Fourthly, although unproven, medical researchers believe that extremely hot climate during summer increases episodes of perspiration. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. This further hardens and numbs the skin. Keratolysis exfoliativa also known as focal palmar peeling is a common disorder that is rarely reported and often overlooked as hand eczema. 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. Acral Peeling Skin Syndrome: A Case Report and Literature Review. Any one of these can be applied up to twice daily. How to treat keratolysis exfoliativa? PubMed. Some believe that it is more frequently associated with underlying atopic dermatitis, while others report an association with primary hyperhidrosis. Eczema is also a quite painful condition, whereas exfoliative keratolysis doesnt hurt as much. Lane, J. E. (1919). Disclaimer: Results are not guaranteed*** and may vary from person to person***. The latest research on exfoliative keratolysis suggests that there is a link between corneocytes and exfoliative keratolysis. Keratolysis Exfoliativa in India may arise due to sunburns or infections that directly cause damage to the skin. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. How is keratolysis exfoliativa treated in India? 3.Reasoning: a. 1996 Aug;37(3):1434. 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. Chang YY, van der Velden J, van der Wier G, et al. European Journal of Pediatric Dermatology, 23(2), 125-125. Picture 2: Palm with Exfoliative Keratolysis. Urea is a natural moisturizing factor found in the outer epidermis. pii: 13030/qt6mv338nx. 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. Some effective essential oils include ginger oil, clove oil, myrrh oil, lavender oil, and frankincense oil. Federal government websites often end in .gov or .mil. Pemphigus Ringworms 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). 2012 Nov;167(5):107684. Aloe vera juice is a completely natural moisturizer which can run the extra mile for your skin. Hautarzt. Generally, skin peeling on fingers is a common symptom in Indians. When the weather is so hot, it can cause skin peeling that may eventually lead to lamellar dyshidrosis and to prevent that it is strongly advised to apply lotion in the sensitive prone areas such as the fingers and the feet. Often times, these creams also contain silicone and urea. Acute exfoliative keratolysis: It is a primary stage of skin peeling of hands. The best material to improve airflow to your feet through your socks is cotton. Another reason for skin peeling off is excessive Vitamin A in the body. Additionally, numbing sensations of the skin are marked accompanied by hardening of the skin as well. While eczema and exfoliative keratolysis look very similar, the difference is that exfoliative keratolysis will peel and shed, whereas eczema also produces itchy skin. Ruiz Rivero J, Campos Dominguez M, Parra Blanco V, Surez Fernndez R. Actas Dermosifiliogr. Dermatol Online J. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. American Osteopathic College of Dermatology. Before that, we should know what it really is. The lower body may also see such signs of flaking in the form of skin peeling on legs. 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. Exfoliative keratolysis can also be called "focal palmar peeling" or "keratolysis exfoliativa." In generic terms it's known as the "skin peeling disease." 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. Updated by Dr Oakley, December 2018. When the whole hand and foot peel off it gone for next six months. Lifelong desquamation of the hands and feet. SANGSTER, A. Because of this prevalent condition, the disease is sometimes mistaken for eczema. So, how long does exfoliative keratolysis last? Peeling skin on fingers near nails Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. This is likely a common condition that rarely presents to physicians because it is largely asymptomatic. The site is secure. Exfoliative keratolysis is mostly a seasonal disease. Aggressive moisturization is one of the most important treatments and is often the safest and most effective treatment modality. How often should I apply topical antibiotics to my skin? This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. There has been no conventional drug proven to be effective to heal exfoliative keratolysis. The infection is characterised by craterlike pits on the surface of the feet and toes. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. 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. These peeled areas lack a normal barrier function and may become dry and cracked. The pathologist examines the biopsy under a microscope. Skin peels off the feet and around the fingers is also a common indication of Keratolysis Exfoliativa in India. Usually the condition subsides with the use of an ointment as prescribed by the general physician. 2.ICD-10-CM classification code L08.89 5. Flaky dry skin around the affected area Work or participate in activities where youre outdoors and on your feet for most of the day. vol. Learn how we can help. When it comes to exfoliative keratolysis treatment, although moisturizers help, more advanced skin therapies may be needed to fully relieve symptoms. Keratolysis exfoliativa (dyshidrosis lamellosa sicca): a distinct peeling entity. Keratolysis Exfoliativa may be wrongly diagnosed as any of the following skin peeling off conditions: How can I prevent this condition from returning in the future? We hope youre enjoying the latest clinical news, full-length features, case studies, and more. Persistent itching. J Cutan Dis, 37, 174-175. When it comes to skin conditions, exfoliative keratolysis is, at times, harmless but also sometimes quite painful. 2015 Dec 16;21(12). What Is Exfoliative Keratolysis? In most cases, it starts with the advent of summer and ends when simmer departs. Choosing socks and shoes that fit your feet and arent too tight. A diet rich in Vitamin B may aid in avoiding the condition in India. Synthetic materials or blended materials in socks can restrict airflow to your feet. Avoiding drying agents, allergens, and irritants by wearing gloves. 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. Pitted keratolysis home treatment. Once the scales and the redness heals, the condition hibernates. 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. Once the skin is completely peeled off has healed, normal skin reforms, but Keratolysis Exfoliativa usually recurs in the following weeks. Dry skin flakes blister and slough off, leaving behind . Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. Yes, sometimes skin peel offs may occur due to a deficit or an excess of a few vitamins. Dont apply bleach or apple cider vinegar to your skin to make the odor from pitted keratolysis go away. ), Abdel-Hafez, K, Safer, AM, Selim, MM, Rehak, A. Copyright 2017, 2013 Decision Support in Medicine, LLC. If you suffer from this condition, you will see red plaques on the skin accompanied by skin peeling on feet and other affected areas. Consult Indias top dermatologists online to get suitable skin treatment from the comfort of your home. In other words, treatment can only deal with the symptoms and signs associated with the condition. Youre most at risk of developing pitted keratolysis if you have sweaty feet and wear shoes with limited airflow. Final Thoughts on Exfoliative Keratolysis, https://www.dermnetnz.org/topics/exfoliative-keratolysis/. Lee, YC, Rycroft, RJ, White, IR, McFadden, JP. Therefore, management of exfoliative keratolysis may still be limited, and treatment is quite difficult. A 21-year-old male asked: . 1. A few observable symptoms in India: Bethesda, MD 20894, Web Policies Patients should be aware that this treatment is purely anecdotal and data to support its benefit is lacking. (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. ), (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), (A study that characterizes the clinical characteristics of 108 atopic dermatitis patients with hand-foot dermatitis. 4. No matter how small and trivial an organ is, we should take good care of that. Enjoying our content? However, the cause of the constant skin shedding in exfoliative keratolysis remains a mystery. Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. Keratolysis exfoliativa is a condition that is treatable at home. 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. Australas J Dermatol. It is possible that sweaty palms are to blame, as hyperhidrosis in the palms is more common. This article will detail everything you need to know about exfoliative keratolysis causes, symptoms, treatments, natural home remedies, and tips to prevent the condition. So, we should take care of the skin and look after the affected area gently. Can my diet help in avoiding peeling skin? Another medical approach to treat the disorder is photochemotherapy (PUVA). (A study that characterizes the clinical characteristics of 108 atopic dermatitis patients with hand-foot dermatitis. 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. Acral skin eruption observed during SARS-CoV-2 pandemic: possible keratolysis exfoliativa with red palms and soles. - And More, (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. Unable to load your collection due to an error, Unable to load your delegates due to an error. The formation of numerous skin tags will look like the skin from the hand is peeling. Our body demands special care from us. In this condition, the skin cells multiply consistently at a speed that is faster than normal. Its dangerous to apply at-home remedies to your skin without approval from your healthcare provider. Exfoliative keratolysis is a skin condition that causes the shedding of the top layer of skin. 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. FOIA The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. Keratolysis Exfoliativa isnt a condition that is of grave concern in India. A patient does not feel any pain with dry skin. It is always important to discuss the effect of risk factors with your healthcare provider. 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. Cleveland Clinic is a non-profit academic medical center. Neri, I., Patrizi, A., Gabrielli, L., Virdi, A., Veronesi, G., Corsini, I., & Guglielmo, A. How can you prevent exfoliative keratolysis? Want to talk to an expert regarding your diet? First, lets take a look at how the outer layer of the skin, the epidermis, is involved in the development of exfoliative keratolysis. In most cases the condition subsides on its own. doi: 10.1111/jdv.16881. - Drug Monographs sharing sensitive information, make sure youre on a federal Exfoliative Keratolysis Treatment Picture 2: Palm with Exfoliative Keratolysis The best way to treat the condition is to avoid the causative factors. As you already know there are no fixed reasons behind exfoliative keratolysis. The odor caused by the infection occurs because the bacteria release a stinky sulfur compound. Skin peeling on hands is the first thing your general physician may notice before diagnosing you with Keratolysis Exfoliativa. The peeling off the skin in keratolysis exfoliativa worsens when the peeling skin will be associated with harsh chemical irritants. Though it looks like dry, peeling skin, water makes it worse. 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. Sign Up for the Latest Health News and Tips, Home Skin Care What Is Exfoliative Keratolysis? Superficial Cutaneous Infections and Pyodermas. 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. Blisters that form and split at the base of a finger often have deeper cracks that later make the skin feel numb and hard. Keratolysis Exfoliativa is a common skin condition in India that can be noticed around the palms and soles. If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. 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. Fans and air conditioning equipments are readily available to neutralize the heating process as lengthened periods of treatment tend to get very hot sometimes. The condition causes discomfort in the skin that leads to persistent itching. Keratolytic creams containing urea, lactic acid, ammonium lactate, or salicylic acid have been the most beneficial treatment for the majority of patients. Athletes foot is a contagious fungal infection that causes an itchy rash on your feet. And because of that, the condition is recurrent as the root problem of the disorder isnt directly addressed. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. The skin may swell and become red due to inflammation. 3. The condition is typically caused by an overgrowth of bacteria on the skin or by a reaction to a medication. This can ensure that exfoliative keratolysis will not be exacerbated by secondary infections. Epub 2012 Oct 5. Chang YY, van der Velden J, van der Wier G, Kramer D, Diercks GF, van Geel M, Coenraads PJ, Zeeuwen PL, Jonkman MF. Topical corticosteroids-usually not of much benefit. A deficiency of Niacin, which is one of the B Vitamins, causes the peeling of skin around the hands and legs. Cutaneous T-cell lymphoma Clinical evaluation of atopic hand-foot dermatitis. This process also involves the application of psoralensplant compounds that include trisoralen, 5-methoxypsoralen, and methoxsalen. 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. Changing your shoes and socks when they get wet. 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. 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. 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. Keratolysis Exfoliativa are generally observed in young adults. No worries! (2020). Visit your healthcare provider if your symptoms dont improve after taking antibiotics for one week. Although there has not been any studies to confirm it, it is very rampant around that time of the year. Dermatologists recommend that one maintains good personal hygiene and avoids spending too much time in the sun. It usually comes about in the summer triggered by humid conditions. Keratolysis exfoliativa is a common skin condition which most often affects the palms, but can develop on the soles of the feet. Exfoliative Keratolysis Treatment The ideal treatment is avoiding the risk factors that are its primary causes. Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. We do not endorse non-Cleveland Clinic products or services. DermNet does not provide an online consultation service. They are also advised to take on protective goggles to shield the eyes from being exposed to the harmful radiation. 8600 Rockville Pike Br J Dermatol. 18. Acral skin eruption observed during SARSCoV2 pandemic: possible keratolysis exfoliativa with red palms and soles. The differential diagnosis of keratolysis exfoliativa includes the following entities: 1. The infection caused by wearing tight or restricting footwear and due to excessive sweating. Wearing shoes with good airflow; avoid rubber boots. Stevens-Johnson syndrome 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. It is best to stay away from such irritants. These hollow spaces are actually the peeked areas. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. Treat hyperhidrosis if present. Thirdly, detergents, irritating soaps and sometimes solvents can cultivate exfoliation reactions. doi: 10.1111/j.1365-2133.2012.11175.x. Pitted keratolysis and athletes foot are both conditions that affect your feet. 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. Key Points Common skin condition which often affects the palms Cause is unknown Initially consists of blisters on the palms and/or fingers, which burst causing areas of skin to peel. White patch of skin or a patch thats lighter than your natural skin tone. Avoid certain bathroom products: Stay away from products with substances that may contribute to exfoliative keratolysis, including solvents, antibacterial soaps, and certain fabrics. Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. These lesions burst later to reveal a new layer of skin. Disclaimer. The peeling is not limited to the hands and feet. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis, Tinea manuum (fungal infection of the hand), Avoiding known irritants, chemicals, and friction, where possible, Application of topical agents such as lactic acid or silicone cream. The peroxide solution should be no more than one part hydrogen peroxide to three parts warm water. 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). The condition can be treated at home by taking necessary precautions: The condition requires no medical test and is detected by a well experienced dermatologist. Supportive investigations may be undertaken. 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Keratolysis exfoliativa. Although exfoliative keratolysis is often painless and relatively harmless at times, the appearance of peeled skin may lead to embarrassment and depression. Advertising on our site helps support our mission. 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. This should include protecting the hands from any physical or chemical irritants and encouraging the patient to wear gloves when possible. There are different ways to do the treatment. In case it doesn't, a dermatologist will prescribe keratolysis exfoliativa creams and keratolysis exfoliativa ointments. 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.