Keratolysis Exfoliativa


Keratolysis exfoliativa is a skin condition that manifests in the palms and hands, soles of feet, and focal surface of fingers. It is characterized by recurring focal palmar peeling. It is known in other names like exfoliative keratolysis, lamellar dyshidrosis, or recurrent palmar peeling. A person with this form of skin condition develops fair filled blisters and flakes on skin, which later slough off thereby leaving the skin dry and itchy. Sometimes, it can occur at fingertips forming some deeper cracks. This may result in numbness sensation making the fingers feel hard.

Keratolysis exfoliativa may be mistaken for other conditions like psoriasis, which present skin patches similar to those of recurrent palmar peeling. However, there is some difference because exfoliative keratolysis only affects the palms of hands, feet, and soles. Keratolysis exfoliativa is also distinct with blisters, which are air filled, and not fluid filled as is common with other skin conditions.

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Your skin helps in protecting the body and internal organs from harmful effects of environment and infections. The skin forms a waterproof barrier and keeps the fluid in body. Keratolysis exfoliativa involves the top layer of skin or the epidermis. The epidermis forms a barrier that protects the body against pathogens and exposure to UV light.

When one has this skin condition, it can give access to microbial pathogens and harmful elements to gain entry into the body meaning the overall health of a person is put in danger. This skin condition affects children and young adults. It is mainly benign and painless.

Also, constant exposure to things like soaps and detergents can make it worse. During hot summer months, the skin condition may be prevalent and it is common in individuals with sweaty hands. It can resolve without causing lifelong damages. However, in extreme cases, it may lead to bleeding and cracking of skin.

What are the symptoms of keratolysis exfoliativa?

People with keratolysis exfoliativa show minor air filled blisters, which peel off in circular pattern and expose new skin that may be tender. Symptoms are mostly seen at fingertips and palmar of hands. Initially, the palmar surface of hands develops blisters with air inside and these blisters peel off and split to form skin tags.

Numerous skin tags make the hands look as though they are peeling off. The fingertips develop peeling skin, which tends to be left with harder skin because of the constant peeling, and it may take time to resolve. The blisters in hands leave scales after bursting thereby making the skin crack and appear reddish. The scales are roundish and tender.

Exfoliative keratolysis is common among children and young adults. The condition is generally harmless or benign and painless, although it can be recurrent and worsened by constant exposure to things like detergents and soaps.  It can be prevalent in certain times such as during the hot summer months and particularly common in people who have sweaty hands.

Exfoliative keratolysis will resolve spontaneously and does not cause lifelong damages. However, in extreme cases, it might cause bleeding alongside cracking of the skin.

Causes of keratolysis exfoliativa

No exact cause of keratolysis exfoliativa has been identified and the disease mainly affects the out layer of skin. The outer most layer of skin is made up of keratin, a protein that is essential for strengthening and allowing flexibility of skin, which makes it maintain its function. When there is break down of keratin, it causes the skin to lose flexibility and strength, and impairs the function of the epidermis.

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Due to loss of strength, the skin begins to exfoliate. However, the cause of the constant shedding of skin remains unknown. Genetic factors may be linked to individuals who develop this disease. Allergy may also be a possible contributing factor. Excessive sweating of hands is believed to stimulate break down of keratin and possibly the constant exfoliation or skin peeling.

Using detergents, soap, and other solvents may trigger the exfoliation of skin. Another possible cause is stress. While there may be no clear implication, saltwater is also considered a possible cause. This may explain why this condition is common among fishermen.


Keratolysis exfoliativa is mild and often benign skin condition. It resolves spontaneously and does not cause lifelong damages. The best treatment method to help prevent this skin condition is avoiding contact with irritants like detergents, solvents, and soaps. Care is needed in times of breakouts such as during hot summer months.

An individual should keep the hands clean to prevent secondary infection due to cracks that expose the skin. Emollients containing urea can help relief dryness and some other symptoms while lactic acid helps keep the skin from infection. When you suspect that you may have keratolysis exfoliativa, visit a dermatologist for further investigation. Early treatment can help in preventing complications that may arise. It can help relief the symptoms and prevent infections.

Keratolysis Exfoliativa  – Pictures

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Keratolysis Exfoliativa pictures

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Keratolysis Exfoliativa photos

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