Youre most at risk of developing pitted keratolysis if you have sweaty feet and wear shoes with limited airflow. Keratolysis exfoliativa is distinct from the following conditions. Zinia is an SEO specialist born and raised in Bangladesh. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. Usually, a skin test can determine the real disease. It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. After a long day on your feet, you might notice a foul odor coming from your feet, shoes and socks. Chang YY, van der Velden J, van der Wier G, Kramer D, Diercks GF, van Geel M, Coenraads PJ, Zeeuwen PL, Jonkman MF. Youve viewed {{metering-count}} of {{metering-total}} articles this month. Often times, these creams also contain silicone and urea. pii: 13030/qt6mv338nx. Mupirocin. 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. Symptoms of pitted keratolysis affect your feet, specifically the web spaces between your toes and the ball, heel and soles of your foot. A 21-year-old male asked: . 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. Interference with other drugs you take, which prevents the medication from working effectively. A dermatologist may recommend the use of keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Eating different kinds of nuts is good for skin. If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Disclaimer. The difference between the two is that the former only peels and shreds while the latter has an accompanying itchy feeling on the skin. In extreme cases, a doctor may recommend photochemotherapy, which is a combination of Psoralen and Ultraviolet. These lesions burst later to reveal a new layer of skin. Exposure to irritants such as washing powder, soap, detergent etc. European Journal of Pediatric Dermatology, 23(2), 125-125. We hope youre enjoying the latest clinical news, full-length features, case studies, and more. Generally, the condition does not require any lab tests to be performed. Pits can cluster together to form a sore (lesion) that looks like a crater. Exfoliative keratolysis is the medical term of what we have commonly known as skin peeling disease. These ointments and lotions will help reduce the discomfort that causes itching in the skin. MeSH As a result, the skin begins to shred. The condition rarely goes away on its own without treatment from your healthcare provider. Approved by: Krish Tangella MD, MBA, FCAP. The best way to treat the condition is to avoid the causative factors. doi: 10.1111/jdv.16881. British Journal of Dermatology, 167(5), 1076-1084. Generally, skin peeling on fingers is a common symptom in Indians. Pitted keratolysis is a bacterial infection that affects the skin on your feet. Chang YY, van der Velden J, van der Wier G, et al. (A study that characterizes the clinical characteristics of 108 atopic dermatitis patients with hand-foot dermatitis. 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. In some cases, the following steps may be considered: The following DoveMed website link is a useful resource for additional information: https://www.dovemed.com/healthy-living/skin-disorders/, American Academy of Dermatology930 E. Woodfield Road Schaumburg, IL 60173Phone: (866) 503-SKIN (7546)Fax: (847) 240-1859Website: http://www.aad.org, https://dermnetnz.org/topics/keratolysis-exfoliativa/(accessed on 05/20/2021), https://en.wikipedia.org/wiki/Keratolysis_exfoliativa (accessed on 05/20/2021). Cleveland Clinic is a non-profit academic medical center. Contact Dermatitis:Contact Dermatitis is a condition that causes acute inflammation of the skin. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Keratolysis Exfoliativa isnt a condition that is of grave concern in India. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. Exfoliative keratolysis is a skin condition that causes the shedding of the top layer of skin. Ultraviolet radiation treatment is also called photochemotherapy (PUVA), and uses ultraviolet rays to treat exfoliative keratolysis. The usage of lotions that are rich in Salicylic Acid and Lactic Acid may prevent infection Exfoliative keratolysis In most cases the condition subsides on its own. The infection is characterised by craterlike pits on the surface of the feet and toes. These hollow spaces are actually the peeked areas. 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. SANGSTER, A. Exfoliative keratolysis at the fingers base will often take longer to heal due to frequent skin peeling. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. In turn, the loss of strength causes the skin to exfoliate. Exfoliative keratolysis is mostly a seasonal 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. Updated by Dr Oakley, December 2018. 1. It may not be possible to prevent Keratolysis Exfoliativa in many cases. In such cases, the cracked skin on fingertips takes longer to peel off and heal. Keratolysis exfoliativa is a common skin condition which most often affects the palms, but can develop on the soles of the feet. For example, rubber boots dont offer sufficient airflow. Superficial Cutaneous Infections and Pyodermas. If you wish to read unlimited content, please log in or register below. Lee YC, Rycroft RJ, White IR, McFadden JP. Then, the blisters burstand it leaves a hollow and blank space underneath the skin. Dermatologie, U. M. C. G., & Jonkman, M. F. (2013). Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Scarlet fever Exfoliative keratolysis. arrow-right-small-blue How often should I apply topical antibiotics to my skin? A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. No worries! Connect with a U.S. board-certified doctor by text or video anytime, anywhere. The cause of keratolysis exfoliativa is unknown. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. How do I avoid peeling skin? Differential diagnosis. Keratolysis exfoliativa. Mood Disorder: Ect or electroconvulsive therapy is used for the treatment of mood disorders such as severe recalcitrant depression. Exfoliative Keratolysis Treatment The ideal treatment is avoiding the risk factors that are its primary causes. 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. , 1999. Picture 2: Palm with Exfoliative Keratolysis. It may be more common in those with sweaty palms due to localised hyperhidrosis. But, this is not suggested till one can endure the pain. Keratolysis exfoliativa is a condition that is treatable at home. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. Chang, Y. Y., Van der Velden, J., Van der Wier, G., Kramer, D., Diercks, G. F. H., van Geel, M., & Jonkman, M. F. (2012). As a result, the condition will recur since the root of the problem does not get addressed. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. The majority of patients, with only mild disease, can be treated with topical moisturizers or keratolytics and followed up as needed. The skin peeling associated with the condition can affect the palms of the hands, the tips of the fingers, and even the soles of the feet. Sweaty hands are also an aggravating factor. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. KE may also resemble acral peeling skin syndrome and localized epidermolysis bullosa simplex. official website and that any information you provide is encrypted Keratolysis exfoliativa codes and concepts. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. However, they are not generally itchy. Using quality lotions and moisturizers that can prevent infection. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. A beautiful hand with nice and thin fingers can add personality to ones style. 10 Most Common Nail Diseases And Disorders. The differential diagnosis of keratolysis exfoliativa includes the following entities: 1. In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. As there is no known remedy for this disease, one can try the precautions and home remedies to get rid of this problem. While eczema and exfoliative keratolysis look very similar, the difference is that exfoliative keratolysis will peel and shed, whereas eczema also produces itchy skin. As they do so, new skin is born out of the process. 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. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Australas J Dermatol. Skin peeling on hands is the first thing your general physician may notice before diagnosing you with Keratolysis Exfoliativa. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. The first indication of Keratolysis Exfoliativa in Indians is peeling of the skin. No, pitted keratolysis isnt contagious and cant spread from person to person. Epub 2016 May 18. The hands and feet should also always be well cleaned. Firstly, exposure to allergens can cause the condition to develop as it can sometimes be a result of an allergic reaction. There are a number of preventative tips that can help you decrease the risk of exfoliative keratolysis symptoms. PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. Keratolysis exfoliativa. J Cutan Dis, 37, 174-175. Copyright and all rights reserved. What Are These Tiny Red Spots on My Skin (Petechiae)? After you start taking an antibiotic, it will begin working within your body to rid it of bacteria. The skin thickens, hardens into a callus, dries out, and peels off. The formation of numerous skin tags will look like the skin from the hand is peeling. 3. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions in India. The same also occurs when the condition affects the palm or the soles of the feet. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. American Osteopathic College of Dermatology. Once the skin is completely peeled off has healed, normal skin reforms, but Keratolysis Exfoliativa usually recurs in the following weeks. 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: Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. Keratolysis Exfoliativa is usually seen in young Indian adults who are active throughout the day. So, there is actually little room to apply drugs. The condition may be seen around other parts of the body as well. Wende, G. W. (1919). There are some home remedies to get rid of this problem. Often misdiagnosed as psoriasis, eczema, or chronic contact dermatitis, exfoliative keratolysis is more common in children and young adults, in those with sweaty hands, and during the summer months. Intravenous steroids may be given in severe cases, but steroids usage has its own side effects, when used for a long time. After bursting, hand blisters will leave scales that look cracked and reddish. No genetic abnormality has been detected to date (2018). Talk to a doctor now . Peeling skin on fingers near nails Key Takeaway: No advanced study has been carried out about what might be the cause of exfoliative keratolysis. So, we should take care of the skin and look after the affected area gently. The condition arises to allergens or irritants that come in contact with the patient. Acute exfoliative keratolysis: It is a primary stage of skin peeling of hands. Keratolysis exfoliativa (dyshidrosis lamellosa sicca), een aparte peelingentiteit. Keratolysis exfoliativa. Medication side effects The infection caused by wearing tight or restricting footwear and due to excessive sweating. Take Care Of Your Nails At Home: Easy Pro Guide. Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. When the keratin breaks down, the skin loses its strength and begins to shed, or exfoliate. Acral Peeling Skin Syndrome: A Case Report and Literature Review. Your healthcare provider will offer treatment to make the bacteria that cause pits in your feet go away, which will ease your fear. 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. Keratolysis exfoliativa generally presents in young active adults. Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. References Hausauer AK, Cohen DE. Keratolysis exfoliativa also known as focal palmar peeling is a common disorder that is rarely reported and often overlooked as hand eczema. How is keratolysis exfoliativa treated in India? The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. Some believe that it is more frequently associated with underlying atopic dermatitis, while others report an association with primary hyperhidrosis. 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. Visit your healthcare provider if you experience anxiety related to your phobia, as well as symptoms of pitted keratolysis. But, treatment is best during the early episodes. Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand, 1999. Consult Indias top dermatologists online to get suitable skin treatment from the comfort of your home. Disclaimer: Results are not guaranteed*** and may vary from person to person***. A patient does not feel any pain with dry skin. Unauthorized use of these marks is strictly prohibited. 2021 Mar;72(3):215-224. doi: 10.1007/s00105-021-04765-w. Epub 2021 Feb 12. This disorder doesnt respond to any drugs except an oral Soriatane. Psoriasis She is passionate about digital marketing and loves to work with fashion-related niches like nails, hairstyles etc. EK is a strange skin condition that is not eczema or psoriasis. British Journal of Dermatology,7(2), 37-39. Exfoliative Keratolysis Treatment Picture 2: Palm with Exfoliative Keratolysis The best way to treat the condition is to avoid the causative factors. The condition is also accompanied by a few blisters around the palms of the hand. It also involves the use of Psoralens which are compounds found in plants that also includes methoxsalen, 5-methoxypsoralen and trisoralen. And because of that, the condition is recurrent as the root problem of the disorder isnt directly addressed. Pediatr Dermatol. Keratolysis Exfoliativa is the condition of peeling of the skin around the palms and soles. 2020 Dec;34(12):e783-e785. Although effective, PUVA treatment can also have some negative side effects such as: As previously mentioned above, there is no definitive cure for this disorder. keratolysis exfoliativa has no known causes in Indians but the condition is found in young adults who are active throughout the day. Any one of these can be applied up to twice daily. 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. Pitted keratolysis and athletes foot are both conditions that affect your feet. Antibiotics could include: Antiseptics like benzoyl peroxide gel or cream can help clear the infection from your feet. Hyperhidrosis The condition isnt constricted to the skin on the hands and face, one may even notice skin peeling on the face. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. Also, not having a risk factor does not mean that an individual will not get the condition. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. Optimal Therapeutic Approach for this Disease, Unusual Clinical Scenarios to Consider in Patient Management. Though it looks like dry, peeling skin, water makes it worse. In case it doesnt, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. 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. The .gov means its official. Acral skin eruption observed during SARSCoV2 pandemic: possible keratolysis exfoliativa with red palms and soles. Secondly, genetic predisposition may also expose someone to this condition as certain environmental or external factors can trigger the disease to develop. As you already know there are no fixed reasons behind exfoliative keratolysis. A bacterial infection causes pitted keratolysis. Worried about the skin peeling off hands or legs? Jock itch Some effective essential oils include ginger oil, clove oil, myrrh oil, lavender oil, and frankincense oil. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Epub 2020 Sep 10. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. Updated by Dr Oakley, December 2018. Therefore, management of exfoliative keratolysis may still be limited, and treatment is quite difficult. 1. Try to prevent sweating by using topical agents. 102-6. However, after a few months or sometimes even after a few weeks the condition recurs again. The condition requires no medical test and is detected by a well experienced dermatologist. ), Close more info about Keratolysis exfoliativa (Lamellar dyshidrosis, Recurrent focal palmar peeling, Recurrent palmar peeling). One common mistake while doing the diagnosis of this disease is, some doctor confuses it with the following diseases. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. Dermatol Online J. In addition to the above, topical use of emollients that contain urea, silicone and lactic acid is also beneficial in keeping the skins layers healthy because the disease usually attacks the outermost layer of the skin therefore it is best to make sure this is protected. One of the more common forms of treatment for exfoliative keratolysis is the application of a lactic acid-infused hand cream. Keratolysis exfoliativa The peeling off the skin in keratolysis exfoliativa worsens when the peeling skin will be associated with harsh chemical irritants. This approach has been present since 1976 and uses ultraviolet rays to treat the condition. Copyright 2017, 2013 Decision Support in Medicine, LLC. 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. 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. 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. All rights reserved. 23-31. Although rare, it can also affect the palm of your hand. Keratolysis exfoliativa treatment. 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. How can I prevent this condition from returning in the future? Keratolysis exfoliativa is a common skin condition in which there is focal peeling of the palms and less often the soles. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. 2014 Jun;150(6):647-8. doi: 10.1001/jamadermatol.2013.9190. Topical corticosteroids-usually not of much benefit. Usually the condition subsides with the use of an ointment as prescribed by the general physician. Psoralens Another way to treat the condition is the use of PUVB ( this is a mixture of psoralens and short wave ultraviolet radiation). Tenia pedis. Oakley, A., Exfoliative keratolysis, DermNet New Zealand; How Long Does Exfoliative Keratolysis Last? But this method is rarely recommended as psoralen activation works best with UVA. Keratolysis exfoliativa is a common skin condition that causes the palms and soles to peel more intensely than usual. The odor caused by the infection occurs because the bacteria release a stinky sulfur compound. Picture 1: Fingers affected withExfoliative Keratolysis. 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. - And More, (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. Topical psoralen emollients such as gels or lotions are typically applied to the affected areas for 10 minutes before skin is exposed to UVA. Additionally, numbing sensations of the skin are marked accompanied by hardening of the skin as well. 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. When the condition affects the lower body, it causes foot skin peeling. Washing your feet and hands with soap and water when you remove your shoes and socks. The palms of the hands, the tips of the fingers, and soles of the feet are the most often affected areas. In most cases, it starts with the advent of summer and ends when simmer departs. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. Photochemotherapy can be applied if the disease goes beyond control. Neri, I., Patrizi, A., Gabrielli, L., Virdi, A., Veronesi, G., Corsini, I., & Guglielmo, A. This oral Soriatane (Acitretin) has been reported as the only one effective drug that has shown improvementwhen used to treat this disease. 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). Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. 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. This is likely a common condition that rarely presents to physicians because it is largely asymptomatic. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. 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. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. Because of this, the skins ability to heal is compromised. The condition causes a foul odor and itchiness. If you take an antibiotic and dont see an improvement in your symptoms after a week, talk to your healthcare provider. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. 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. Prevent the bacteria from returning by changing your shoes and socks when they get wet and wearing shoes with good airflow. Please enable it to take advantage of the complete set of features! Pitted keratolysis is a bacterial skin infection that causes a foul odor and itchiness. The application of cucumber juice, aloe vera gel, witch hazel, or pineapple juice can also help improve exfoliative keratolysis. Stay away from skin irritants and allergens that may cause peeling of skin Yes, sometimes skin peel offs may occur due to a deficit or an excess of a few vitamins. There are some texts that mention the use of photochemotherapy with hand/foot psoralen and ultraviolet A light (PUVA) for severe cases. Use of topical steroids and cortisone cream and even increased levels of prednisone is also effective in treating the problem. Cutaneous T-cell lymphoma 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. Aloe vera juice is a completely natural moisturizer which can run the extra mile for your skin. (2020). I experience it twice in a year. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. Familial continual skin peeling. The pathologist examines the biopsy under a microscope. The exact cause of exfoliative keratolysis is not known. The etiology of keratolysis exfoliativa is unknown, but the condition appears to be worsened by heat or sweating. No matter how small and trivial an organ is, we should take good care of that. Speak to a dietician on MFine to know how changes in your food can help you address your situation today!
