The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. If you have any concerns with your skin or its treatment, see a dermatologist for advice. ), Close more info about Keratolysis exfoliativa (Lamellar dyshidrosis, Recurrent focal palmar peeling, Recurrent palmar peeling). In some cases, the blisters leave a deeper split in the skin that makes the skin around the fingers hard and numb. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. After the soak, you can use a pumice stone to remove dry skin from your feet. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. It may not be possible to prevent Keratolysis Exfoliativa in many cases. Microscopy reveals cleavage within the outside horny layer of skin, the stratum corneum. (Provides a description of the microscopic pattern of splitting seen in keratolysis exfoliativa and contrasts these finding with that of familial continual peeling of the skin), Lee, HJ, Ha, SJ, Ahn, WK, Kim, D, Park, YM, Byun, DG. Peeling skin on fingers near nails British Journal of Dermatology, 167(5), 1076-1084. 102-6. Pits or tiny indentations in the patch of skin that look like small holes. There is no definitive cure for exfolaitive keratolysis; however, the right treatments can help control symptoms of the condition, such as lactic acid application, ultraviolet radiation treatment, or home remedies like certain essential oils or a coconut oil moisturizer. The condition can be treated at home by taking necessary precautions: official website and that any information you provide is encrypted It is its own thing. There are some home remedies to get rid of this problem. Just another site JAMA Dermatol. The first sign of keratolysis exfoliativa is one or more superficial air-filled blisters on the fingers or palms. Fusidic acid. Picture 2: Palm with Exfoliative Keratolysis. 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. Any exacerbating factors should be controlled. So, how long does exfoliative keratolysis last? The usage of lotions that are rich in Salicylic Acid and Lactic Acid may prevent infection Topical corticosteroids-usually not of much benefit. Proper hand hygiene: Maintain hygiene with frequent cutting of your toenails and fingernails. If you notice an odor, along with tiny indentations in the skin on the bottom of your foot, visit your healthcare provider. The condition may also be a sign of immune system disorders. In addition to the lactic acid content, hand creams used to treat the condition oftentimes also contain urea and silicone as well.. Hausauer, A. K., & Cohen, D. E. (2015). Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand, 1999. Urea is a natural moisturizing factor found in the outer epidermis. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. Do the antibiotics interfere with any of the medications I currently take? , 1999. As they do so, new skin is born out of the process. Washing your feet and hands with soap and water when you remove your shoes and socks. 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. Last reviewed by a Cleveland Clinic medical professional on 06/17/2022. Make sure to clean hands to prevent bacteria from spreading and developing as it penetrates inside the open skin and worsesn the situation. If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. 23-31. Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. doi: 10.1111/jdv.16881. 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. When the keratin breaks down, the skin loses its strength and begins to shed, or exfoliate. Federal government websites often end in .gov or .mil. Please login or register first to view this content. The best way to treat the condition is to avoid the causative factors. Background: Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, is a palmoplantar dermatosis characterized by air-filled blisters and collarette desquamation. The peeling off the skin in keratolysis exfoliativa worsens when the peeling skin will be associated with harsh chemical irritants. Psychiatry 27 years experience. When your hands are covered in ruptured blisters, the first thing you want to know is the cause of this irritating skin condition. Most patients deny any itching, but may rarely complain of slight tenderness. No matter how small and trivial an organ is, we should take good care of that. Wende, G. W. (1919). Your socks can play a role in how much air gets to your feet too. What Is Exfoliative Keratolysis? Keratolysis exfoliativa generally presents in young active adults. What Are These Tiny Red Spots on My Skin (Petechiae)? Picture 1: Fingers affected withExfoliative Keratolysis. The most affected areas of the body are usually the fingers and the soles. There has been no conventional drug proven to be effective to heal exfoliative keratolysis. Dont miss out on todays top content on Dermatology Advisor. Use this soak for a few minutes. Inquire about any history of atopic dermatitis. 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. Epub 2020 Sep 10. Disclaimer. vol. HHS Vulnerability Disclosure, Help It is distinct from other diseases of volar skin, such as dyshidrosis, contact dermatitis, tinea, epidermolysis bullosa, and acral skin peeling. If you have pitted keratolysis, that odor will still be present after you wash your feet and change your socks and shoes. But this method is rarely recommended as psoralen activation works best with UVA. In extreme cases, a doctor may recommend photochemotherapy, which is a combination of Psoralen and Ultraviolet. Dermatology Made Easybook. Exfoliative keratolysis. Dry skin DermNet does not provide an online consultation service. The epidermis is made up of several layers of keratin, a type of protein which helps the skin to remain flexible, strong and waterproof. References Hausauer AK, Cohen DE. Keratolytic creams containing urea, lactic acid, ammonium lactate or salicyclic acid. This is your part and enjoy being different. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Antibiotics treat the infection to remove the bacteria from your body. Exfoliative keratolysis treatment is available; however, the treatment is more of a palliative solution. Once the scales and the redness heals, the condition hibernates. Another cause of the skin peeling is sweating in your shoes. This is likely a common condition that rarely presents to physicians because it is largely asymptomatic. It is also known as Focal Palmar Peeling and is typically observed in young adults 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. Educating the patient on the benign nature of this condition is imperative, as often the patient merely wants a diagnosis and does not desire any further treatment. Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. This situation is linked to destruction of keratin layers in the epidermis resulting to unwarranted skin exfoliation. Dont apply bleach or apple cider vinegar to your skin to make the odor from pitted keratolysis go away. 2001. pp. J. Cutan. Lee YC, Rycroft RJ, White IR, McFadden JP. Arch Dermatol, 3(202), 11. How can I prevent this condition from returning in the future? 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. These hollow spaces are actually the peeked areas. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. Familial continual skin peeling. It is possible that sweaty palms are to blame, as hyperhidrosis in the palms is more common. 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). 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. However, the cause of the constant skin shedding in exfoliative keratolysis remains a mystery. Pitted keratolysis is a bacterial infection that affects the skin on your feet. keratolysis exfoliativa has no known causes in Indians but the condition is found in young adults who are active throughout the day. Having said all that, we want to enumerate some risk factors that intrigue this disease. MeSH Pitted keratolysis and athletes foot are both conditions that affect your feet. After you start taking an antibiotic, it will begin working within your body to rid it of bacteria. Pediatr Dermatol. We hope youre enjoying the latest clinical news, full-length features, case studies, and more. Supportive investigations may be undertaken. If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Non-Hodgkins lymphoma Copyright and all rights reserved. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. The latter isnt seasonal as well and happens all year round and is also common for people who have skin asthma. In such cases, the cracked skin on fingertips takes longer to peel off and heal. Keratolysis exfoliativa is diagnosed clinically. 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. The symptoms are aggravated by exposure to irritants including water, soap, detergents and solvents. If the peeling of skin does not reduce or the condition does not improve, a specialist may recommend using photochemotherapy. Recurrent focal palmar peeling. When keratin breaks down, it impairs the skins strength and elasticity. It usually comes about in the summer triggered by humid conditions. An official website of the United States government. MacKee, G. M., & Lewis, G. M. (1931). FOIA Stevens-Johnson syndrome 24/7 visits - just $44! This is common among fishermen but no significant evidence has been correlated to this incident. Clinical evaluation of atopic hand-foot dermatitis. 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. In most cases the condition subsides on its own. 2. There can be multiple layers of peeling skin (lamellae). In case it doesn't, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. Keratolysis exfoliativa does not improve with topical steroids, unlike hand dermatitis. Exfoliative keratolysis will hibernate beneath the skin once the redness and scales have healed. How long does Exfoliative Keratolysis last? Keratolysis Exfoliativa is usually seen in young Indian adults who are active throughout the day. There are also forms of exfoliative keratolysis natural treatment that may help relieve the condition. White patch of skin or a patch thats lighter than your natural skin tone. Keratolysis exfoliativa. Contact dermatitis 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. It can be treated with an application of coconut oil and keep your hand moist. Keratolysis exfoliativa (dyshidrosis lamellosa sicca), een aparte peelingentiteit. It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. 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 infection is characterised by craterlike pits on the surface of the feet and toes. Keratolysis Exfoliativa are generally observed in young adults. Dr. Heidi Fowler answered. SANGSTER, A. The condition causes a foul odor and itchiness. Pemphigus Your body isnt able to stop future infections (. Treating Exfoliative Keratolysis at Home Keratolysis can be treated at home if it is in the nascent stages. Jock itch Usually the condition subsides with the use of an ointment as prescribed by the general physician. Thus, the skin peels off and sometimes cause pain too. Chiriac, A., & Solovan, C. (2013). Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Blisters that form and split at the base of a finger often have deeper cracks that later make the skin feel numb and hard. Registration is free. When the condition affects the lower body, it causes foot skin peeling. Exfoliative keratolysis treatment. Before that, we should know what it really is. Differential diagnosis. PubMed. As use of PUVA can be costly sometimes, some dermatologists recommend exposure to sunlight as it is safer compared to methoxsalen. At the same time, several factors can lead to the skin peeling associated with exfoliative keratolysis. 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. 18. 1996 Aug;37(3):1434. Some individuals have a family history of the disorder. Exfoliative Keratolysis Treatment The ideal treatment is avoiding the risk factors that are its primary causes. 4. Almonds, walnuts, cashew nuts etc. Aloe vera juice is a completely natural moisturizer which can run the extra mile for your skin. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. 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. 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. fix microsoft teams not displaying images and gifs. There are different ways to do the treatment. Keratolysis Exfoliativa in India may arise due to sunburns or infections that directly cause damage to the skin. So, we should take care of the skin and look after the affected area gently. Cutaneous T-cell lymphoma Treat hyperhidrosis if present. Protection from irritants, wear gloves, good moisturization. The best material to improve airflow to your feet through your socks is cotton. Skin peels off the feet and around the fingers is also a common indication of Keratolysis Exfoliativa in India. 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. Pompholyx or dyshidrotic eczema (differentiated by its chronic nature, associated pruritus, fissures, and lichenification seen on examination), 2. It most commonly occurs in young adults and is typically worse in the summer months or with warm weather. It can activate the condition or worsen it if one is already afflicted by it. To enhance improvement, add a few drops of anti-inflammatory essential oils to the hand bath. DermNet provides Google Translate, a free machine translation service. So, you can say it lasts during the summer. Exfoliative keratolysis. In many cases, Keratolysis Exfoliativa may not require any treatment; the condition is also known to spontaneously resolve in a majority of individuals. Hautarzt. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. Home remedies or preventions are more effective with respect to this problem. Allergic contact dermatitis (differentiated by its pruritic nature, response to topical steroids, inflammatory appearance with erythema on exam, and a possible exposure history), 4. Though it looks like dry, peeling skin, water makes it worse. 1996. pp. 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. 1. Erythromycin. Epub 2012 Oct 5. The condition causes discomfort in the skin that leads to persistent itching. 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. Exfoliative keratolysis This painful or harmless skin problem also goes by names such as keratolysis exfoliativa, lamellar dyshidrosis, dyshidrosis lamellosa sicca, and recurrent palmar peeling. Usually, a skin test can determine the real disease. 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. Topics AZ Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. Pits can cluster together to form a sore (lesion) that looks like a crater. Some effective essential oils include ginger oil, clove oil, myrrh oil, lavender oil, and frankincense oil. Natural moisturizers: Since dry skin is both a symptom and cause of exfoliative keratolysis, it is important to moisturize the affected skin at least twice each day. Prevent the bacteria from returning by changing your shoes and socks when they get wet and wearing shoes with good airflow. She spends her free time reading books and watching TV series. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. | Find, read and cite all the research you . Exfoliative keratolysis is such a problem that gives a bad feeling to the beholders of the affected hands. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. Once the skin is completely peeled off has healed, normal skin reforms, but Keratolysis Exfoliativa usually recurs in the following weeks. Copyright 2017, 2013 Decision Support in Medicine, LLC. Lee, YC, Rycroft, RJ, White, IR, McFadden, JP. In other words, treatment can only deal with the symptoms and signs associated with the condition. - Full-Length Features Scarlet fever A person suffering from exfoliative keratolysis could experience sores and peeling skin; skin peeling occurs gradually over time resulting in formation of very dry and itchy skin. The peeling is not limited to the hands and feet. Using quality lotions and moisturizers that can prevent infection. Its dangerous to apply at-home remedies to your skin without approval from your healthcare provider. It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. 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. Although rare, it can also affect the palm of your hand. Staph infections Please remove adblock to help us create the best medical content found on the Internet. There are a number of preventative tips that can help you decrease the risk of exfoliative keratolysis symptoms. KE may also resemble acral peeling skin syndrome and localized epidermolysis bullosa simplex. Although PUVA can be effective, it can also have various side effects, like itching, burning, eye damage, and skin cancer. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. You can reduce your risk of pitted keratolysis by: Pitted keratolysis causes your feet to smell bad. 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. In most cases, it starts with the advent of summer and ends when simmer departs. 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, 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. Key Takeaway: How often should I apply topical antibiotics to my skin? European Journal of Pediatric Dermatology, 23(2), 125-125. Recurrent focal palmar peeling. Lee HJ, Ha SJ, Ahn WK, Kim D, Park YM, Byun DG, Kim JW Pediatr Dermatol 2001 Mar-Apr;18 (2):102-6. doi: 10.1046/j.1525-1470.2001.018002102.x. The skin thickens, hardens into a callus, dries out, and peels off. Unable to load your collection due to an error, Unable to load your delegates due to an error. Last modified on March 2021With inputs from Dr.Vedalatha Kakani, General Physician. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. Split Fingernails (Onychoschizia): Symptoms, Causes & Remedies, Beaus Lines 101: Causes, Treatments & Whos At Risk, Black Spot on Toenails: Symptoms, Causes & Treatments, 11 Practical Ways to Stop Biting Your Nails, Subungual Melanoma Addressing All Your Concerns, White Superficial Onychomycosis: Types, Symptoms, Causes & Treatment, 22 Vacation Nail Designs for Your Next Getaway, Black & Gold Nail Designs: 51 Fabulous Ways To Rockem, 18 Best Tropical Nail Designs Try These Trends, 33 Stylish Patriotic Nail Designs to Celebrate, 21 Trendiest Red and Silver Nail Designs for 2023, 35 Trendy Ways to Wear Navy Blue Nails in 2023, How To Use Cuticle Remover Tool: Step-by-Step Guide.