Generally, the condition does not require any lab tests to be performed. Keratolysis Exfoliativa: Skin Peeling Treatment in India - mfine 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. Dermatologica. Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand, 1999. Seborrheic dermatitis How is keratolysis exfoliativa treated in India? What causes keratolysis exfoliativa in Indians? Unable to load your collection due to an error, Unable to load your delegates due to an error. Keratolysis exfoliativa (Lamellar dyshidrosis, Recurrent focal palmar Unfortunately, what causes exfoliative keratolysis is relatively unknown. The application of cucumber juice, aloe vera gel, witch hazel, or pineapple juice can also help improve exfoliative keratolysis. Although there has not been any studies to confirm it, it is very rampant around that time of the year. How can I prevent this condition from returning in the future? 1996. pp. Acral skin eruption observed during SARSCoV2 pandemic: possible keratolysis exfoliativa with red palms and soles. Most of the time, when a patient walks in for help, the disease has already worsened and has repeatedly recurred. Chiriac, A., & Solovan, C. (2013). A diagnosis of Keratolysis Exfoliativa may involve the following exams and procedures: A differential diagnosis may be necessary to eliminate other conditions that present similar signs and symptoms such as: Many clinical conditions may have similar signs and symptoms. Persistent itching. In case it doesnt, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Any exacerbating factors should be controlled. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. Approved by: Krish Tangella MD, MBA, FCAP. The symptoms are aggravated by exposure to irritants including water, soap, detergents and solvents. The differential diagnosis of keratolysis exfoliativa includes the following entities: 1. Peeling skin on fingers near nails It is thought that for some reason the desmosomes on the corneocytes separate from each other prematurely. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. The following may be helpful: Protection from irritants Emollient hand creams especially those containing urea, lactic acid, or silicone Acitretin Photochemotherapy. and transmitted securely. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. There are no associated systemic implications or complications seen in patients with keratolysis exfoliativa. Thanks for visiting Dermatology Advisor. However, they are not generally itchy. 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. Chang, Y. Y., Van der Velden, J., Van der Wier, G., Kramer, D., Diercks, G. F. H., van Geel, M., & Jonkman, M. F. (2012). For example, rubber boots dont offer sufficient airflow. This situation is linked to destruction of keratin layers in the epidermis resulting to unwarranted skin exfoliation. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks, Hausauer AK, Cohen DE. 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: 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. Exfoliative keratolysis is mostly a seasonal disease. Summer is the period when it attacks. keratolysis exfoliativa home treatment Keratolysis exfoliativa (Concept Id: C0343064) The latter isnt seasonal as well and happens all year round and is also common for people who have skin asthma. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Others may associate it with hyperhidrosis. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. Antibiotics treat the infection to remove the bacteria from your body. Exfoliative Keratolysis: Pictures, Causes, Symptoms, Diagnosis Learn how we can help. 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. Photochemotherapy can be applied if the disease goes beyond control. Stevens-Johnson syndrome So extra attention should be drawn to the sweaty parts of the body. 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. Worldwide, there is no racial or ethnic preference observed, A positive family history of the condition is observed sometimes, Keratolysis Exfoliativa is more common during the warm summers. Red spots arise on the skin that turn into blisters and finally into ulcers. The best material to improve airflow to your feet through your socks is cotton. Cutaneous T-cell lymphoma 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 is usually seen in young Indian adults who are active throughout the day. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. Yes, sometimes skin peel offs may occur due to a deficit or an excess of a few vitamins. Sometimes on the ends of the fingers, the split in the skin is deeper, in which case the skin feels hard and numb and takes longer to peel off. Keratolysis exfoliativa is a condition that is treatable at home. However, this is not generally itchy in contrast to eczema. Dry skin flakes blister and slough off, leaving behind . The skin may swell and become red due to inflammation. Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. Bathwater PUVA in this scenario the patient soaks himself to a bath tub with water mixed with psoralen solution. This is usually repeated 2-3 rows in a week. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. No matter how small and trivial an organ is, we should take good care of that. The odor caused by the infection occurs because the bacteria release a stinky sulfur compound. 102-6. The following factors may have a role to play in its formation and/or exacerbation: The signs and symptoms of Keratolysis Exfoliativa may include: Recurrence of the localized condition is observed within a few weeks. 18. Pitted Keratolysis: What It Is, Causes & Treatment - Cleveland Clinic After a long day on your feet, you might notice a foul odor coming from your feet, shoes and socks. 2023 mfine Pvt Ltd. Getting oneself rehydrated is a good condition as well as well hydrated cells arent easily affected by extremely hot weather conditions. Keratolysis exfoliativa treatment. Picture 2: Palm with Exfoliative Keratolysis. It is its own thing. Reports the frequency of keratolysis exfoliativa in patients with atopic dermatitis. She is passionate about digital marketing and loves to work with fashion-related niches like nails, hairstyles etc. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. 1996 Aug;37(3):1434. A few cases witness skin peeling on face as well. Salt water, sun, and other bacteria can cause skin peeling. A trial of potent (betamethasone dipropionate 0.05% or equivalent) or ultrapotent (clobetasol 0.05% or equivalent) topical corticosteroid applied twice daily for no more than 2 weeks could be attempted; however, these are typically not found to be very beneficial as this disease is characterized by a lack of inflammation. If you notice an odor, along with tiny indentations in the skin on the bottom of your foot, visit your healthcare provider. Exfoliative Keratolysis: Causes Treatment And More It can be treated with an application of coconut oil and keep your hand moist. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. If you have pitted keratolysis, that odor will still be present after you wash your feet and change your socks and shoes. Firstly, exposure to allergens can cause the condition to develop as it can sometimes be a result of an allergic reaction. A beautiful hand with nice and thin fingers can add personality to ones style. 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. Archives of Dermatology and Syphilology, 23(3), 445-471. Note that this may not provide an exact translation in all languages, Home Last modified on March 2021With inputs from Dr.Vedalatha Kakani, General Physician. A deficiency of Niacin, which is one of the B Vitamins, causes the peeling of skin around the hands and legs. Jock itch 2. 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. The peeling off the skin in keratolysis exfoliativa worsens when the peeling skin will be associated with harsh chemical irritants. Lets take a brief look at the possible exfoliative keratolysis causes below: One of the first key exfoliative keratolysis symptoms is air-filled blisters that later peel in a circular pattern, or split and form skin tags. There are some texts that mention the use of photochemotherapy with hand/foot psoralen and ultraviolet A light (PUVA) for severe cases. The site is secure. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Epub 2016 May 18. The best exfoliative keratolysis treatment is to avoid factors that cause the condition, including irritants like soaps, solvents, and detergents. There is no definitive cause for Exfoliative Keratolysis, however, there are a couple of situations that make someone susceptible to accumulating the disease. The first sign of keratolysis exfoliativa is one or more superficial air-filled blisters on the fingers or palms. Sign Up for the Latest Health News and Tips, Home Skin Care What Is Exfoliative Keratolysis? When it comes to the blisters, the former is usually air filled while the latter tend to be fluid filled. I need to mention after peeling it gives me very shiny,healthy and soft hands. References Hausauer AK, Cohen DE. Pemphigus Then, the blisters burstand it leaves a hollow and blank space underneath the skin. Chang YY, van der Velden J, van der Wier G, Kramer D, Diercks GF, van Geel M, Coenraads PJ, Zeeuwen PL, Jonkman MF. 37. Presently, it is not known to occur from genetic factors, even though a family history is occasionally noted. They might ask questions about the type of shoes and socks you wear, especially around the time you noticed your symptoms. Familial continual skin peeling. The condition is diagnosed when your dermatologist notices peeling skin on palms of hands and cracked skin on fingertips. Keratolysis exfoliativa Secrets That You All Need To Know! Usually, a skin test can determine the real disease. Inquire about any history of atopic dermatitis. Keratolysis exfoliativa also known as focal palmar peeling is a common disorder that is rarely reported and often overlooked as hand eczema. 2001. pp. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. Exfoliative keratolysis is such a problem that gives a bad feeling to the beholders of the affected hands. If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Pitted keratolysis is a bacterial infection that affects the skin on your feet. Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. The .gov means its official. The scales are also tender and dry after the skin has peeled off. The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. Normal skin gradually develops as the blisters split and new skin forms. It is also wise to eat a healthy anti-inflammatory diet and maintain proper hygiene by cutting your nails on a regular basis and washing your hands and feet. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. If you take an antibiotic and dont see an improvement in your symptoms after a week, talk to your healthcare provider. If you are struggling with exfoliative keratolysis or another skin condition, visit a dermatologist or a natural health practitioner familiar with skin problems to learn more about the best treatment approaches available for you. The process is usually painless but the underlying skin may get hard and rough because of the recurring condition. Common symptoms that accompany skin peeling are rashes, itching, dryness and other irritants. Acne pitted scar treatment. As there is no known remedy for this disease, one can try the precautions and home remedies to get rid of this problem. Worried about the skin peeling off hands or legs? Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. Australas J Dermatol. Also, be sure to clean your hands to keep bacteria from getting inside the cracks on your hands and fingers. 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. Key Takeaway: Eating a healthy diet can be a good source of natural components which may heal the skin. Recurrent focal palmar peeling. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. - Full-Length Features The pathologist examines the biopsy under a microscope. Exfoliative keratolysis. Psoriasis: Psoriasis is a chronic condition that affects the skin. Ringworms 3.Reasoning: a. Although rare, it can also affect the palm of your hand. If the peeling of skin does not reduce or the condition does not improve, a specialist may recommend using photochemotherapy. Another medical approach to treat the disorder is photochemotherapy (PUVA). 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. Aggressive moisturization is one of the most important treatments and is often the safest and most effective treatment modality. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. Although PUVA can be effective, it can also have various side effects, like itching, burning, eye damage, and skin cancer. 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. PMC Almonds, walnuts, cashew nuts etc. Keratolysis exfoliativa is thought to be a very common condition with limited epidemological data available since it rarely presents itself to physicians because of its asymptomatic nature. Arch Dermatol, 3(202), 11. Enjoying our content? But this method is rarely recommended as psoralen activation works best with UVA. We do not endorse non-Cleveland Clinic products or services. Youve viewed {{metering-count}} of {{metering-total}} articles this month. Patients typically complain of asymptomatic peeling on the palms (and occasionally the soles) that recurs every few weeks. HHS Vulnerability Disclosure, Help Exfoliative Keratolysis - Symptoms, Causes, Treatment, Pictures - Healthh Epub 2012 Oct 5. Wende, G. W. (1919). Tests arent always necessary, as pitted keratolysis has a distinct appearance on your skin, but your healthcare provider might offer tests to rule out similar conditions, which could include: Treatment for pitted keratolysis focuses on removing the bacterial infection from your body. The disruption and premature separation of corneocytes are responsible for this disease. However, there are situations that local approach is utilized. If you wish to read unlimited content, please log in or register below. It most often affects the skin on your feet. Fusidic acid. Still, it will reappear weeks and even months later. , 1999. Though it looks like dry, peeling skin, water makes it worse. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. Speak to a doctor on MFine to know more about its causes and risk factors today! Wearing shoes with good airflow; avoid rubber boots. 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. List of photos, images and pictures ofExfoliative Keratolysis: The health information provided on this web site is for educational purposes only and is not to be used as a substitute for medical advice, diagnosis or treatment. This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. However, the condition is recurrent sometime after the skin returns to normal. Its dangerous to apply at-home remedies to your skin without approval from your healthcare provider. 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. Pits can cluster together to form a sore (lesion) that looks like a crater. Australas J Dermatol. Dermatol Online J. 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. Usually the condition subsides with the use of an ointment as prescribed by the general physician. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. Foot skin peeling 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). The most common types of bacteria that can cause infection include: These types of bacteria grow and thrive in warm and moist conditions, which is why it commonly affects your feet if youre wearing tight socks and shoes with minimal airflow. Wear shoes and/or socks that are too tight (occlusive) and have limited airflow. renowned by other titles, such as Lamellar dyshidrosis, recurrent focal palmar peeling and recurrent palmar peeling, keratolysis exfoliativa afflicts the palms of the hands and tender soles of the feet. Eczema can be painful too unlike the aforementioned which doesnt have accompanying pain. Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Dermatologists recommend that one maintains good personal hygiene and avoids spending too much time in the sun. 2.ICD-10-CM classification code L08.89 5. When keratin breaks down, it impairs the skins strength and elasticity. Washing your feet and hands with soap and water when you remove your shoes and socks. - Evidence-Based Guidance Lets take a deeper look at some of the other exfoliative keratolysis treatments available. are preferable. Acral skin eruption observed during SARS-CoV-2 pandemic: possible keratolysis exfoliativa with red palms and soles. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. This method has been used by Egyptians thousands of years ago to treat severe integumentary disorders. | Find, read and cite all the research you . 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. Aloe vera juice is a completely natural moisturizer which can run the extra mile for your skin. Using quality lotions and moisturizers that can prevent infection. 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. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. Pitted Keratolysis and its treatment in Homoeopathy:case Report Acute exfoliative keratolysis: It is a primary stage of skin peeling of hands. Treat hyperhidrosis if present. Coconut oil is the best natural moisturizer due to its antimicrobial, antifungal, and antibacterial properties that may speed healing and soothe the skin. Psychiatry 27 years experience. As now we know that exfoliative keratolysis is not sever or dangerous. 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. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Keratolysis Exfoliativa may be wrongly diagnosed as any of the following skin peeling off conditions: Staph infections keratolysis exfoliativa has no known causes in Indians but the condition is found in young adults who are active throughout the day. If the skins of the palms and the soles start to peel off, thats the first sign of exfoliative keratolysis. Exfoliative keratolysis Your healthcare provider will diagnose pitted keratolysis after reviewing your complete medical history and performing a physical exam to learn more about your symptoms. Keratolysis Exfoliativa: Description of a Case Report If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. Proper hand hygiene: Maintain hygiene with frequent cutting of your toenails and fingernails. When the condition affects the lower body, it causes foot skin peeling. Recent histopathologic and molecular studies have linked KE to premature corneo-desmosomal disruption. Exfoliative keratolysis is a skin condition that causes the shedding of the top layer of skin. 24/7 visits - just $44! PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. The peroxide solution should be no more than one part hydrogen peroxide to three parts warm water. And, a less confirmed theory says that this is somewhat related to the genetic inheritance. Meaning, the signs are symptoms are treated but the underlying cause is not addressed. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. The best way to treat the condition is to avoid the causative factors. Exfoliative Keratolysis: Causes Symptoms And Treatment Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream.