Exfoliative keratolysis is a skin condition that causes the shedding of the top layer of skin. Want to talk to an expert regarding your diet? Psychiatry 27 years experience. Eventually normal skin forms, but frequently exfoliative keratolysis recurs within a few weeks. 1983. pp. Antibiotics treat the infection to remove the bacteria from your body. 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. 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. Interference with other drugs you take, which prevents the medication from working effectively. 37. Foot skin peeling The peeling skin on hands and feet usually occurs when the temperature is hotter than normal. Contact Dermatitis:Contact Dermatitis is a condition that causes acute inflammation of the skin. The skin loses its strength with breakdown of keratin, as a result it begins to peel off or exfoliate. Provides a good description of the clinical features of recurrent focal palmar peeling and how to differentiate it from other conditions. 166. Although treatments are available, it is more of palliative. 2.ICD-10-CM classification code L08.89 5. Dry skin flakes blister and slough off, leaving behind . Blisters that form and split at the base of a finger often have deeper cracks that later make the skin feel numb and hard. Staph infections European Journal of Pediatric Dermatology, 23(2), 125-125. - Evidence-Based Guidance Eczema is also a quite painful condition, whereas exfoliative keratolysis doesnt hurt as much. Topical steroids are not known to be helpful, Phototherapy may be considered for severe cases, Avoid using soaps, detergents, and harsh chemicals, If seawater aggravates the condition, then minimizing or avoiding exposure to the same, Where possible, avoid activities that cause friction in the affected palms or soles, Try to use suitable gloves to protect the hands, where necessary, The prognosis of Keratolysis Exfoliativa is generally good as a majority of the cases are self-limited and a spontaneous resolution is noted, In some individuals, the condition may be severe with frequent recurrences being noted. Examples of these include urea 20% or 40% cream, ammonium lactate 12% cream, salicyclic acid 6% cream, and lactic acid 12% cream. (A report of three cases of recurrent focal palmar peeling, of which two were misdiagnosed as chronic dermatitis. Topics AZ The epidermis is made of several layers of keratina protein necessary for skin strength and flexibility. There are some texts that mention the use of photochemotherapy with hand/foot psoralen and ultraviolet A light (PUVA) for severe cases. Who is at Risk for Developing this Disease? Speak to a dietician on MFine to know how changes in your food can help you address your situation today! 3. Exfoliative keratolysis creates air-filled blisters, while eczema creates fluid-filled blisters. Lee, YC, Rycroft, RJ, White, IR, McFadden, JP. 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. Bethesda, MD 20894, Web Policies Keratolysis Exfoliativa isnt a condition that is of grave concern in India. It is also known as Focal Palmar Peeling and is typically observed in young adults The condition isnt constricted to the skin on the hands and face, one may even notice skin peeling on the face. 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. We do not endorse non-Cleveland Clinic products or services. 143-4. A patient complains of dry skin of the palm with initial air-filled blisters on fingers. All rights reserved. Some Observations on Keratolysis Exfoliativa. Cutaneous T-cell lymphoma Photograph of keratolysis exfoliativa on the hand. This is common among fishermen but no significant evidence has been correlated to this incident. Exposure to irritants such as washing powder, soap, detergent etc. Our expert physicians and surgeons provide a full range of dermatologic, reconstructive and aesthetic treatments options at Cleveland Clinic. Note that this may not provide an exact translation in all languages, Home Acne pitted scar treatment. PUVA ultimately serves as a last-resort treatment when exfoliative keratolysis becomes too severe. Before that, we should know what it really is. Keratolysis exfoliativa is a straightforward diagnosis; for any unusual clinical presentations, the correct diagnosis should be questioned. 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. Meaning, the signs are symptoms are treated but the underlying cause is not addressed. 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. Federal government websites often end in .gov or .mil. The Licensed Content is the property of and copyrighted by DSM. For an accurate diagnosis of exfoliative keratolysis, a negative result from a patch test is required. Visit your healthcare provider if you have symptoms so they can offer treatment to remove the infection from your body. J Cutan Dis, 37, 174-175. 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. If you regularly use essential oils, like tea tree oil, ask your healthcare provider before using it on your affected skin. Getting oneself rehydrated is a good condition as well as well hydrated cells arent easily affected by extremely hot weather conditions. - Full-Length Features Adverts are the main source of Revenue for DoveMed. If there is a component of primary hyperhidrosis, attempt to treat it with topical medication. Also, be sure to clean your hands to keep bacteria from getting inside the cracks on your hands and fingers. It has been regarded as a subtype of dyshidrotic eczema, a fungal infection or a dermatophytid reaction. 2014 Jun;150(6):647-8. doi: 10.1001/jamadermatol.2013.9190. The hand cream can prevent the excessive scales and dryness that lead to peeling from forming. The .gov means its official. 3.Reasoning: a. The condition usually develops in the summer and people with sweaty palms are the first to notice their skin peeling off on their palms. But, people spend a whole bunch of years without knowing that they are having this disease. The infection is characterised by craterlike pits on the surface of the feet and toes. Jock itch Unfortunately, what causes exfoliative keratolysis is relatively unknown. 24/7 visits - just $44! The peroxide solution should be no more than one part hydrogen peroxide to three parts warm water. Key Takeaway: 2001. pp. A CASE OF CONGENITAL EXFOLIATION OF THE SKIN.(KERATOLYSIS EXFOLIATIVA?). There can be multiple layers of peeling skin (lamellae). Before One common mistake while doing the diagnosis of this disease is, some doctor confuses it with the following diseases. 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. There has been no conventional drug proven to be effective to heal exfoliative keratolysis. 2012 Nov;167(5):1076-84. doi: 10.1111/j.1365-2133.2012.11175.x. Patients should be aware that this treatment is purely anecdotal and data to support its benefit is lacking. Refer to more of our medical guides for information on nutrition and diet remedies for similar conditions. Archives of Dermatology and Syphilology, 23(3), 445-471. Eating a healthy diet can be a good source of natural components which may heal the skin. This should be reserved for severe or symptomatic patients, as otherwise the risks outweigh the benefits. 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. Thirdly, detergents, irritating soaps and sometimes solvents can cultivate exfoliation reactions. are preferable. (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. After you start taking an antibiotic, it will begin working within your body to rid it of bacteria. vol. Lets take a deeper look at some of the other exfoliative keratolysis treatments available. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. The first sign of the condition in India is generally flaky dry skin around the fingers and skin peeling on palms. Oakley, A., Exfoliative keratolysis, DermNet New Zealand; How Long Does Exfoliative Keratolysis Last? Salt water, sun, and other bacteria can cause skin 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. So, you can say it lasts during the summer. How can I prevent this condition from returning in the future? 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. Hausauer, A. K., & Cohen, D. E. (2015). SANGSTER, A. Plant-based applications: Try making a natural homemade exfoliative keratolysis cream with raw honey, shea butter, and coconut oil. The exact cause of exfoliative keratolysis is not known. She is passionate about digital marketing and loves to work with fashion-related niches like nails, hairstyles etc. 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. Exfoliative keratolysis. 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. 100 Jaar Leerstoel Dermatologie Rijksuniversiteit te Groningen. Wear shoes and/or socks that are too tight (occlusive) and have limited airflow. Exfoliative Keratolysis Treatment The ideal treatment is avoiding the risk factors that are its primary causes. Lee YC, Rycroft RJ, White IR, McFadden JP. 1. Another sign of the condition is the appearance of skin tags. Keratolysis exfoliativa. Exfoliative keratolysis is mostly a seasonal disease. The condition is recurring causing the skin to harden and become rough. 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. Your use of this website constitutes acceptance of Haymarket Medias Privacy Policy and Terms & Conditions. Books about skin diseasesBooks about the skin The skin thickens, hardens into a callus, dries out, and peels off. There are a number of preventative tips that can help you decrease the risk of exfoliative keratolysis symptoms. 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. It is also recommended to keep the hands clean to keep the bacteria away from getting inside the cracks. The same also occurs when the condition affects the palm or the soles of the feet. Some believe that it is more frequently associated with underlying atopic dermatitis, while others report an association with primary hyperhidrosis. Most patients deny any itching, but may rarely complain of slight tenderness. Lifelong desquamation of the hands and feet. Sweaty hands are also an aggravating factor. There are no associated systemic implications or complications seen in patients with keratolysis exfoliativa. Split Fingernails: Symptoms, Causes & Remedies. Washing your feet and hands with soap and water when you remove your shoes and socks. I experience it twice in a year. Your doctor may identify Keratolysis Exfoliativa when air filled lesions appear on the skin near the hands or legs. Pompholyx or dyshidrotic eczema (differentiated by its chronic nature, associated pruritus, fissures, and lichenification seen on examination), 2. The most affected areas of the body are usually the fingers and the soles. Therefore, management of exfoliative keratolysis may still be limited, and treatment is quite difficult. b. Pits can cluster together to form a sore (lesion) that looks like a crater. Keratolysis Exfoliativa is a common skin condition in India that can be noticed around the palms and soles. Chang YY, van der Velden J, van der Wier G, et al. This can be done by applying the medical ointments like OTC moisturizer on the affected area and then avoiding any water or moisture contact with that affected region. Want to know more about exfoliative keratolysis? We hope youre enjoying the latest clinical news, full-length features, case studies, and more. and transmitted securely. The odor caused by the infection occurs because the bacteria release a stinky sulfur compound. Can my diet help in avoiding peeling skin? It also involves the use of Psoralens which are compounds found in plants that also includes methoxsalen, 5-methoxypsoralen and trisoralen. It could take between two to three days before you start to feel better. Epub 2012 Oct 5. Familial continual skin peeling. It is important to explain the natural history of keratolysis exfoliativa to the patient before initiating any treatment. Chiriac, A., & Solovan, C. (2013). These ointments and lotions will help reduce the discomfort that causes itching in the skin. No, pitted keratolysis isnt contagious and cant spread from person to person. , 1999. Supportive investigations may be undertaken. She spends her free time reading books and watching TV series. Keratolysis Exfoliativa . Provides a good description of the clinical features of recurrent focal palmar peeling and how to differentiate it from other conditions. This article will detail everything you need to know about exfoliative keratolysis causes, symptoms, treatments, natural home remedies, and tips to prevent the condition. When the condition affects the lower body, it causes foot skin peeling. The https:// ensures that you are connecting to the pii: 13030/qt6mv338nx. 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. 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. This situation is linked to destruction of keratin layers in the epidermis resulting to unwarranted skin exfoliation. 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. They might ask questions about the type of shoes and socks you wear, especially around the time you noticed your symptoms. Some patients may find that this condition is exacerbated by chemical or physical irritants such as water, soap, and detergents. 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. Cleveland Clinic is a non-profit academic medical center. PubMed. We present a 55-year-old woman with extensive disease on the hands and feet, who failed to respond to standard topical therapy but showed a marked dose-response improvement with the use of oral acitretin. The cause of development of Keratolysis Exfoliativa is currently unknown. Use of topical steroids and cortisone cream and even increased levels of prednisone is also effective in treating the problem. 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. Visit your healthcare provider if you experience anxiety related to your phobia, as well as symptoms of pitted keratolysis. Acitretin has previously been used to treat diseases of abnormal corneocyte desquamation, for example Netherton's disease. In most cases, it starts with the advent of summer and ends when simmer departs. DermNet provides Google Translate, a free machine translation service. 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. Normal skin gradually develops as the blisters split and new skin forms. It can activate the condition or worsen it if one is already afflicted by it. 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. Approved by: Krish Tangella MD, MBA, FCAP. Keratolysis exfoliativa is more common during the summer months in about 50% of affected individuals. 1996. pp. 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. 2020 Dec;34(12):e783-e785. You can soak your feet in a diluted mixture of hydrogen peroxide and water to clean your feet. The peeled skin from the fingers and fingertips is often harder due to constant peeling before healing takes place. Topical corticosteroids-usually not of much benefit. Youve viewed {{metering-count}} of {{metering-total}} articles this month. The treatment process in India does not require any surgery or frequent doctor visits. In other words, treatment can only deal with the symptoms and signs associated with the condition. 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. Exfoliative keratolysis Acral skin eruption observed during SARSCoV2 pandemic: possible keratolysis exfoliativa with red palms and soles. Also, keep in mind that exposure to soaps and detergents will make exfoliative keratolysis worse. But, treatment is best during the early episodes. Pitted keratolysis occurs as a result of a bacterial infection that causes smelly and itchy feet. There are different ways to do the treatment. The infection caused by wearing tight or restricting footwear and due to excessive sweating. Copyright 2023 Haymarket Media, Inc. All Rights Reserved. DermNet does not provide an online consultation service. Presently, it is not known to occur from genetic factors, even though a family history is occasionally noted. A few observable symptoms in India: 18. If the skins of the palms and the soles start to peel off, thats the first sign of exfoliative keratolysis. Pitted keratolysis is a bacterial infection that can cause your feet to smell bad. 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. It is a result when blisters concentrated on the palm peel off and split making it look like it is shredding. Youll be sure from this test whether this is due to an allergic problem or other underlying problems which should be determined. - Drug Monographs Exfoliative keratolysis treatment is available; however, the treatment is more of a palliative solution. Register for free and gain unlimited access to: - Clinical Updates, with personalized daily picks for you Lastly, stress can be an important triggering factor for Exfoliative Keratolysis. Antibiotics could include: Clindamycin. The best material to improve airflow to your feet through your socks is cotton. Exfoliative keratolysis is the medical term of what we have commonly known as skin peeling disease. Common symptoms that accompany skin peeling are rashes, itching, dryness and other irritants. Any exacerbating factors should be controlled. 5.3k views Answered >2 years ago. FOIA Protection from irritants, wear gloves, good moisturization. 2. Keratolytic creams containing urea, lactic acid, ammonium lactate or salicyclic acid. The condition requires no medical test and is detected by a well experienced dermatologist. Keratolysis Exfoliativa are generally observed in young adults. It can also fortify the epidermal barrier that may prevent future exfoliative keratolysis outbreaks. Physical and mental stress can affect the skin sometimes. 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.