WHAT IS EXFOLIATIVE KERATOLYSIS?
It is a common skin condition where patients present with localised peeling of skin from palms and soles.
Other medical terms used to describe it are- dyshidrosis lamellosa sicca and focal palmar peeling.
It is more commonly found in:
- It is seen more in active young adults.
- Some presents with a long positive family history.
- It is also more common during the summer months and in those with sweaty palms
Most of the cases resolve gradually on their own but a few cases may present with deep cracks and bleeding.
SYMPTOMS AND CAUSES
The first sign is one or more thin layered blisters on the fingers of palms or soles.
These blisters then burst to leave many scales along with a red, round and tender peeled area. These peeled areas later become dry and cracked.
These lesions are not generally itchy.
The exact cause of exfoliative keratolysis is unknown. Some studies have shown that there is premature separation of 2 layers of skin which gives rise to this condition.
DIAGNOSIS AND TREATMENT
Keratolysis exfoliativa is diagnosed by visualising the skin clinically.
Other supportive investigations includes:
- Patch test
- Skin scrapings and
- Skin biopsy
Keratolysis exfoliativa does not improve with topical steroids. Patients are advised to wear protection when exposed to irritants, hand creams containing urea or lactic acid are also advised in some cases.
- Protection from irritants
- Use hand creams especially those containing urea, silicone or lactic acid.
- washing hands with water and very mild soaps
- wearing gloves when washing dishes or using cleaning products
- wearing cotton socks to absorb sweat and reduce friction.
Homeopathic medicines give very good results with this condition. It even ends the tendency to its recurrence. Some of the common useful remedies are- graphites, mezereum, hepar sulph, arsenic album, psorinum, rhus tox, sulphur, antim crud etc.
DO’S AND DON’TS
- wash your hands only when necessary and moisturize afterwards.
- use mild, chemical-free soaps
- Wear gloves when washing clothes or dishes.
- Avoid drying the skin with a rough paper towel or synthetic clothes.
- Avoid picking the affected skin.
- Avoid harsh cleaning products.