By Gary M. White, MD
Keratolysis exfoliativa is an uncommon, benign, scaly condition in which ringed collarettes of scale develop on the palms. The term ringed keratolysis has also been used. The patient is usually a young adult and the condition is most common in the summer. No bacterial or fungal agent has been found.
Initially, a small bubble or small white ring may be seen. Collarettes of scale without significant erythema of both palms is typical [Dermatology Online Journal 2015;21;12].
KE is not pruritic and not vesicular. Pompholyx presents with tapioca-like vesicles on the sides of the fingers, palms and occasionally soles.
Emollients are usually not helpful. One may try keratolytics. As this may be a forme fruste of irritant hand dermatitis, a topical steroid may be tried. One patient of mine got significant suppression of her disease with oral erythromycin.
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