PEELING SKIN SYNDROME

By Gary M. White, MD


Peeling skin syndrome (PSS) may be separated into acral and generalized. Generalized PSS may be further separated into non-inflammatory PSS manifesting year-round peeling of the stratum corneum without inflammatory change, and inflammatory PSS showing inflammatory changes resembling mild congenital ichthyosiform erythroderma. A subcorneal split is seen on biopsy.

Genetic Mutations

Clinical

PSS is characterized by fragile skin and recurrent superficial peeling. Residual erythematous macules may be seen at sites of healing. Onset is usually in infancy. One 46 year old woman developed chronic PSS after undergoing 4 massage treatments with exfoliating scrubs [Ann Dermatol. 2017 Feb;29(1):119-120].

Treatment

There is no known effective therapy. Avoidance of exacerbating factors is an obvious recommendation. Topical steroids and ammonium lactate have been tried without much benefit. The condition does seem to improve with age.

References

A 34-year-old woman presented with generalized and painless peeling of the skin since her early childhood. A worsening of the exfoliation was noted in summer and with exposure to humidity. Her parents were third degree cousins. Her twin sister and her two cousins exhibited the same condition. Dermatology Online Journal 16 (3)

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