis Last? Spending long hours and over-exposing your body to the sun can cause cracks in the skin resulting in peeling of the skin in India. Psoralens Another way to treat the condition is the use of PUVB ( this is a mixture of psoralens and short wave ultraviolet radiation). Another is to be extra careful during outbreaks particularly summer season. 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. 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. Avoid certain bathroom products: Stay away from products with substances that may contribute to exfoliative keratolysis, including solvents, antibacterial soaps, and certain fabrics. Last modified on March 2021With inputs from Dr.Vedalatha Kakani, General Physician. Antibiotics could include: Antiseptics like benzoyl peroxide gel or cream can help clear the infection from your feet. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. Who is at Risk for Developing this Disease? The pathologist examines the biopsy under a microscope. 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. Learn how we can help. The process is usually painless but the underlying skin may get hard and rough because of the recurring condition. 1. As a result, the condition will recur since the root of the problem does not get addressed. Some of the precautions and home remedies are given below. However, the cause of the constant skin shedding in exfoliative keratolysis remains a mystery. 100 Jaar Leerstoel Dermatologie Rijksuniversiteit te Groningen. 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. 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. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. Australas J Dermatol. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. 10 Most Common Nail Diseases And Disorders. 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 also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. Fox, H. (1921). The etiology of keratolysis exfoliativa is unknown, but the condition appears to be worsened by heat or sweating. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. 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. Exfoliative keratolysis is the medical term of what we have commonly known as skin peeling disease. Ringworms Epub 2020 Sep 10. Visit your healthcare provider if you experience anxiety related to your phobia, as well as symptoms of pitted keratolysis. These lesions burst later to reveal a new layer of skin. We do not endorse non-Cleveland Clinic products or services. Exfoliative keratolysis. Fans and air conditioning equipments are readily available to neutralize the heating process as lengthened periods of treatment tend to get very hot sometimes. In most cases the condition subsides on its own. Although PUVA can be effective, it can also have various side effects, like itching, burning, eye damage, and skin cancer. Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. 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. 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. This process also involves the application of psoralensplant compounds that include trisoralen, 5-methoxypsoralen, and methoxsalen. Non-Hodgkins lymphoma Peeling skin can be a menace to treat in India. Keratolysis exfoliativa, as a self-limiting condition, can be treated. The condition is recurring causing the skin to harden and become rough. Generally, the condition does not require any lab tests to be performed. Stevens-Johnson syndrome Updated by Dr Oakley, December 2018. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. This can ensure that exfoliative keratolysis will not be exacerbated by secondary infections. Another cause of the skin peeling is sweating in your shoes. Getting oneself rehydrated is a good condition as well as well hydrated cells arent easily affected by extremely hot weather conditions.
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