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Keratolysis Exfoliativa

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Keratolysis Exfoliativa

  • See Also
  1. Palm and Sole Desquamation
  2. Desquamation
  • Pathophysiology
  1. Premature corneodesmolysis within the Stratum Corneum (outer skin layer)
    1. Early breakdown of Protein bridges that hold dead skin cells (corneocytes) together
  • Symptoms
  1. Often asymptomatic
  2. Pruritus or burning may occur
  • Signs
  1. Superficial palmoplantare Desquamation (palms more than soles)
  2. Onset
    1. Annular pink Macule with central air filled bulla
  3. Next
    1. Bulla eventually ruptures leaving a collarette of scale
    2. In more severe cases, lesions may coalesce to form large areas of Desquamation
  4. Provocative
    1. Friction
    2. Water
    3. Warm environments
  • Differential Diagnosis
  1. See Palm and Sole Desquamation
  • Associated Conditions
  1. Hyperhidrosis (palmoplantar)
  • Management
  1. Limit palm and sole exposure to exacerbating factors
    1. Excessive moisture
    2. Harsh cleansers
    3. Friction
    4. Hot environments
  2. Keratolytic Agents applied to Scaling in desquamated regions
    1. Ammonium Lactate
    2. Urea
    3. Salicylic acid
  3. Avoid unhelpful measures
    1. Corticosteroids
    2. Calcineurin Inhibitors
  • References
  1. Chang (2012) Br J Dermatol 167(5): 1076-84 [PubMed]
  2. Davis (2026) Am Fam Physician 114(4): 423-4 [PubMed]