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Wyprysk z hiperkeratozą - Objawy, Diagnoza i Leczenie
Treatment / Management
Basic skincare measures are important to prevent excessive dryness and to encourage exfoliation. Those remedies include soaps with skin-specific pH, soap-free cleansers, and avoidance of hot baths. Emollients and topical keratolytic agents (lactic acid, salicylic acid, urea) should be advised to be applied over affected areas at the appropriate times.
Surgical procedures have limited relevance in the treatment of hyperkeratosis. In cases of untreatable plantar keratosis with significant daily limitation, skin grafts with rotation skin flap have been demonstrated effective.[25][26]
Corticosteroids are the treatment of choice for inflammation-driven diseases such as lichen planus or psoriasis. Topical application is the best choice for localized disease. Topical applications should last one to two weeks.
Immunosuppressant or immunomodulators (cyclosporin, hydroxychloroquine, mycophenolate mofetil, sulfasalazine, alefacept, efalizumab) can be used in severe recurrent cases.
Topical calcineurin inhibitors (tacrolimus or pimecrolimus) can also be used.
Retinoids, topical or oral-based, are used in disorders of keratinization such as ichthyoses, keratosis folliculitis, and psoriasis. Topical administration is variable and must be evaluated in the appropriate clinical context, treatment usually lasts 8 to 12 weeks.
Combination treatments with lasers (e.g., pulsed-dye laser, 755-nm alexandrite laser, 810-nm diode laser, 1064-nm Nd:YAG laser) and microdermabrasion are noninvasive techniques currently under approval for different hyperkeratotic diseases.
Histopathology
Psoriasis and psoriasiform dermatitis: It shows perivascular aggregates of lymphocytes in the dermal-epidermal junction with focal migration of leukocytes (neutrophils, lymphocytes) into the epidermis. There is increased epidermal proliferation and elongation of rete ridges giving an undulating appearance to the epidermis (papillomatosis) with or without spongiosis. The altered differentiation of keratinocytes results in hyperkeratosis with parakeratosis. Psoriasis also shows the formation of microabscesses by small aggregates of neutrophils in the upper epidermis (pustules) or in the stratum corneum (Munro microabscesses).
Interface and lichenoid dermatitis: Dense aggregates of lymphocytes along the dermal-epidermal junction associated with vacuolation of basal keratinocytes.[6] There is dyskeratosis, hyperkeratosis, and is sometimes associated with hypergranulosis.
Verrucae vulgaris and plana are characterized by marked hyperkeratosis, papillomatosis, and acanthosis. A typical feature is the presence of koilocytes, cells infected with papillomavirus which have structural changes like perinuclear halos and keratohyalin granules. Koilocytes can be absent in older lesions, but when present, are located in the upper stratum spinosum or granulosum. Parakeratosis may be present.
Seborrheic keratosis features marked hyperkeratosis, papillomatosis, and acanthosis. Pseudo-cysts and horn cysts are frequently present. There may be lymphocytic infiltrate and pigmentation as secondary features when irritated or inflamed.
The ichthyoses are a group of diseases caused by altered keratinization. The most common forms are ichthyosis vulgaris, X-linked, congenital, and epidermolytic hyperkeratosis.[7] They can be hereditary or acquired during life.[8][9] All of the forms show a defective epidermal barrier that induces hyperkeratosis, skin scaling, and inflammation.
Squamous cell carcinoma (SCC) is a neoplastic proliferation of atypical keratinocytes, restricted only to the epidermis (SCC in situ or Bowen's disease) or infiltrating the dermis (infiltrative SCC). Classic features are hyper-parakeratosis and loss of the granular layer.
A Word From Verywell
A skin condition can be challenging to deal with, especially if it causes painful symptoms. The good news is that dealing with most forms of hyperkeratosis is manageable with the proper treatment. In most cases, this condition is not severe or life-threatening.
The best thing you can do if you have hyperkeratosis is to speak to a dermatologist (a medical doctor specializing in conditions of the skin, hair, and nails) about your condition and any concerns you have. They will be able to determine the next steps to address your condition.
Frequently Asked Questions
The treatment for hyperkeratosis will depend entirely on its type and the underlying cause. Treatment isn't always necessary because some forms of hyperkeratosis are either asymptomatic or present with mild cosmetic symptoms. The most common forms of treatment include keratolytics, moisturizers, emollients, and retinoids.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
- Jakeman A. The effective management of hyperkeratosis.Wounds Int. 2012,1:65-73.
- National Human Genome Research Institute. Genetic disorders.
- Tian Y, Li XX, Zhang JJ, Yun Q, Zhang S, Yu JY, Feng XJ, Xia AT, Kang Y, Huang F, Wan F. Clinical outcomes and 5-year follow-up results of keratosis pilaris treated by a high concentration of glycolic acid.World J Clin Cases. 2021 Jun 26,9(18):4681-4689. doi:10.12998/wjcc.v9.i18.4681
- Harvard Health Publishing Harvard Medical School. Hyperkeratosis.
- National Organization for Rare Disorders. Lamellar Ichthyosis.
By Angelica Bottaro
Bottaro has a Bachelor of Science in Psychology and an Advanced Diploma in Journalism. She is based in Canada.
Coping with a skin condition like hyperkeratosis isn’t always easy because of physical and cosmetic symptoms. However, with the proper treatment, you will be able to manage your symptoms and improve the visual appearance of your skin.
"Hyperkeratosis" is a blanket term used to describe various skin conditions. The health conditions associated with hyperkeratosis have different symptoms. However, they one thing in common: the excess production of keratin.
Hyperkeratosis can be hereditary and passed down through families, but it can also develop later in life because of different factors. Some forms of the condition have no known cause.
Hyperkeratosis may take time to diagnose. Work with your healthcare provider to determine the underlying cause of your skin condition. Once that is done, you can begin the proper treatment to manage your skin condition.
