This approach has been present since 1976 and uses ultraviolet rays to treat the condition. It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. 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. On physical examination there are symmetrical, irregular circumscribed annular or circinate patches of superficial scaling on the palms and, less often, the soles (Figure 1). Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. It is triggered by allergic reactions to substances, food or even air. If the peeling of skin does not reduce or the condition does not improve, a specialist may recommend using photochemotherapy. The condition causes discomfort in the skin that leads to persistent itching. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. However, this is not generally itchy in contrast to eczema. There are some home remedies to get rid of this problem. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. Because of this, the skins ability to heal is compromised. 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. The latter isnt seasonal as well and happens all year round and is also common for people who have skin asthma. Blisters that form and split at the base of a finger often have deeper cracks that later make the skin feel numb and hard. Dont miss out on todays top content on Dermatology Advisor. Exfoliative keratolysis mainly attacks and is common during the summer months. PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. The hands and feet should also always be well cleaned. The disruption and premature separation of corneocytes are responsible for this disease. Keratolysis exfoliativa also known as focal palmar peeling is a common disorder that is rarely reported and often overlooked as hand eczema. Acne pitted scar treatment. Journal of the European Academy of Dermatology and Venereology. Proper hand hygiene: Maintain hygiene with frequent cutting of your toenails and fingernails. Foot skin peeling Exfoliative keratolysis can also be called "focal palmar peeling" or "keratolysis exfoliativa." In generic terms it's known as the "skin peeling disease." 1. Accessibility Still, it will reappear weeks and even months later. Pediatr Dermatol. Hautarzt. The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Br J Dermatol. Protection from irritants, wear gloves, good moisturization. (1895). Eczema is also a quite painful condition, whereas exfoliative keratolysis doesnt hurt as much. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. Almonds, walnuts, cashew nuts etc. The peeling is not limited to the hands and feet. How often should I apply topical antibiotics to my skin? Inquire about any history of atopic dermatitis. The example can be best explained by skin asthma. The condition is also accompanied by a few blisters around the palms of the hand. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. 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. A diet rich in Vitamin B may aid in avoiding the condition in India. Although treatments are available, it is more of palliative. As a result, the skin begins to shred. Exfoliative Keratolysis Treatment Topical steroids are often given exfoliative keratolysis. However, there are situations that local approach is utilized. Cutaneous T-cell lymphoma What type of shoes do you recommend I wear? The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. 102-6. One of the more common forms of treatment for exfoliative keratolysis is the application of a lactic acid-infused hand cream. 2015 Dec 16;21(12). If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Last modified on March 2021With inputs from Dr.Vedalatha Kakani, General Physician. Key Takeaway: The following are some of the better home remedies you can try: 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. Copyright and all rights reserved. Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand, 1999. From now on, be watchful towards your health and try these remedies if you ever have exfoliative keratolysis. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. fix microsoft teams not displaying images and gifs. The lower body may also see such signs of flaking in the form of skin peeling on legs. Keratolysis exfoliativa is also characterized by a lack of inflammation. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. National Library of Medicine Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. The best exfoliative keratolysis treatment is to avoid factors that cause the condition, including irritants like soaps, solvents, and detergents. Initially, it doesnt cause any pain or abnormality but gradually some air-filledblisters take over the skin of palms and/or soles. Familial continual skin peeling. It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. Exfoliative keratolysis at the fingers base will often take longer to heal due to frequent skin peeling. 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. Toxic shock syndrome, Keratolysis Exfoliativas symptoms are quickly noticed and require no lab tests. In case it doesn't, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. The procedure runs from a minimum of one minute to a maximum of 30 minutes depending on the patients tolerance. Picture 1: Fingers affected withExfoliative Keratolysis. Changing your shoes and socks when they get wet. No genetic abnormality has been detected to date (2018). Pitted keratolysis home treatment. This situation is linked to destruction of keratin layers in the epidermis resulting to unwarranted skin exfoliation. Pits or tiny indentations in the patch of skin that look like small holes. A dermatologist may notice these signs and up on further investigation recommend the right treatment for the patient. DermNet provides Google Translate, a free machine translation service. Topical psoralen emollients such as gels or lotions are typically applied to the affected areas for 10 minutes before skin is exposed to UVA. Last reviewed by a Cleveland Clinic medical professional on 06/17/2022. There is no definitive cure for exfoliative keratolysis. Exfoliative keratolysis will hibernate beneath the skin once the redness and scales have healed. 100 Jaar Leerstoel Dermatologie Rijksuniversiteit te Groningen. Tenia pedis. The infection caused by wearing tight or restricting footwear and due to excessive sweating. JAMA Dermatol. Applying lactic acid hand cream to the skin is one of the more common exfoliative keratolysis treatments. Skin shedding (keratolysis exfoliativa congenita): report of a case. Visit your healthcare provider if your symptoms dont improve after taking antibiotics for one week. Dermatologica. Common symptoms that accompany skin peeling are rashes, itching, dryness and other irritants. SANGSTER, A. The exact cause of exfoliative keratolysis is not known. Chang, Y. Y., Van der Velden, J., Van der Wier, G., Kramer, D., Diercks, G. F. H., van Geel, M., & Jonkman, M. F. (2012). It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. Athletes foot Keratolysis exfoliativa. Causes and Treatment. An official website of the United States government. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. DermNet does not provide an online consultation service. Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. Lets take a deeper look at some of the other exfoliative keratolysis treatments available. Careers. Adverts are the main source of Revenue for DoveMed. So, we should take care of the skin and look after the affected area gently. J Cutan Dis, 37, 174-175. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. These ointments and lotions will help reduce the discomfort that causes itching in the skin. It can be treated with an application of coconut oil and keep your hand moist. There are no associated systemic implications or complications seen in patients with keratolysis exfoliativa. Dermatology Made Easybook. Contact Dermatitis:Contact Dermatitis is a condition that causes acute inflammation of the skin. Dr. Heidi Fowler answered. Bookshelf These peeled areas lack a normal barrier function and may become dry and cracked. 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: Avoid certain bathroom products: Stay away from products with substances that may contribute to exfoliative keratolysis, including solvents, antibacterial soaps, and certain fabrics. Fox, H. (1921). Prevent the bacteria from returning by changing your shoes and socks when they get wet and wearing shoes with good airflow. Lee, YC, Rycroft, RJ, White, IR, McFadden, JP. Acral skin eruption observed during SARS-CoV-2 pandemic: possible keratolysis exfoliativa with red palms and soles. MacKee, G. M., & Lewis, G. M. (1931). Synthetic materials or blended materials in socks can restrict airflow to your feet. Australas J Dermatol. Thus, the skin peels off and sometimes cause pain too. 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. Therefore, management of exfoliative keratolysis may still be limited, and treatment is quite difficult. Keratolysis exfoliativa is more common during the summer months in about 50% of affected individuals. Speak to a doctor on MFine to know more about its causes and risk factors today! Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. Keratolysis exfoliativa treatment. That being said, there are certain scenarios that make someone more susceptible to exfoliative keratolysis. Pitted keratolysis is a bacterial infection that affects the skin on your feet. 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. In turn, the loss of strength causes the skin to exfoliate. This problem is more prevalent in younger age groups. The odor caused by the infection occurs because the bacteria release a stinky sulfur compound. A deficiency of Niacin, which is one of the B Vitamins, causes the peeling of skin around the hands and legs. 37. Epub 2020 Sep 10. - Full-Length Features Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. 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. ), Abdel-Hafez, K, Safer, AM, Selim, MM, Rehak, A. , 1999. Keratolysis Exfoliativa is the condition of peeling of the skin around the palms and soles. Please remove adblock to help us create the best medical content found on the Internet. References Hausauer AK, Cohen DE. After bursting, hand blisters will leave scales that look cracked and reddish. A few observable symptoms in India: It may be more common in those with sweaty palms due to localised hyperhidrosis. In most cases, it starts with the advent of summer and ends when simmer departs. The https:// ensures that you are connecting to the Australas J Dermatol. Exfoliative keratolysis is mostly a seasonal disease. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. Exfoliative keratolysis The condition arises to allergens or irritants that come in contact with the patient. Psoriasis: Psoriasis is a chronic condition that affects the skin. When it comes to skin conditions, exfoliative keratolysis is, at times, harmless but also sometimes quite painful. Flaky dry skin around the affected area 5.3k views Answered >2 years ago. 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. In addition to amino acids and lactic acids, urea is a natural moisturizing factor (NMF) that is commonly found in the outermost layer of . Keratolysis exfoliativa generally presents in young active adults. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. Provides a good description of the clinical features of recurrent focal palmar peeling and how to differentiate it from other conditions. American Osteopathic College of Dermatology. The Licensed Content is the property of and copyrighted by DSM. And, a less confirmed theory says that this is somewhat related to the genetic inheritance. The best way to treat the condition is to avoid the causative factors. - Drug Monographs 3.Reasoning: a. 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. Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. Generally, the condition does not require any lab tests to be performed. This can ensure that exfoliative keratolysis will not be exacerbated by secondary infections. 4. Sweaty hands are also an aggravating factor. Treatment options are summarized in Table I. The application of cucumber juice, aloe vera gel, witch hazel, or pineapple juice can also help improve exfoliative keratolysis. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis.). Dis., 37, 223. 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. She spends her free time reading books and watching TV series. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. It is periodic. Keratolysis exfoliativa and the mosaic fungus. 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. Chang YY, van der Velden J, van der Wier G, et al. PubMed. Can my diet help in avoiding peeling skin? 2. Treat hyperhidrosis if present. Dermatologie, U. M. C. G., & Jonkman, M. F. (2013). It is important to note that prolonged healing occurs when the blisters centers on the base of the fingers due to consistent shredding and peeling of the skin. There is no definitive cause for Exfoliative Keratolysis, however, there are a couple of situations that make someone susceptible to accumulating the disease. 8600 Rockville Pike The cause of development of Keratolysis Exfoliativa is currently unknown. Chiriac, A., & Solovan, C. (2013). Keratolysis Exfoliativa are generally observed in young adults. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Please login or register first to view this content. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. In others, the following treatment measures may be considered: Regular follow up visits with the healthcare provider is important and recommended. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. Treatment for exfoliative keratolysis typically involves the use of antibiotics or antifungal medications. vol. DermNet does not provide an online consultation service.If you have any concerns with your skin or its treatment, see a dermatologist for advice. Young adult people are mostly victims of this disease. Peeling skin on fingers near nails What is the treatment for keratolysis exfoliativa? However, after a few months or sometimes even after a few weeks the condition recurs again. Scarlet fever Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions in India. No, pitted keratolysis isnt contagious and cant spread from person to person. Your healthcare provider will offer treatment to make the bacteria that cause pits in your feet go away, which will ease your fear. Ultraviolet radiation treatment is also called photochemotherapy (PUVA), and uses ultraviolet rays to treat exfoliative keratolysis. What Are These Tiny Red Spots on My Skin (Petechiae)? Pitted keratolysis and athletes foot are both conditions that affect your feet. Acral Peeling Skin Syndrome: A Case Report and Literature Review. The formation of numerous skin tags will look like the skin from the hand is peeling. The peeling may be painful in some cases and it is best to get it treated immediately. The condition can be treated at home by taking necessary precautions: Some risk factors are more important than others. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. This is usually repeated 2-3 rows in a week. If possible, use drugs which can reduce sweating excessively. So extra attention should be drawn to the sweaty parts of the body. Another is to be extra careful during outbreaks particularly summer season. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks, Hausauer AK, Cohen DE. Keratolysis exfoliativa is a condition that is treatable at home. Epub 2016 May 18. Who is at Risk for Developing this Disease? A dermatologist may recommend the use of keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Acute exfoliative keratolysis: It is a primary stage of skin peeling of hands. The peeled skin from the fingers and fingertips is often harder due to constant peeling before healing takes place. Although PUVA can be effective, it can also have various side effects, like itching, burning, eye damage, and skin cancer. Wear shoes and/or socks that are too tight (occlusive) and have limited airflow. Instead, eat plenty of anti-inflammatory, essential fatty acid-rich foods like flaxseed oil and wild-caught fish, and other foods that assist with wound healing like vitamin A-rich foods, probiotic-rich foods, and pumpkin seeds and chia seeds. - And More, (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. Is the reason for your skin peeling keratolysis exfoliativa Speak to a doctor on MFine and find out how to tackle it! The etiology of keratolysis exfoliativa is unknown, but the condition appears to be worsened by heat or sweating. Generally, skin peeling on fingers is a common symptom in Indians. 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. A 21-year-old male asked: . It also involves the use of Psoralens which are compounds found in plants that also includes methoxsalen, 5-methoxypsoralen and trisoralen. Want to talk to an expert regarding your diet? Causes and Treatment. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. 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. Erythromycin. 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. It is its own thing. Presently, it is not known to occur from genetic factors, even though a family history is occasionally noted. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Yes, sometimes skin peel offs may occur due to a deficit or an excess of a few vitamins. There are different ways to do the treatment. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. 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. She is passionate about digital marketing and loves to work with fashion-related niches like nails, hairstyles etc. are preferable. Your body isnt able to stop future infections (. Hausauer, A. K., & Cohen, D. E. (2015). Exfoliative Keratolysis Treatment The ideal treatment is avoiding the risk factors that are its primary causes. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. 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). On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you Keratolysis Exfoliativa in India may arise due to sunburns or infections that directly cause damage to the skin. Secondly, genetic predisposition may also expose someone to this condition as certain environmental or external factors can trigger the disease to develop. 2. Another reason for skin peeling off is excessive Vitamin A in the body. vol. So, you can say it lasts during the summer. When the whole hand and foot peel off it gone for next six months. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. The skin may swell and become red due to inflammation. In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. Recent histopathologic and molecular studies have linked KE to premature corneo-desmosomal disruption. The most affected areas of the body are usually the fingers and the soles. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. This is likely a common condition that rarely presents to physicians because it is largely asymptomatic. Picture 2: Palm with Exfoliative Keratolysis. Visit the emergency room if you have symptoms of an allergic reaction from taking antibiotics, including: If you have a fear of patterns with a lot of holes (trypophobia), a pitted keratolysis diagnosis can be a trigger for your fear. Your socks can play a role in how much air gets to your feet too. Supportive investigations may be undertaken. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. Pits can cluster together to form a sore (lesion) that looks like a crater. Eczema can be painful too unlike the aforementioned which doesnt have accompanying pain. | Find, read and cite all the research you . Mood Disorder: Ect or electroconvulsive therapy is used for the treatment of mood disorders such as severe recalcitrant depression. As a result, the condition will recur since the root of the problem does not get addressed. Epub 2012 Oct 5. Some Observations on Keratolysis Exfoliativa. Keratolysis exfoliativa codes and concepts. In such cases, the cracked skin on fingertips takes longer to peel off and heal. So, how long does exfoliative keratolysis last? Peeling skin can be a menace to treat in India. Keratolysis exfoliativa, as a self-limiting condition, can be treated. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. Key Points Common skin condition which often affects the palms Cause is unknown Initially consists of blisters on the palms and/or fingers, which burst causing areas of skin to peel. vol. The process is usually painless but the underlying skin may get hard and rough because of the recurring condition. But, this is not suggested till one can endure the pain. 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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.
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