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Wyprysk z hiperkeratozą - Objawy, Diagnoza i Leczenie
Types of Hyperkeratosis
"Hyperkeratosis" is an umbrella term for skin conditions that develop from excess amounts of keratin. There are various types of hyperkeratosis, each marked by its cause.
Hereditary Types of Hyperkeratosis
Some types of hyperkeratosis develop due to a hereditary component. Examples include:
- Epidermolytic hyperkeratosis
- Multiple minute digitate hyperkeratosis (MMDH)
- Focal acral hyperkeratosis
- Lamellar ichthyosis
- X-linked ichthyosis (XLI)
- Keratosis pilaris, otherwise known as follicular hyperkeratosis
Acquired Hyperkeratosis
Other forms of hyperkeratosis are acquired later in life. It’s not always clear what the cause of each type is. Some acquired hyperkeratosis conditions include:
Acquired vs. Hereditary
Hereditary conditions are passed down through families. Often if a person is related by blood to someone with a genetic disorder, their risk of getting it is a lot higher. Acquired conditions, on the other hand, develop for many reasons unrelated to genetics.
History and Physical
Hyperkeratosis is a histopathological term defining a thickened stratum corneum and may be present in many different skin conditions, with many possible overlaps. History and clinical evaluation are key, and the main goal is to collect as much information as possible and discern which cases require a histopathological diagnosis to direct the most appropriate treatment.
The history comprises the age of the patient, family history, exposure to toxic substances, drugs, occupational duties, anamnesis of the current lesion, concomitant pathologies, and treatments. In those patients where the diagnosis was already established, it is appropriate to reevaluate it, monitor progression and complications following the treatment.
The physical examination must be thorough to exactly understand the extent of the disease. Except for localized disease, it is important to inspect the entire skin surface, including scalp, eyelids, ears, perineum and genital mucosa, hair, and nails. The lesion should be described in terms of color, texture, shape, and distribution. Surrounding skin should be examined as well to detect the presence of generalized xerosis (dryness), seborrhea, hyper or hypohidrosis (sweating), texture, photoaging such as lentigines, actinic purpura, rhytides.
Small folliculocentric keratotic nodules can be found in cases of keratosis pilaris, where papules are centered on small hair follicles, and it can be associated with erythema. On close examination, it is possible to recognize a small coiled hair beneath the papule formed by a keratin plug.
Scaling is an important finding in cases of hyperkeratosis. Scales may be described as soft, rough, greyish, bran-like, and so on. Crusts should not be confused with scale as it is the result of dried fluid on the epidermis (serum, blood, pus, or a combination of those) and not thickening of the epidermis. Lichenification is a thickening of the skin and results from chronic injuries such as repetitive scratching. It is present in most chronic eczematous or neurogenic processes.
NADMIERNE ROGOWACENIE I ZESPÓŁ PĘKAJĄCYCH PIĘT
Przerośnięta żółto-szara warstwa rogowa pięt jest zazwyczaj sucha, łuszczy się i często pęka. Pęknięcia mogą być rysami, szczelinami, bądź nawet głębokimi rozpadlinami w suchym przerosłym naskórku.
W zależności od postaci klinicznej wyróżniamy:
PĘKNIĘCIA WILGOTNE wiążą się z maceracją na skutek nadpotliwości lub długotrwałego kontaktu z wodą. Każde pęknięcie skóry staje się wrotami infekcji. Zakażenie rany noże być przyczyną, a także skutkiem wysięku.
SUCHE PĘKNIĘCIA są następstwem przesuszenia (uszkodzony płaszcz hydrolipidowy) i utraty elastyczności skóry. Suche pęknięcia z małych rys mogą przechodzić w głębokie, krwawiące rany.