exfoliative keratolysis; keratolysis exfoliativa; lamellar dyshidrosis; recurrent focal palmar peeling; recurrent palmar peeling

Etiology

• due to excessive sweating & friction
• detergents & solvents
• salt water vs bacteria from fish

Epidemiology

• normally appears during warm weather
• common in salt water fisherman

Pathology

• benign
• loss of horny layer of the skin, which protects the underlying layers, leaves skin more vulnerable to dryness & cracking

Clinical manifestations

• sometimes painful skin condition
• can affect the focal surface of the fingers &/or the palm or soles of the feet
• dry skin & superficial, air-filled blisters
  • blisters are easily peeled off & leave reddish, tender areas

Differential diagnosis

• contact dermatitis
• psoriasis

Management

• generally no treatment necessary
• creams, especially those with silicone & lactic acid may be helpful

More general terms

• keratolysis
• exfoliation (desquamation)