What Causes Peeling Skin On Palms Of Hands
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Peeling skin conditions
Concluding UPDATED: Jun 08, 2021
Introduction
While there are many conditions that tin can cause skin peeling, this chapter, which is set out as beneath, focuses on the less common, chronic peelings conditions such as the Peeling Skin syndromes.
- Clinical findings
- Images
- Management
Clinical findings
Conditions associated with acral peeling
Keratolysis exfoliativa
- A common status, mainly seen in young adults over summer months, and probably more ofttimes in those who sweat more
- Lesions present as small white rings or very superficial blisters on the fingers or palms, which soon peel off. The soles are less frequently affected
- The condition is self-limiting, and can be improved with the use of emollients
Other common causes
- Hand / pes eczema
- Juvenile plantar dermatosis
Acutely unwell children
- Ruby fever
- Kawasaki illness
The Acral Peeling Skin syndrome (APSS)
- Built or familial acral peeling is extremely rare
- Information technology is an autosomal recessive condition. This means that a person with APSS has inherited a defective copy of the gene from both parents
- The signs and symptoms of peeling pare unremarkably appear shortly afterward birth, simply they may also develop later in life
- The main symptom is painless peeling of the skin on the hands and feet. Patients may also feel itching and erythema. Symptoms can be made worse with exposure to h2o, perspiration, oestrus, or friction
- I of the chief differential diagnoses is localised epidermolysis bullosa simplex
Oudtshoorn disease (syn. keratolytic winter erythema)
- A rare autosomal dominant status that was first described in the Oudtshoorn commune of Cape Provence, Southward Africa
- Symptoms tend to present anywhere from infancy through to early adult life
- Unlike with the Peeling Skin syndromes, the main exacerbations are during cold, dry climatic periods
- The condition is characterised clinically by intermittent and recurrent centrifugal peeling with erythema, especially of the palms and soles
- In more severe cases, similar patches can be plant extending up the limbs to the buttocks and torso. Lesions can too be annular or polycyclic
Conditions associated with generalised peeling
In addition to the Staphylococcal Scalded Skin syndrome, Stevens Johnson syndrome / toxic epidermal necrolysis, and pustular psoriasis, generalised skin peeling tin follow on from a number of widespread inflammatory and bullous eruptions. The listing that follows are all rare weather condition.
Peeling Peel syndromes (PSS)
- The Peeling Skin Syndrome (PSS) refers to a grouping of rare autosomal recessive conditions characterised by episodic or persistent, superficial, asymptomatic, spontaneous peeling of the skin and histologically by a separation of the stratum corneum from the stratum granulosum at the subcorneal level
- Symptoms normally present at nascence or in early on childhood, and then becomes persistent or episodic.Symptoms tend to be exacerbated in the summer
- PSS presents with either an acral (as described earlier) or generalised distribution (or both). In the generalised form, the peeling is widespread, with the palms and soles, usually, but not always, spared. Some cases remain hard to classify
- PSS can as well be classified as non-inflammatory (blazon A) or inflammatory (type B):
- Type A (non-inflammatory) PSS- generalised asymptomatic peeling of the torso, limbs and occasionally the face. Histological examination shows an orthokeratotic epidermis with a separation that occurs either within the lower part of the stratum corneum or just above the granular layer
- Blazon B (inflammatory) PSS- characterised by erythematous migratory patches with a peeling border, pruritus, and a tendency towards atopy. Histology can show an absence of the stratum corneum or a few layers of parakeratosis, which tend to be separated from the stratum granulosum. Psoriasiform acanthosis and perivascular infiltration with mononuclear leucocytes tin besides be seen
Erythrokeratoderma
- Is the association between localised hyperkeratotic plaques, singled-out areas of erythema, and sometimes peeling
- The clinically and genetically heterogeneous group of erythrokeratodermas encompasses several rare genetic skin disorders, including autosomal dominant erythrokeratoderma variabilisand progressive symmetric erythrokeratoderma
- The majority of patients present in infancy
- The skin lesions of erythrokeratoderma variabilis and progressive symmetric erythrokeratoderma bear witness many similarities:
- Erythrokeratoderma variabilis (EKV)
- Most cases present initially with well-circumscribed, annular or polycyclic erythematous patches. Episodes usually persist for minutes to hours, although may last for days. Fine scaling or peeling may be nowadays. There is a very marked variation in the number, size, shape, distribution and location of the lesions
- Over time the hyperkeratosis develops, which may be generalised or localised with well-defined, yellowish-brown, thickened, crude, hyperkeratotic plaques, which accept accentuated pare markings. The most commonly afflicted pattern is a symmetrical involvement of the extensor surfaces, lateral torso and buttocks. The flexures, face, and scalp are generally spared
- In about 50% of cases the hyperkeratosis involves the palms and soles, and this is often associated with peeling
- The plaques are relatively stable and concluding for months to years, simply they can too clear completely
- Lesions are virtually prevalent during babyhood. Improvement and periodic clearing of the skin are not unusual as the patient ages
- Progressive symmetric erythrokeratoderma (PSEK)
- The condition causes fixed, orange-red, hyperkeratotic plaques, which gradually extend through babyhood. The about commonly affected sites are the cheeks, upper trunk, buttocks and extensor surfaces
- In dissimilarity to EKV, there is no migratory erythema
- The palms and soles are often affected
Ichthyoses
- These atmospheric condition are generally associated with scaling as opposed to peeling, although Netherton'south syndrome is characterised by variable degrees of erythema, with episodic peel peeling, and later a characteristic serpiginous migratory annular / polycyclic rash with double-edged scale
- Refer to the chapter Ichthyosis
Images
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Management
- There is no known treatment that can cure these weather condition althoughemollients can provide symptomatic relief
- Treatments sometimes provided in Secondary Care include systemicretinoids (mainly acitretin),and occasionally phototherapy
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Source: https://www.pcds.org.uk/clinical-guidance/peeling-skin-syndromes1
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