Often times, these creams also contain silicone and urea. One common mistake while doing the diagnosis of this disease is, some doctor confuses it with the following diseases. Archives of Dermatology and Syphilology, 23(3), 445-471. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. 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. PMC Although rare, it can also affect the palm of your hand. This painful or harmless skin problem also goes by names such as keratolysis exfoliativa, lamellar dyshidrosis, dyshidrosis lamellosa sicca, and recurrent palmar peeling. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. The peeling is not limited to the hands and feet. 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. ), Close more info about Keratolysis exfoliativa (Lamellar dyshidrosis, Recurrent focal palmar peeling, Recurrent palmar peeling). 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. National Library of Medicine Seborrheic dermatitis - Evidence-Based Guidance These ointments and lotions will help reduce the discomfort that causes itching in the skin. Disclaimer: Results are not guaranteed*** and may vary from person to person***. 8600 Rockville Pike As a result, the disorder is already difficult to treat. This further hardens and numbs the skin. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. - Conference Coverage In this condition, the skin cells multiply consistently at a speed that is faster than normal. Journal of the European Academy of Dermatology and Venereology. Speak to a dietician on MFine to know how changes in your food can help you address your situation today! Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Psoralens Another way to treat the condition is the use of PUVB ( this is a mixture of psoralens and short wave ultraviolet radiation). MacKee, G. M., & Lewis, G. M. (1931). No, pitted keratolysis isnt contagious and cant spread from person to person. It is always important to discuss the effect of risk factors with your healthcare provider. Flaky dry skin around the affected area Fusidic acid. Fourthly, although unproven, medical researchers believe that extremely hot climate during summer increases episodes of perspiration. 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. I experience it twice in a year. Symptoms of pitted keratolysis affect your feet, specifically the web spaces between your toes and the ball, heel and soles of your foot. Accessibility Epub 2012 Oct 5. It may not be possible to prevent Keratolysis Exfoliativa in many cases. Exfoliative Keratolysis Treatment Topical steroids are often given exfoliative keratolysis. Exfoliative keratolysis will hibernate beneath the skin once the redness and scales have healed. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. 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. 166. 1.clinical diagnosis- Pitted keratolysis. Dr. Heidi Fowler answered. In case it doesn't, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. 24/7 visits - just $44! 2.ICD-10-CM classification code L08.89 5. 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. But this method is rarely recommended as psoralen activation works best with UVA. That being said, there are certain scenarios that make someone more susceptible to exfoliative keratolysis. 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. Psoriasis: Psoriasis is a chronic condition that affects the skin. As a result, the skin begins to shred. Meaning, the signs are symptoms are treated but the underlying cause is not addressed. The condition causes a foul odor and itchiness. No advanced study has been carried out about what might be the cause of exfoliative keratolysis. They are also advised to take on protective goggles to shield the eyes from being exposed to the harmful radiation. This is usually repeated 2-3 rows in a week. This can ensure that exfoliative keratolysis will not be exacerbated by secondary infections. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions in India. When this is the case, it is best to consult your doctor for exfoliative keratolysis treatment. The usage of lotions that are rich in Salicylic Acid and Lactic Acid may prevent infection Normal skin will develop in due time, although it is common for exfoliative keratolysis to return within a few weeks after normal skin has formed. J Cutan Dis, 37, 174-175. The epidermis is made up of several layers of keratin, a type of protein which helps the skin to remain flexible, strong and waterproof. American Osteopathic College of Dermatology. When the blisters present around the palms burst, they cause circular marks leaving cracked skin on fingertips. 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 is a straightforward diagnosis; for any unusual clinical presentations, the correct diagnosis should be questioned. Ringworms Ultraviolet radiation treatment is also called photochemotherapy (PUVA), and uses ultraviolet rays to treat exfoliative keratolysis. Hyperhidrosis Recurrent focal palmar peeling. There are a number of preventative tips that can help you decrease the risk of exfoliative keratolysis symptoms. Our body demands special care from us. Chang, Y. Y., Van der Velden, J., Van der Wier, G., Kramer, D., Diercks, G. F. H., van Geel, M., & Jonkman, M. F. (2012). 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. After a long day on your feet, you might notice a foul odor coming from your feet, shoes and socks. Policy. A beautiful hand with nice and thin fingers can add personality to ones style. Dermatologists recommend that one maintains good personal hygiene and avoids spending too much time in the sun. The Licensed Content is the property of and copyrighted by DSM. What Is Exfoliative Keratolysis? This disorder doesnt respond to any drugs except an oral Soriatane. Acne pitted scar treatment. If possible, use drugs which can reduce sweating excessively. This site needs JavaScript to work properly. 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. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. Please remove adblock to help us create the best medical content found on the Internet. Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. Dry skin 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. Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. Lane, J. E. (1919). The infection is characterised by craterlike pits on the surface of the feet and toes. In other words, treatment can only deal with the symptoms and signs associated with the condition. Persistent itching. Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. Br J Dermatol. Key Takeaway: 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. 1996 Aug;37(3):1434. Because of this prevalent condition, the disease is sometimes mistaken for eczema. How long does Exfoliative Keratolysis last? It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. There are no associated systemic implications or complications seen in patients with keratolysis exfoliativa. Visit your healthcare provider if your symptoms dont improve after taking antibiotics for one week. Keratolysis exfoliativa. Hausauer, A. K., & Cohen, D. E. (2015). 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. 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. Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. The latter isnt seasonal as well and happens all year round and is also common for people who have skin asthma. 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. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. Photograph of keratolysis exfoliativa on the hand. The condition requires no medical test and is detected by a well experienced dermatologist. Plant-based applications: Try making a natural homemade exfoliative keratolysis cream with raw honey, shea butter, and coconut oil. Some believe that it is more frequently associated with underlying atopic dermatitis, while others report an association with primary hyperhidrosis. Patients should be aware that this treatment is purely anecdotal and data to support its benefit is lacking. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. Bookshelf Treatment options are summarized in Table I. These hollow spaces are actually the peeked areas. keratolysis exfoliativa has no known causes in Indians but the condition is found in young adults who are active throughout the day. This problem is more prevalent in younger age groups. Please login or register first to view this content. It could take between two to three days before you start to feel better. There can be multiple layers of peeling skin (lamellae). Keratolysis exfoliativa. Recent histopathologic and molecular studies have linked KE to premature corneo-desmosomal disruption. The scaling gradually extends peripherally, leaving an adherent collarette. The condition can be treated at home by taking necessary precautions: Scarlet fever Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. The pathologist examines the biopsy under a microscope. A patient complains of dry skin of the palm with initial air-filled blisters on fingers. Usually the condition subsides with the use of an ointment as prescribed by the general physician. Latest News Your top articles for Saturday, Continuing Medical Education (CME/CE) Courses. The condition is diagnosed when your dermatologist notices peeling skin on palms of hands and cracked skin on fingertips. Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. Normally, its not painful but swelling blisters or inflamed layer of skins can cause pain to the body. ), (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. DermNet provides Google Translate, a free machine translation service. Antibiotics effectively treat the condition to make the odor go away. 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. 10 Ways to Control Blood Sugar without Medication, What Is Exfoliative Keratolysis? Treatment for exfoliative keratolysis typically involves the use of antibiotics or antifungal medications. 1996. pp. In most cases the condition subsides on its own. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. It is periodic. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. There are some home remedies to get rid of this problem. So, how long does exfoliative keratolysis last? 2023 mfine Pvt Ltd. Maintaining good personal hygiene and avoiding overexposure to the sun. 2. (I am still searching tha A deficiency of Niacin, which is one of the B Vitamins, causes the peeling of skin around the hands and legs. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. A 21-year-old male asked: . Atopic dermatitis (eczema) Epub 2012 Oct 5. 2014 Jun;150(6):647-8. doi: 10.1001/jamadermatol.2013.9190. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks. 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. In addition to the lactic acid content, hand creams used to treat the condition oftentimes also contain urea and silicone as well.. Getting oneself rehydrated is a good condition as well as well hydrated cells arent easily affected by extremely hot weather conditions. Initially, it doesnt cause any pain or abnormality but gradually some air-filledblisters take over the skin of palms and/or soles. The following may be helpful: Protect the affected area from irritants Pediatr Dermatol. A patient does not feel any pain with dry skin. arrow-right-small-blue Keratolysis exfoliativa Lee HJ, Ha SJ, Ahn WK, Kim D, Park YM, Byun DG, Kim JW Pediatr Dermatol 2001 Mar-Apr;18 (2):102-6. doi: 10.1046/j.1525-1470.2001.018002102.x. The procedure runs from a minimum of one minute to a maximum of 30 minutes depending on the patients tolerance. Copyright 2017, 2013 Decision Support in Medicine, LLC. As there is no known remedy for this disease, one can try the precautions and home remedies to get rid of this problem. Eating a healthy diet can be a good source of natural components which may heal the skin. Once the skin is completely peeled off has healed, normal skin reforms, but Keratolysis Exfoliativa usually recurs in the following weeks. This is common among fishermen but no significant evidence has been correlated to this incident. - Drug Monographs Fox, H. (1921). (adsbygoogle = window.adsbygoogle || []).push({}); Heart Palpitations at Night: Common Causes and How to Treat, Essential Oils for Cough, Cold and Congestion, Sudden High Blood Pressure: Causes, Symptoms and Prevention Tips, Sore Throat on One Side: 7 Causes and Treatments, Natural Remedies for the Burning Sensation in Your Stomach After Eating, Hibiscus Tea: Health Benefits, Nutrition, Side Effects, and Recipes, Vegetable Oil Substitutes: 5 Healthy Alternatives for Baking, Frying, and More, How to Treat Nausea After Eating Eggs or Chicken, Diarrhea after Eating: Causes and Natural Treatments, Top 11 Homeopathic Remedies for High Blood Pressure, Heavy Breathing: Common Causes and Treatments, Pineapple Juice for Cough: Effective Homemade Cough Remedies, Pain in the Left Temple of the Head: 10 Causes and Treatments. 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. This is your part and enjoy being different. pii: 13030/qt6mv338nx. Treating Exfoliative Keratolysis at Home Keratolysis can be treated at home if it is in the nascent stages. As they do so, new skin is born out of the process. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. MeSH If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. Keratolysis exfoliativa is thought to be a very common condition with limited epidemological data available since it rarely presents itself to physicians because of its asymptomatic nature. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Contact dermatitis No worries! Tenia pedis. Keratolytic creams containing urea, lactic acid, ammonium lactate or salicyclic acid. How can you prevent exfoliative keratolysis? 102-6. Provides a good description of the clinical features of recurrent focal palmar peeling and how to differentiate it from other conditions. However, they are not generally itchy. All rights reserved. Then, the blisters burstand it leaves a hollow and blank space underneath the skin. Eating different kinds of nuts is good for skin. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. Skin shedding (keratolysis exfoliativa congenita): report of a case. Chang YY, van der Velden J, van der Wier G, et al. The best material to improve airflow to your feet through your socks is cotton. 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. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. The condition does not limit itself to the hands. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Peeling skin can be a menace to treat in India. 23-31. Talk to a doctor now . Dont apply bleach or apple cider vinegar to your skin to make the odor from pitted keratolysis go away. The first sign of keratolysis exfoliativa is one or more superficial air-filled blisters on the fingers or palms. Some individuals have a family history of the disorder. doi: 10.1111/j.1365-2133.2012.11175.x. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. Copyright and all rights reserved. Blisters that form and split at the base of a finger often have deeper cracks that later make the skin feel numb and hard. Acral Peeling Skin Syndrome: A Case Report and Literature Review. 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. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. PubMed. Keratolysis exfoliativa. Updated by Dr Oakley, December 2018. She is passionate about digital marketing and loves to work with fashion-related niches like nails, hairstyles etc. Acral skin eruption observed during SARS-CoV-2 pandemic: possible keratolysis exfoliativa with red palms and soles. Dis., 37, 223. There is no definitive cure for exfoliative keratolysis. When the whole hand and foot peel off it gone for next six months. When keratin breaks down, it impairs the skins strength and elasticity. 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. It can also fortify the epidermal barrier that may prevent future exfoliative keratolysis outbreaks. Youll be sure from this test whether this is due to an allergic problem or other underlying problems which should be determined. 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. 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. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. Medication side effects British Journal of Dermatology,7(2), 37-39. However, the cause of the constant skin shedding in exfoliative keratolysis remains a mystery. The site is secure. 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. Lets take a deeper look at some of the other exfoliative keratolysis treatments available. If you take an antibiotic and dont see an improvement in your symptoms after a week, talk to your healthcare provider. 18. You can reduce your risk of pitted keratolysis by: Pitted keratolysis causes your feet to smell bad. Some risk factors are more important than others. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis.). As you already know there are no fixed reasons behind exfoliative keratolysis. If you notice an odor, along with tiny indentations in the skin on the bottom of your foot, visit your healthcare provider. It has been regarded as a subtype of dyshidrotic eczema, a fungal infection or a dermatophytid reaction. Peeling skin on fingers near nails Athletes foot Pitted keratolysis and athletes foot are both conditions that affect your feet. Please enable it to take advantage of the complete set of features! However, after a few months or sometimes even after a few weeks the condition recurs again. Your socks can play a role in how much air gets to your feet too. 10 Most Common Nail Diseases And Disorders. Most patients deny any itching, but may rarely complain of slight tenderness. These peeled areas lack a normal barrier function and may become dry and cracked. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. 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. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. 1. The condition is typically caused by an overgrowth of bacteria on the skin or by a reaction to a medication. Adverts are the main source of Revenue for DoveMed. Photochemotherapy can be applied if the disease goes beyond control. We do not endorse non-Cleveland Clinic products or services. If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. 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. Eat the proper diet: It is best to eliminate processed foods and additives, fried foods, high-sugar foods, and common food allergens from the diet. 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. It can also affect the whole fingers and fingertips at the advanced level. Keratolysis Exfoliativa is the condition of peeling of the skin around the palms and soles. Having said all that, we want to enumerate some risk factors that intrigue this disease. 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. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. Staph infections Australas J Dermatol. are preferable. Your healthcare provider will offer treatment to make the bacteria that cause pits in your feet go away, which will ease your fear. Stay away from skin irritants and allergens that may cause peeling of skin and transmitted securely. Epub 2016 May 18. Would you like email updates of new search results? The latest research on exfoliative keratolysis suggests that there is a link between corneocytes and exfoliative keratolysis. Changing your shoes and socks when they get wet. Inquire about any history of atopic dermatitis. doi: 10.1111/jdv.16881. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. Neri, I., Patrizi, A., Gabrielli, L., Virdi, A., Veronesi, G., Corsini, I., & Guglielmo, A. Picture 2: Palm with Exfoliative Keratolysis. Keratolysis exfoliativa is a condition that is treatable at home. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. Keratolysis exfoliativa is a condition that is treatable at home. The following methods are Listed below: Oral for this method, methoxsalen capsules are ingested orally a few hours before the procedure usually 2-3 hours. Dont miss out on todays top content on Dermatology Advisor. It is best to stay away from such irritants. You might be more at risk of developing pitted keratolysis if you: Pitted keratolysis is common among people who work in certain occupations where you spend most of your day on your feet or among people who participate in strenuous physical activities, including: You might notice your symptoms become more apparent when your skin is wet. Exfoliative keratolysis is the medical term of what we have commonly known as skin peeling disease. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. 3. Once the scales and the redness heals, the condition hibernates. The condition is also accompanied by a few blisters around the palms of the hand. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. Unfortunately, what causes exfoliative keratolysis is relatively unknown. - And More, (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. The condition is recurring causing the skin to harden and become rough. Careers. A bacterial infection causes pitted keratolysis. Your body isnt able to stop future infections (. Keratolysis exfoliativa, as a self-limiting condition, can be treated. Intravenous steroids may be given in severe cases, but steroids usage has its own side effects, when used for a long time.