Skin shedding (keratolysis exfoliativa congenita): report of a case. Epub 2016 May 18. The following may be helpful: Protect the affected area from irritants Approved by: Krish Tangella MD, MBA, FCAP. The peeled skin from the fingers and fingertips is often harder due to constant peeling before healing takes place. Exfoliative Keratolysis often called keratolysis exfoliativa or focal palmar peeling is an integumentary disease wherein peeling of the skin occurs, it usually affects the distal parts of the fingers and the palmar toes. Wearing shoes with good airflow; avoid rubber boots. 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. Usually the condition subsides with the use of an ointment as prescribed by the general physician. In addition, the patient is advised to wear minimal clothing sometimes just underwear so the body can be openly exposed. 37. Keratolysis exfoliativa and the mosaic fungus. The diagnosis of keratolysis exfoliativa is made based on history and clinical examination. No, pitted keratolysis isnt contagious and cant spread from person to person. Antibiotics treat the infection to remove the bacteria from your body. Although rare, it can also affect the palm of your hand. Seborrheic dermatitis Exfoliative keratolysis. However, the cause of the constant skin shedding in exfoliative keratolysis remains a mystery. 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. Epub 2020 Sep 10. When the whole hand and foot peel off it gone for next six months. Physical and mental stress can affect the skin sometimes. 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. This should include protecting the hands from any physical or chemical irritants and encouraging the patient to wear gloves when possible. Archives of Dermatology and Syphilology, 23(3), 445-471. And, a less confirmed theory says that this is somewhat related to the genetic inheritance. Youre most at risk if you have sweaty feet and wear shoes that dont offer adequate airflow. It is possible that sweaty palms are to blame, as hyperhidrosis in the palms is more common. 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. The condition rarely goes away on its own without treatment from your healthcare provider. Symptoms of pitted keratolysis affect your feet, specifically the web spaces between your toes and the ball, heel and soles of your foot. Enjoying our content? Generally, the condition does not require any lab tests to be performed. Erythromycin. Worried about the skin peeling off hands or legs? Acne pitted scar treatment. The Licensed Content is the property of and copyrighted by DSM. Exfoliative keratolysis is the medical term of what we have commonly known as skin peeling disease. The cause of development of Keratolysis Exfoliativa is currently unknown. As you already know there are no fixed reasons behind exfoliative keratolysis. Your healthcare provider will prescribe topical antibiotics that you rub on your skin like a lotion. For this procedure, the patient is contained in a cabinet consisting 24 UVA fluorescent bulbs. 2016 Oct;107(8):702-4. doi: 10.1016/j.ad.2016.03.006. 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. In some cases, the blisters leave a deeper split in the skin that makes the skin around the fingers hard and numb. Some risk factors are more important than others. We do not endorse non-Cleveland Clinic products or services. Keratolysis exfoliativa is a innocuous but bothersome skin status in which the slim epidermis of the skin flakes, blisters and peels off. Br J Dermatol. 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. Please enable it to take advantage of the complete set of features! The difference between the two is that the former only peels and shreds while the latter has an accompanying itchy feeling on the skin. vol. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. Dermatologie, U. M. C. G., & Jonkman, M. F. (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. and transmitted securely. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. As there is no known remedy for this disease, one can try the precautions and home remedies to get rid of this problem. The first sign of this condition is constant discomfort on the skin that provokes itching. For example, avoiding irritants such as soap, detergents and solvents can really prevent the condition from recurring again. 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. There are some texts that mention the use of photochemotherapy with hand/foot psoralen and ultraviolet A light (PUVA) for severe cases. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. How do I avoid peeling skin? Avoid certain bathroom products: Stay away from products with substances that may contribute to exfoliative keratolysis, including solvents, antibacterial soaps, and certain fabrics. 5.3k views Answered >2 years ago. 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. vol. Eating different kinds of nuts is good for skin. 100 Jaar Leerstoel Dermatologie Rijksuniversiteit te Groningen. 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. Exfoliative keratolysis is mostly a seasonal disease. This site needs JavaScript to work properly. 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. 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. 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. Once the skin is completely peeled off has healed, normal skin reforms, but Keratolysis Exfoliativa usually recurs in the following weeks. 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. Zinia is an SEO specialist born and raised in Bangladesh. If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. If the patients condition worsens or becomes symptomatic, then the diagnosis should be questioned and it may be important to review the differential diagnosis and re-evaluate the patient to rule out other etiologies. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). After the soak, you can use a pumice stone to remove dry skin from your feet. 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. #1 Protect from Irritants. Treatments are mainly anecdotal and may or may not lead to improvement. Picture 2: Palm with Exfoliative Keratolysis. Psychiatry 27 years experience. Neri I, Patrizi A, Gabrielli L, Virdi A, Veronesi G, Corsini I, Lazzarotto T, Lanari M, Misciali C, Guglielmo A. J Eur Acad Dermatol Venereol. However, exfoliative keratolysis will recur several weeks after skin appears to return to normal. Also, not having a risk factor does not mean that an individual will not get the condition. Initially, it doesnt cause any pain or abnormality but gradually some air-filledblisters take over the skin of palms and/or soles. Generally, skin peeling on fingers is a common symptom in Indians. Bethesda, MD 20894, Web Policies Lifelong desquamation of the hands and feet. In extreme cases, a doctor may recommend photochemotherapy, which is a combination of Psoralen and Ultraviolet. Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. No matter how small and trivial an organ is, we should take good care of that. 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. Split Fingernails: Symptoms, Causes & Remedies. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. Skin peels off the feet and around the fingers is also a common indication of Keratolysis Exfoliativa in India. 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. This is common among fishermen but no significant evidence has been correlated to this incident. Lane, J. E. (1919). Blisters that form and split at the base of a finger often have deeper cracks that later make the skin feel numb and hard. These ointments and lotions will help reduce the discomfort that causes itching in the skin. Use this soak for a few minutes. Staph infections 10 Most Common Nail Diseases And Disorders. 2012 Nov;167(5):107684. These hollow spaces are actually the peeked areas. 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. 1. Would you like email updates of new search results? The condition does not limit itself to the hands. 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. Dermatologica. 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). As now we know that exfoliative keratolysis is not sever or dangerous. (A study that characterizes the clinical characteristics of 108 atopic dermatitis patients with hand-foot dermatitis. Keratolysis exfoliativa is a common skin condition in which there is focal peeling of the palms and less often the soles. Another sign of the condition is the appearance of skin tags. The condition isnt constricted to the skin on the hands and face, one may even notice skin peeling on the face. Eczema can be painful too unlike the aforementioned which doesnt have accompanying pain. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. The patient should be aware of the conditions benign nature and understand that typically, it will improve over time without any treatment. To the best of our knowledge, this report is the first that documents the efficacy of the use of systemic acitretin in KE. Consult Indias top dermatologists online to get suitable skin treatment from the comfort of your home. 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. Red spots arise on the skin that turn into blisters and finally into ulcers. The hands and feet should also always be well cleaned. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream.