II. Pathophysiology
- Premature corneodesmolysis within the Stratum Corneum (outer skin layer)
- Early breakdown of Protein bridges that hold dead skin cells (corneocytes) together
III. Symptoms
- Often asymptomatic
- Pruritus or burning may occur
IV. Signs
- Superficial palmoplantare Desquamation (palms more than soles)
- Onset
- Annular pink Macule with central air filled bulla
- Next
- Bulla eventually ruptures leaving a collarette of scale
- In more severe cases, lesions may coalesce to form large areas of Desquamation
- Provocative
- Friction
- Water
- Warm environments
V. Differential Diagnosis
VI. Associated Conditions
- Hyperhidrosis (palmoplantar)
VII. Management
- Limit palm and sole exposure to exacerbating factors
- Excessive moisture
- Harsh cleansers
- Friction
- Hot environments
-
Keratolytic Agents applied to Scaling in desquamated regions
- Ammonium Lactate
- Urea
- Salicylic acid
- Avoid unhelpful measures