WHAT IS  EXFOLIATIVE KERATOLYSIS?

It is a common skin condition where patients present with localized peeling of skin from palms and soles.

Other medical terms used to describe it are- dyshidrosis lamellosa sicca and focal palmar peeling.

WHAT ARE THE RISK FACTORS FOR EXFOLIATIVE KERATOLYSIS?

It is more commonly found in:

• It is seen more in active young adults.
• Some present with a long positive family history.
• It is also more common during the summer months and in those with sweaty palms 

WHAT ARE THE COMPLICATIONS OF EXFOLIATIVE KERATOLYSIS?

Most of the cases resolve gradually on their own but a few cases may present with deep cracks and bleeding. 

WHAT ARE THE SYMPTOMS OF EXFOLIATIVE KERATOLYSIS?

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. 

WHAT ARE THE CAUSES OF EXFOLIATIVE KERATOLYSIS?

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 OF EXFOLIATIVE KERATOLYSIS

Keratolysis exfoliativa is diagnosed by visualizing the skin clinically.

Other supportive investigations include:

• Patch test
• Skin scrapings and
• Skin biopsy

TREATMENT OF EXFOLIATIVE KERATOLYSIS

Exfoliative Keratolysis 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.

MANAGEMENT OF EXFOLIATIVE KERATOLYSIS

• 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 MANAGEMENT OF EXFOLIATIVE KERATOLYSIS

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

DO’S

• Wash your hands only when necessary and moisturize afterward.
• Use mild, chemical-free soaps
• Wear gloves when washing clothes or dishes.

DON’TS

• Avoid drying the skin with a rough paper towel or synthetic clothes.
• Avoid picking the affected skin.
• Avoid harsh cleaning products.