Lamellar Dyshidrosis

Key Points
Common skin condition which often affects the palms
Cause is unknown
Initially consists of blisters on the palms and/or fingers, which burst causing areas of skin to peel

Keratolysis exfoliativa is a common skin condition which most often affects the palms, but can develop on the soles of the feet. Presentation initially consists of the formation of blisters on the palms and/or fingers, which then burst. This leads to scaling and/or peeling, and exposed skin may experience dryness, redness and cracking, though it is rarely accompanied by pain. Exposure to irritants may aggravate the condition. The condition may also recur up to several weeks after healing.

Keratolysis exfoliativa's cause is unknown. In some persons it may precede a blistering form of eczema called pompholyx. Anyone may develop keratolysis exfoliativa.

Differential Diagnosis (Other conditions with similar appearance)
Psoriasis
Eczema
Tinea
Burns

Diagnosis
Key Points
Diagnosis based on appearance of the affected area
Other testing may be performed to confirm diagnosis and rule out other conditions

Keratolysis exfoliativa is typically diagnosed based on the appearance of the affected area. Other testing may be performed to confirm the diagnosis, and to rule out other conditions with similar presentation.

Treatment
Treatment is typically not needed, as the condition is self-resolving
*Proper hand care and protection from irritants may prove helpful in resolving the condit0ion
OTC Options: emollient hand creams containing urea, silicone or lactic acid

Keratolysis exfoliativa does not typically require treatment, as the condition tends to resolve itself with little discomfort. However, proper hand care and use of emollient creams may prove helpful in resolving the condition. Protecting the affected area from irritants is also recommended. Additionally, photochemotherapy has been used in treatment with some success.