Exfoliative keratolysis. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. 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. Thus, the skin peels off and sometimes cause pain too. vol. Any of these conditions cause irritation in the skin, resulting in itching and the peeling of the skin. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. Lane, J. E. (1919). To the best of our knowledge, this report is the first that documents the efficacy of the use of systemic acitretin in KE. In most cases, it starts with the advent of summer and ends when simmer departs. Because of this, the skins ability to heal is compromised. Normally, its not painful but swelling blisters or inflamed layer of skins can cause pain to the body. 4. 2014 Jun;150(6):647-8. doi: 10.1001/jamadermatol.2013.9190. 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. Tenia pedis. Clinical evaluation of atopic hand-foot dermatitis. Sometimes, it lasts for only a few weeks and sometimes a number of months pass by without any relief. Dermatol Online J. There are no associated systemic implications or complications seen in patients with keratolysis exfoliativa. How can you prevent exfoliative keratolysis? No matter how small and trivial an organ is, we should take good care of that. Differential diagnosis. Mood Disorder: Ect or electroconvulsive therapy is used for the treatment of mood disorders such as severe recalcitrant depression. References Hausauer AK, Cohen DE. Treatments are mainly anecdotal and may or may not lead to improvement. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks, Hausauer AK, Cohen DE. In such cases, the cracked skin on fingertips takes longer to peel off and heal. Therefore, management of exfoliative keratolysis may still be limited, and treatment is quite difficult. Peeling skin can be a menace to treat in India. 166. Neri, I., Patrizi, A., Gabrielli, L., Virdi, A., Veronesi, G., Corsini, I., & Guglielmo, A. Dry skin Picture 1: Fingers affected withExfoliative Keratolysis. Maintaining good personal hygiene and avoiding overexposure to the sun. Want to know more about exfoliative keratolysis? 18. If the skins of the palms and the soles start to peel off, thats the first sign of exfoliative keratolysis. In het boek wordt de geschiedenis beschreven van de Groningse leerstoel huid-en geslachtziekten van 15 september 1913, toen prof. dr. RA Reddingius bij Koninklijk Besluit werd, 466. Antibiotics could include: Antiseptics like benzoyl peroxide gel or cream can help clear the infection from your feet. Dermatology online journal, 21(12). Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. A few observable symptoms in India: You can reduce your risk of pitted keratolysis by: Pitted keratolysis causes your feet to smell bad. Optimal Therapeutic Approach for this Disease, Unusual Clinical Scenarios to Consider in Patient Management. 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. Youve viewed {{metering-count}} of {{metering-total}} articles this month. Erythromycin. There can be multiple layers of peeling skin (lamellae). Learn how we can help. This can ensure that exfoliative keratolysis will not be exacerbated by secondary infections. We do not endorse non-Cleveland Clinic products or services. Please login or register first to view this content. It is triggered by allergic reactions to substances, food or even air. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. Enjoying our content? Interference with other drugs you take, which prevents the medication from working effectively. Fourthly, although unproven, medical researchers believe that extremely hot climate during summer increases episodes of perspiration. Microscopy reveals cleavage within the outside horny layer of skin, the stratum corneum. Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. Changing your shoes and socks when they get wet. There are different ways to do the treatment. PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. Intravenous steroids may be given in severe cases, but steroids usage has its own side effects, when used for a long time. Try to prevent sweating by using topical agents. A deficiency of Niacin, which is one of the B Vitamins, causes the peeling of skin around the hands and legs. Please enable it to take advantage of the complete set of features! 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. The hands and feet should also always be well cleaned. - Evidence-Based Guidance Washing your feet and hands with soap and water when you remove your shoes and socks. Foot skin peeling Disclaimer: Results are not guaranteed*** and may vary from person to person***. While Indian home remedies may give fruitful results, some cases are too severe to be treated with these remedies. 1996. pp. If you notice an odor, along with tiny indentations in the skin on the bottom of your foot, visit your healthcare provider. A 21-year-old male asked: . It has been regarded as a subtype of dyshidrotic eczema, a fungal infection or a dermatophytid reaction. But, treatment is best during the early episodes. If you still have an odor coming from your feet after you wash your feet at the end of the day, its a sign that you have pitted keratolysis. The condition requires no medical test and is detected by a well experienced dermatologist. Visit your healthcare provider if you experience anxiety related to your phobia, as well as symptoms of pitted keratolysis. It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. As you already know there are no fixed reasons behind 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. Photograph of keratolysis exfoliativa on the hand. It is its own thing. 8600 Rockville Pike So, we should take care of the skin and look after the affected area gently. First, lets take a look at how the outer layer of the skin, the epidermis, is involved in the development of exfoliative keratolysis. Once the scales and the redness heals, the condition hibernates. Pitted keratolysis is a bacterial infection that affects the skin on your feet. Topical corticosteroids-usually not of much benefit. Keratolysis exfoliativa LAST UPDATED: Jul 14, 2021 Introduction Refer to the chapter Peeling skin conditions Disclaimer - the author PCDS cannot accept responsibility for any misleading or incorrect statements, and the management of individual patients remains the direct responsibility of the individual doctor. The disruption and premature separation of corneocytes are responsible for this disease. Exfoliative keratolysis at the fingers base will often take longer to heal due to frequent skin peeling. These lesions burst later to reveal a new layer of skin. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. 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. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. The treatment process in India does not require any surgery or frequent doctor visits. One of the primary signs of the disease starts with bursting blisters, scales that peel and are circular in shape, and areas appear to be cracked and peeled too. It can be treated with an application of coconut oil and keep your hand moist. When your hands are covered in ruptured blisters, the first thing you want to know is the cause of this irritating skin condition. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. It could take between two to three days before you start to feel better. Hand dermatitis can be a very difficult condition to diagnosis due to the numerous conditions that mimic one another when presenting on the hands. Inquire about any history of atopic dermatitis. The example can be best explained by skin asthma. Last modified on March 2021With inputs from Dr.Vedalatha Kakani, General Physician. The skin thickens, hardens into a callus, dries out, and peels off. Dermatologie, U. M. C. G., & Jonkman, M. F. (2013). 2021 Mar;72(3):215-224. doi: 10.1007/s00105-021-04765-w. Epub 2021 Feb 12. HHS Vulnerability Disclosure, Help 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. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. Applying lactic acid hand cream to the skin is one of the more common exfoliative keratolysis treatments. This further hardens and numbs the skin. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Accessibility It is always important to discuss the effect of risk factors with your healthcare provider. 2015 Dec 16;21(12). The condition is typically caused by an overgrowth of bacteria on the skin or by a reaction to a medication. What Is Exfoliative Keratolysis? Just another site The etiology of keratolysis exfoliativa is unknown, but the condition appears to be worsened by heat or sweating. Physical and mental stress can affect the skin sometimes. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. PMC Treatment for Keratolysis Exfoliativa in India doesnt require any major medical processes. Eczema can be painful too unlike the aforementioned which doesnt have accompanying pain. Oakley, A., Exfoliative keratolysis, DermNet New Zealand; How Long Does Exfoliative Keratolysis Last? One common mistake while doing the diagnosis of this disease is, some doctor confuses it with the following diseases. Another reason for skin peeling off is excessive Vitamin A in the body. Athletes foot No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. 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. How to treat keratolysis exfoliativa? 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. 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. The .gov means its official. 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. Prevent the bacteria from returning by changing your shoes and socks when they get wet and wearing shoes with good airflow. Generally, the condition does not require any lab tests to be performed. Cleveland Clinic is a non-profit academic medical center. Antibiotics could include: Clindamycin. Advertising on our site helps support our mission. For example, rubber boots dont offer sufficient airflow. An official website of the United States government. How is keratolysis exfoliativa treated in India? This is likely a common condition that rarely presents to physicians because it is largely asymptomatic. The following may be helpful: Protect the affected area from irritants Although rare, it can also affect the palm of your hand. 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. 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). 143-4. The scaling gradually extends peripherally, leaving an adherent collarette. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. Note that this may not provide an exact translation in all languages, Home A diet rich in Vitamin B may aid in avoiding the condition in India. Exfoliative Keratolysis Treatment Topical steroids are often given exfoliative keratolysis. The condition is recurring causing the skin to harden and become rough. No, pitted keratolysis isnt contagious and cant spread from person to person. pii: 13030/qt6mv338nx. If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. When the blisters present around the palms burst, they cause circular marks leaving cracked skin on fingertips. Pemphigus Exfoliative keratolysis can also be called "focal palmar peeling" or "keratolysis exfoliativa." In generic terms it's known as the "skin peeling disease." Careers. After a long day on your feet, you might notice a foul odor coming from your feet, shoes and socks. Recurrent focal palmar peeling. Psoriasis: Psoriasis is a chronic condition that affects the skin. arrow-right-small-blue Keratolysis exfoliativa codes and concepts. Treat hyperhidrosis if present. Skin peeling on hands is the first thing your general physician may notice before diagnosing you with Keratolysis Exfoliativa. This is your part and enjoy being different. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse.