Peeling skin syndrome (PSS), or keratolysis exfoliativa congenita, is an unusual autosomal recessive disease characterized by life-long, spontaneous superficial peeling of the skin that may be persistent or periodic.104-106 The Nikolsky sign tends to be positive. Keratolysis exfoliativa is a straightforward diagnosis; for any unusual clinical presentations, the correct diagnosis should be questioned. b. Ultraviolet radiation treatment is also called photochemotherapy (PUVA), and uses ultraviolet rays to treat exfoliative keratolysis. Flaky dry skin around the affected area Another cause of the skin peeling is sweating in your shoes. Keratolysis exfoliativa is a common skin condition which most often affects the palms, but can develop on the soles of the feet. Hautarzt. Your socks can play a role in how much air gets to your feet too. Peeling skin can be a menace to treat in India. The example can be best explained by skin asthma. Because of this, the skins ability to heal is compromised. Secondly, genetic predisposition may also expose someone to this condition as certain environmental or external factors can trigger the disease to develop. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. But this method is rarely recommended as psoralen activation works best with UVA. Copyright 2017, 2013 Decision Support in Medicine, LLC. The infection caused by wearing tight or restricting footwear and due to excessive sweating. 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. Skin shedding (keratolysis exfoliativa congenita): report of a case. The majority of patients, with only mild disease, can be treated with topical moisturizers or keratolytics and followed up as needed. The procedure runs from a minimum of one minute to a maximum of 30 minutes depending on the patients tolerance. Using quality lotions and moisturizers that can prevent infection. Dermatologica. For this procedure, the patient is contained in a cabinet consisting 24 UVA fluorescent bulbs. Some individuals have a family history of the disorder. So, we should take care of the skin and look after the affected area gently. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. First, lets take a look at how the outer layer of the skin, the epidermis, is involved in the development of exfoliative keratolysis. Keratolysis exfoliativa. Journal of the European Academy of Dermatology and Venereology. Lane, J. E. (1919). Careers. The epidermis is made of several layers of keratina protein necessary for skin strength and flexibility. Can my diet help in avoiding peeling skin? After you start taking an antibiotic, it will begin working within your body to rid it of bacteria. 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). A few cases witness skin peeling on face as well. When this is the case, it is best to consult your doctor for exfoliative keratolysis treatment. PDF | An 8 year-old boy, previously healthy, presented on the emergency department, during the summer, with air-filled blisters on the volar aspect of. are preferable. Getting oneself rehydrated is a good condition as well as well hydrated cells arent easily affected by extremely hot weather conditions. 2001. pp. 8600 Rockville Pike A patient does not feel any pain with dry skin. It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. 1983. pp. There are also forms of exfoliative keratolysis natural treatment that may help relieve the condition. There are different ways to do the treatment. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Aloe vera juice is a completely natural moisturizer which can run the extra mile for your skin. Psychiatry 27 years experience. Fourthly, although unproven, medical researchers believe that extremely hot climate during summer increases episodes of perspiration. There has been no conventional drug proven to be effective to heal exfoliative keratolysis. Want to talk to an expert regarding your diet? Wende, G. W. (1919). 1. Recurrent focal palmar peeling. When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. Visit your healthcare provider if you experience anxiety related to your phobia, as well as symptoms of pitted keratolysis. Exfoliative keratolysis is such a problem that gives a bad feeling to the beholders of the affected hands. Choosing socks and shoes that fit your feet and arent too tight. 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. Unauthorized use of these marks is strictly prohibited. How to treat keratolysis exfoliativa? On the other hand, a skin that is prone to peel off can make your hands look ugly and dirty. J. Cutan. No worries! Though it looks like dry, peeling skin, water makes it worse. Updated by Dr Oakley, December 2018. I need to mention after peeling it gives me very shiny,healthy and soft hands. The condition is typically caused by an overgrowth of bacteria on the skin or by a reaction to a medication. After bursting, hand blisters will leave scales that look cracked and reddish. 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. (1895). 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. 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. No matter how small and trivial an organ is, we should take good care of that. Summer is the period when it attacks. The condition can be treated at home by taking necessary precautions: And because of that, the condition is recurrent as the root problem of the disorder isnt directly addressed. Applying lactic acid hand cream to the skin is one of the more common exfoliative keratolysis treatments. 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. As a result, the disorder is already difficult to treat. The first sign of this condition is constant discomfort on the skin that provokes itching. Most patients deny any itching, but may rarely complain of slight tenderness. Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. Disclaimer: Results are not guaranteed*** and may vary from person to person***. An official website of the United States government. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. Microscopy reveals cleavage within the outside horny layer of skin, the stratum corneum. Synthetic materials or blended materials in socks can restrict airflow to your feet. 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. Learn how we can help. 2. This is your part and enjoy being different. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. Talk to a doctor now . Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 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. Bookshelf Protection from irritants, wear gloves, good moisturization. Clinical evaluation of atopic hand-foot dermatitis. - And More, (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. Once the scales and the redness heals, the condition hibernates. Non-Hodgkins lymphoma Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. This approach has been present since 1976 and uses ultraviolet rays to treat the condition. Exfoliative keratolysis is a skin condition where there is frequent focal skin peeling on the palms of the hands, the surface of the fingers, and, less often, on the soles of the feet. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. If you wish to read unlimited content, please log in or register below. Treatment for exfoliative keratolysis typically involves the use of antibiotics or antifungal medications. Keratolysis exfoliativa and the mosaic fungus. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. Home remedies or preventions are more effective with respect to this problem. Normal skin gradually develops as the blisters split and new skin forms. Note that this may not provide an exact translation in all languages, Home Keratolysis exfoliativa codes and concepts. 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. PMC 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. Washing your feet and hands with soap and water when you remove your shoes and socks. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. Seborrheic dermatitis 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. These hollow spaces are actually the peeked areas. While Indian home remedies may give fruitful results, some cases are too severe to be treated with these remedies. 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: Exfoliative Keratolysis Treatment Picture 2: Palm with Exfoliative Keratolysis The best way to treat the condition is to avoid the causative factors. There may be an association with underlying atopic dermatitis, thus one may also see a combination of asthma and allergies more frequently. The scaling gradually extends peripherally, leaving an adherent collarette. Athletes foot This problem is more prevalent in younger age groups. Another sign of the condition is the appearance of skin tags. Bethesda, MD 20894, Web Policies Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. It is also known as Focal Palmar Peeling and is typically observed in young adults, The cause of the condition is generally unknown, but it may be aggravated by contact with irritants, such as chemicals and solvents, and is more common in summers. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. This should include protecting the hands from any physical or chemical irritants and encouraging the patient to wear gloves when possible. Disclaimer. She is passionate about digital marketing and loves to work with fashion-related niches like nails, hairstyles etc. 2. Recent histopathologic and molecular studies have linked KE to premature corneo-desmosomal disruption. 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. Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. These ointments and lotions will help reduce the discomfort that causes itching in the skin. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. But, this is not suggested till one can endure the pain. Pits or tiny indentations in the patch of skin that look like small holes. The infection is characterised by craterlike pits on the surface of the feet and toes. No advanced study has been carried out about what might be the cause of exfoliative keratolysis. These peeled areas lack a normal barrier function and may become dry and cracked. Keratolysis exfoliativa (dyshidrosis lamellosa sicca), een aparte peelingentiteit. 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. 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). Exfoliative Keratolysis Treatment Topical steroids are often given exfoliative keratolysis. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. Exfoliative keratolysis Keratolysis exfoliativa also known as focal palmar peeling is a common disorder that is rarely reported and often overlooked as hand eczema. Split Fingernails: Symptoms, Causes & Remedies. 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. 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). Normally, its not painful but swelling blisters or inflamed layer of skins can cause pain to the body. Maintaining good personal hygiene and avoiding overexposure to the sun. 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. It is possible that sweaty palms are to blame, as hyperhidrosis in the palms is more common. Some Observations on Keratolysis Exfoliativa. References Hausauer AK, Cohen DE. It can be treated with an application of coconut oil and keep your hand moist. Contact Dermatitis:Contact Dermatitis is a condition that causes acute inflammation of the skin. Eating a healthy diet can be a good source of natural components which may heal the skin. Treatments are mainly anecdotal and may or may not lead to improvement. However, they are not generally itchy. They are also advised to take on protective goggles to shield the eyes from being exposed to the harmful radiation. Also, not having a risk factor does not mean that an individual will not get the condition. Kawasaki disease As you already know there are no fixed reasons behind exfoliative keratolysis. Federal government websites often end in .gov or .mil. Patients should be aware that this treatment is purely anecdotal and data to support its benefit is lacking. She spends her free time reading books and watching TV series. Having said all that, we want to enumerate some risk factors that intrigue this disease. Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. Because of this prevalent condition, the disease is sometimes mistaken for eczema. Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand, 1999. 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. Youre most at risk of developing pitted keratolysis if you have sweaty feet and wear shoes with limited airflow. Latest News Your top articles for Saturday, Continuing Medical Education (CME/CE) Courses. Firstly, exposure to allergens can cause the condition to develop as it can sometimes be a result of an allergic reaction. Sometimes, it lasts for only a few weeks and sometimes a number of months pass by without any relief. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. There is no definitive cure for exfoliative keratolysis. Cleveland Clinic is a non-profit academic medical center. Epub 2012 Oct 5. 1.clinical diagnosis- Pitted keratolysis. SANGSTER, A. Treatment for Keratolysis Exfoliativa in India doesnt require any major medical processes. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. Supportive investigations may be undertaken. doi: 10.1111/j.1365-2133.2012.11175.x. What causes keratolysis exfoliativa in Indians? Lee YC, Rycroft RJ, White IR, McFadden JP. 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 known as Focal Palmar Peeling and is typically observed in young adults If possible, use drugs which can reduce sweating excessively. This site needs JavaScript to work properly. There can be multiple layers of peeling skin (lamellae). It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. Thus, the skin peels off and sometimes cause pain too. The treatment process in India does not require any surgery or frequent doctor visits. 2023 mfine Pvt Ltd. But, treatment is best during the early episodes. Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. How is keratolysis exfoliativa treated in India? Pitted keratolysis can affect anyone who has feet but its most common among men and people assigned male at birth (AMAB). All rights reserved. (I am still searching tha Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. Is the reason for your skin peeling keratolysis exfoliativa Speak to a doctor on MFine and find out how to tackle it! Epub 2020 Sep 10. 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. Enjoying our content? MacKee, G. M., & Lewis, G. M. (1931). Antibiotics treat the infection to remove the bacteria from your body.