Last reviewed by a Cleveland Clinic medical professional on 06/17/2022. Keratolysis exfoliativa (dyshidrosis lamellosa sicca), een aparte peelingentiteit. As a result, the skin begins to shred. Epub 2012 Oct 5. Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. b. This site needs JavaScript to work properly. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. The lower body may also see such signs of flaking in the form of skin peeling on legs. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. How can I prevent this condition from returning in the future? After the soak, you can use a pumice stone to remove dry skin from your feet. 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. Keratolysis exfoliativa treatment. Our body demands special care from us. 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. In most cases, it starts with the advent of summer and ends when simmer departs. Zinia is an SEO specialist born and raised in Bangladesh. 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, 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. These ointments and lotions will help reduce the discomfort that causes itching in the skin. On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. Keratolysis Exfoliativa may be wrongly diagnosed as any of the following skin peeling off conditions: She spends her free time reading books and watching TV series. However, there are situations that local approach is utilized. It may be more common in those with sweaty palms due to localised hyperhidrosis. The condition rarely goes away on its own without treatment from your healthcare provider. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. As there is no known remedy for this disease, one can try the precautions and home remedies to get rid of this problem. For this procedure, the patient is contained in a cabinet consisting 24 UVA fluorescent bulbs. Generally, skin peeling on fingers is a common symptom in Indians. It most often affects the skin on your feet. But, treatment is best during the early episodes. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. Exfoliative keratolysis 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. At times it may affect the tips of the fingers; cracks formed due to the skin condition could go deeper into the skin. The hand cream can prevent the excessive scales and dryness that lead to peeling from forming. No genetic abnormality has been detected to date (2018). Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. The procedure runs from a minimum of one minute to a maximum of 30 minutes depending on the patients tolerance. A dermatologist may recommend the use of keratolysis exfoliativa creams and keratolysis exfoliativa ointments. 23-31. Psoriasis Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. Keratolysis exfoliativa. How do I avoid peeling skin? Speak to a doctor on MFine to know more about its causes and risk factors today! 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. Causes and Treatment. Prevent the bacteria from returning by changing your shoes and socks when they get wet and wearing shoes with good airflow. 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. Arch Dermatol, 3(202), 11. They are also advised to take on protective goggles to shield the eyes from being exposed to the harmful radiation. And because of that, the condition is recurrent as the root problem of the disorder isnt directly addressed. Red spots arise on the skin that turn into blisters and finally into ulcers. The disease is thought about as seasonal as this usually affects young adults during summer. sharing sensitive information, make sure youre on a federal 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. 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. official website and that any information you provide is encrypted Interference with other drugs you take, which prevents the medication from working effectively. The treatment process in India does not require any surgery or frequent doctor visits. Protection from irritants, wear gloves, good moisturization. This is usually repeated 2-3 rows in a week. Thanks for visiting Dermatology Advisor. A CASE OF CONGENITAL EXFOLIATION OF THE SKIN.(KERATOLYSIS EXFOLIATIVA?). Keratolysis Exfoliativa . Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. 2.ICD-10-CM classification code L08.89 5. European Journal of Pediatric Dermatology, 23(2), 125-125. The first sign of the condition in India is generally flaky dry skin around the fingers and skin peeling on palms. There can be multiple layers of peeling skin (lamellae). We do not endorse non-Cleveland Clinic products or services. It is its own thing. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. Educating the patient on the benign nature of this condition is imperative, as often the patient merely wants a diagnosis and does not desire any further treatment. Take Care Of Your Nails At Home: Easy Pro Guide. - And More, (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. As you already know there are no fixed reasons behind exfoliative keratolysis. The condition may be seen around other parts of the body as well. It is also known as exfoliative keratolysis, dyshidrosis lamellosa sicca, and focal palmar peeling. That being said, there are certain scenarios that make someone more susceptible to exfoliative keratolysis. Want to talk to an expert regarding your diet? Work or participate in activities where youre outdoors and on your feet for most of the day. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. Do the antibiotics interfere with any of the medications I currently take? Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. Australas J Dermatol. In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. If you take an antibiotic and dont see an improvement in your symptoms after a week, talk to your healthcare provider. Key Takeaway: To the best of our knowledge, this report is the first that documents the efficacy of the use of systemic acitretin in KE. This disorder doesnt respond to any drugs except an oral Soriatane. It is always important to discuss the effect of risk factors with your healthcare provider. Policy. 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. 4. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you Summer is the period when it attacks. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. Disclaimer: Results are not guaranteed*** and may vary from person to person***. It is also known as Focal Palmar Peeling and is typically observed in young adults There are some home remedies to get rid of this problem. The majority of patients, with only mild disease, can be treated with topical moisturizers or keratolytics and followed up as needed. So, there is actually little room to apply drugs. Recurrent focal palmar peeling. There is no definitive cause for Exfoliative Keratolysis, however, there are a couple of situations that make someone susceptible to accumulating the disease. Picture 2: Palm with Exfoliative Keratolysis. 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). Dr. Heidi Fowler answered. A beautiful hand with nice and thin fingers can add personality to ones style. Epub 2012 Oct 5. There has been no conventional drug proven to be effective to heal exfoliative keratolysis. 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. Visit your healthcare provider if your symptoms dont improve after taking antibiotics for one week. No, pitted keratolysis isnt contagious and cant spread from person to person. Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. Stevens-Johnson syndrome 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. 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: Dont apply bleach or apple cider vinegar to your skin to make the odor from pitted keratolysis go away. The usage of lotions that are rich in Salicylic Acid and Lactic Acid may prevent infection Pitted keratolysis home treatment. Some effective essential oils include ginger oil, clove oil, myrrh oil, lavender oil, and frankincense oil. The exact cause of exfoliative keratolysis is not known. Exfoliative keratolysis The first indication of Keratolysis Exfoliativa in Indians is peeling of the skin. In such cases, the cracked skin on fingertips takes longer to peel off and heal. 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. In extreme cases, a doctor may recommend photochemotherapy, which is a combination of Psoralen and Ultraviolet. Keratolysis exfoliativa, as a self-limiting condition, can be treated. The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. They might ask questions about the type of shoes and socks you wear, especially around the time you noticed your symptoms. Picture 1: Fingers affected withExfoliative Keratolysis. Exfoliative keratolysis is mostly a seasonal disease. Acne pitted scar treatment. Stay away from skin irritants and allergens that may cause peeling of skin Chang YY, van der Velden J, van der Wier G, Kramer D, Diercks GF, van Geel M, Coenraads PJ, Zeeuwen PL, Jonkman MF. The best way to treat the condition is to avoid the causative factors. Staph infections Your socks can play a role in how much air gets to your feet too. One of the more common forms of treatment for exfoliative keratolysis is the application of a lactic acid-infused hand cream. If you notice an odor, along with tiny indentations in the skin on the bottom of your foot, visit your healthcare provider. Copyright and all rights reserved. Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Keratolysis exfoliativa is a condition that is treatable at home. 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. In addition to amino acids and lactic acids, urea is a natural moisturizing factor (NMF) that is commonly found in the outermost layer of . A patient complains of dry skin of the palm with initial air-filled blisters on fingers. 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 MedGen UID: 575367 Concept ID: C0343064 Congenital Abnormality; Disease or Syndrome Recent clinical studies Etiology Clinical evaluation of atopic hand-foot dermatitis. Toxic shock syndrome, Keratolysis Exfoliativas symptoms are quickly noticed and require no lab tests. 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. Keratolysis exfoliativa. Archives of Dermatology and Syphilology, 23(3), 445-471. Your healthcare provider will offer treatment to make the bacteria that cause pits in your feet go away, which will ease your fear. Keratolytic creams containing urea, lactic acid, ammonium lactate or salicyclic acid. Pitted keratolysis is a bacterial infection that affects the skin on your feet. - Drug Monographs Usually the condition subsides with the use of an ointment as prescribed by the general physician. The disruption and premature separation of corneocytes are responsible for this disease. MacKee, G. M., & Lewis, G. M. (1931). 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 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. (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. Try to prevent sweating by using topical agents. In case it doesn't, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Wearing shoes with good airflow; avoid rubber boots. Hand dermatitis can be a very difficult condition to diagnosis due to the numerous conditions that mimic one another when presenting on the hands. Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Dermatology online journal, 21(12). Some risk factors are more important than others. Keratolysis Exfoliativa is usually seen in young Indian adults who are active throughout the day. Flaky dry skin around the affected area As a result, the disorder is already difficult to treat. The condition is also accompanied by a few blisters around the palms of the hand. Keratolysis exfoliativa is also characterized by a lack of inflammation. SANGSTER, A. Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand, 1999. The best material to improve airflow to your feet through your socks is cotton. A diet rich in Vitamin B may aid in avoiding the condition in India. Fans and air conditioning equipments are readily available to neutralize the heating process as lengthened periods of treatment tend to get very hot sometimes. Aloe vera juice is a completely natural moisturizer which can run the extra mile for your skin. Dermatol Online J. I experience it twice in a year. 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. Pitted keratolysis is a bacterial skin infection that causes a foul odor and itchiness. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. 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. If you have pitted keratolysis, that odor will still be present after you wash your feet and change your socks and shoes. Please login or register first to view this content. Exfoliative keratolysis treatment. The infection caused by wearing tight or restricting footwear and due to excessive sweating. The epidermis is made up of several layers of keratin, a type of protein which helps the skin to remain flexible, strong and waterproof.