When excessive growth of the stratum corneum of the epidermis occurs, they speak of hyperkeratosis. Hyperkeratosis can occur in individuals of both sexes, but often (especially hyperkeratosis of the feet) is diagnosed in men.
Depending on the origin of hyperkeratosis is divided into hereditary and acquired. By the way the disease manifests itself clinically, the following forms of it are distinguished:
- seborrheic (hyperkeratosis of the head);
- hyperkeratosis of the feet,
- disseminated (scattered, common);
In turn, follicular hyperkeratosis is divided into subtypes (depending on the lack of a particular vitamin). That is, distinguish the disease that developed with vitamin A deficiency, or C.
All the causes that lead to hyperkeratosis can be divided into factors acting from the outside and internal factors.
To external factors can be attributed too tight and pressing on the skin; shoes that are uncomfortable, small or too large; occupational hazards (contacts, for example, with chemicals); neglect of personal hygiene; washing with water of excessive hardness.
Internal causes include various skin diseases:
- seborrhea and seborrheic dermatitis;
- various forms of lichen;
- foot fungus;
- genetic disorders in keratin production;
- pathology of the gastrointestinal tract;
- endocrine diseases (eg, diabetes);
- lack of vitamins A and C;
The clinical picture of various forms of hyperkeratosis is somewhat different. Common signs are increased dryness of the skin and a slightly bumpy surface.
In the follicular form of hyperkeratosis, follicles are involved in the pathological process. Excessive keratinization leads to a violation of the detachment of the epidermis, which becomes the cause of filling the mouth of the follicle with scales of the epidermis. Aseptic inflammation develops in them, and during examination, the skin looks like a goose, that is, it is covered with small bright red tubercles.
Usually affected areas of the elbows and knees, buttocks, thighs from the outside. If the process progresses, new skin areas are involved and the area of the lesion increases in size.
The warty form of the disease develops with genetic disruptions in keratin formation and can be both congenital and acquired (occupational hazards).
This type of hyperkeratosis is characterized by the appearance of multiple formations similar to warts, which have a yellowish color. Warts tend to crack with the formation of crusts on the surface.
Lenticular hyperkeratosis is characterized by periods of exacerbations and remissions. This form of the disease is manifested by the development of large papules up to 0.5 cm, having a yellowish or brownish color. First, the skin of the thighs, the legs, the outer surface of the feet are involved in the process, then the disease spreads to the ears, hands, and even the oral mucosa.
Seborrheic form (hyperkeratosis of the head)
When a seborrheic form of hyperkeratosis affects the skin of the scalp and face. It is characterized by the formation of multiple small spots, having a dense structure and a yellowish or pinkish color. A fatty crust forms on their surface and is easy to remove. With further progression of the process, the spots grow and become warts that rise above the skin.
In the diffuse form of hyperkeratosis, huge skin areas or even completely the skin are affected. The skin is prone to flaking and dryness.
Differential diagnosis of hyperkeratosis should be carried out with other skin diseases, for example, psoriasis and herpes, in which peeling of the skin is also noted.
Diagnosis of the disease includes the collection of complaints and examination of damaged skin, and is not difficult. If in doubt, a biopsy of suspicious skin is performed.
Treatment of hyperkeratosis is carried out by a dermatologist.
During the exacerbation of the disease, ointments with topical corticosteroids are administered, which are used to treat the damaged skin:
- hydrocortisone ointment
- prednisone ointment
- fluacinolone-based ointment (sinalar, sinaflan, flucinar)
- clobetasol (dermoveit)
Glucocorticoids have anti-inflammatory, exfoliating effect, and also acts as a peeling or scrub.
Mechanical peeling with the disease is contraindicated (except in cases of hyperkeratosis of the feet), as it can aggravate the condition. Appointed creams for chemical (acid) peeling, which provides a mild effect. The composition of such creams include acids (salicylic, citric, lactic and others). Ascorbic acid and vitamin A are also prescribed orally, in pills, and locally, in ointments.
When plantar hyperkeratosis is necessary to find out the cause of the disease and eliminate the pathological factor. So, fungal infections are treated with antifungal ointments (exoderil, clotrimazole).
It is recommended to change shoes to a more comfortable, and in the case of clubfoot or flatfoot, the patient is sent to the orthopedist. Saline (non-hot) trays for feet are also shown, followed by mechanical grinding procedures (pumice, hard washcloth). After treatment, their feet should be lubricated with a moisturizing or nourishing cream.
In addition, patients with hyperkeratosis are shown common warm baths with baking soda, salt or starch. After bathing, the skin should be moistened with cosmetic creams or lotions. The treatment of hyperkeratosis is long, in some cases it lasts a lifetime.
Plantar hyperkeratosis is complicated by cracks, corns and the attachment of a secondary fungal infection.
Follicular hyperkeratosis is a dangerous development of pyoderma.
Warty hyperkeratosis can develop into a malignant form.
The prognosis for life is favorable, in cosmetic terms, relatively favorable.