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Exfoliative Keratolysis
I have suffered with Exfoliative Keratolysis on my hands and feet for 27 years now.
In fact it was only by going online recently that I finally learned the exact name of this condition. No doctor I saw ever put a name to it other than "It's some type of dematitis or exzema." As like many others, I went through all the standard treatments including topical steroids. The ONLY times it has completely cleared was when I would get a cortizone injection in my bad shoulder as well as the one time I was put on a Prednisone treatment for an eye infection. That's it. I live with it. But I would like to know if anyone has an idea as to what brings it on in the first place. Why, out of the blue, does it appear? I have no allergies nor exposures past or present to chemicals or the like. Any ideas? Any treatments that work?

Thanks!
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I had just written a 5 line comment and my registration did not allow me to post it. After I got a new password the comment had been errased. I am trying to see what happens this time. This forum web is pretty uncertain.
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Well, it seems to have worked. I have a comments earlier on under "thumb peeling". I don't know if you have seen it. My condition seems a lower intensity than yours but could have the same cause. I was following the reports from someone under the name bbally who was having his skin cultured to check for possible fungus or bacteria. The comment thread was unexpectedly closed and I have not seen any comment from him since. Myself I am trying an antibiotic cream and see if it works. I know that water makes it worse, but not so sure about sea water.
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I had a biopsy done years ago with no results.
I have used over the counter anti-biotic ointments but it hasn't helped other than to act as a lubricant, much like Vaseline. Everything seems to aggravate it including stress.
I was told that much like any other exczema or dermatitis, no known causes or cures.
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Thanks for the info, although sounds very hopeless. A biopsy is different from a culture in an apropriate media. For myself, It's hard to believe that after 50 yrs of having no skin problems something just shows up due to ? and because of being in a particular area and spreading down the thumb slowly I tend to think is some bug rather than stress. I am trying and learning whatever I can.
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As I mentioned before, steroids cleared it up but obviously that could never be a long term solution. I also had allergy patch testing done but no reactions to anything.
Every explanation I've read has been vague at best. But let me know how the culture thing goes. Even if I never get rid of it I'd find some consolation in knowing the cause!
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Also forgot to mention that I have read that a lot of these types of skin disorders can be a reaction to stress / nerves possibly from a critical life event. Don't know if there's any truth to that possibility but something to think about. I do know that my condition worsened recently after my best friend died suddenly in April. Within a week I noticed a marked increase in peeling and cracking and it hasn't gotten any better. My original outbreak with this came at the same time I was going through a divorce in 1982.
Connections?
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I had never thought about possible connections to stressful periods, but it may be. The first time it happened to me I was organizing an exhibit and having a lot of stress because of family matters. Later it has shown up at different times, and since I have been stressed or depresed often, it hard to say. This last time occurred after a very stressful period as well and it has not dissapeared yet but it's better now. I will pay more attention to it from now on.  
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i have had for 15 yrs  tried lots of therapy  have lived in tropics  and high desert...no stress  then high stress  doesnt seem to make a difference  it only gets worse month by month   waiting for someone to find a remedy  
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i have had for 15 yrs  tried lots of therapy  have lived in tropics  and high desert...no stress  then high stress  doesnt seem to make a difference  it only gets worse month by month   waiting for someone to find a remedy  
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dont waste your money on dermitologists they are no help  and yes the creams only act as a moistener to help with cracking   i actually find relief with gloves to keep the air off
has anyone noticed their fingernails grow really fast with an outbreak?

i have never had an outbreak on the outer side of hands..only where the sun doesnt fully reach..on the palms and inside of fingers   i was thinking light therapy may help  a uv light? anyone tried?

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I suffer from Exfoliative Keratolysis now about 10 years...
Tried everything...biopsie, test of allergies, bloodtest, etc...
Every doctor and dermatologist in Belgium I have visited.
No doc ever called it that whay.
Till one... he knew directly a cure: he prescribeded me Prednisolone, corticosteroids and I was treated by that doctor 3 times a week with UV-radiation. I had to put a verry fat layer of cream with lots of ureum (urea) I guess in it on my handpalms and foot soles and then take place in a UV cabine for a few minutes. This was the only method that had result. But I stopped with it because due of the cortico's my haire felt out...etc.
I lived with it for so many years now... I don't want to poison my body all the time taking cortico's etc... and now my hand are back peeling all the time...!!! frustrating!!! (sorry for the spelling mistakes) greeting to all
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Exfoliative Keratolysis


Please note that any medically related information provided in this report/advice is not intended as a substitute for advice from any registered physician or other healthcare professional.  Whilst I have endeavored to ensure that all information provided in this report/advice is accurate and up to date, I take no responsibility for any error or omission relating to this information, nor any responsibility for what any person may or may not do as a result of reading this report/advice.

I am a 50+ year old male and have had the condition Exfoliative Keratolysis (EK) for over 35 years, and have tried most if not all (cures) – Doctors, Dermatologists, Naturopaths, Herbalists and several ‘Theorists’.  Have been researching and experimenting with my EK for over 30 years. My parents were in medicine, and so I had some inside knowledge and access to research, although a lot of it (some unqualified) is now available on the net. I don't know everything, but I do know what works for my EK.  I believe that EK 'management' is really a matter of trial and error – unlike some medical conditions there is no ‘penicillin’ type cure (yet).

The following is a brief summary of what works and doesn't work for me, and my thoughts on EK.  I am providing this in the hope it may help some others.  

The first step I had to make was to accept that my EK condition will not kill me, but it is something I have to live with and have to manage myself.  In my experience there is no miracle pill/lotion/cream I can get that will cure it, and there is no plant growing on Mount Himalaya or in the Amazon Jungle that will either.  Some things make it better for a while, but there is no permanent cure - although it does run its course and 'go away' in some people. My advice to others is to accept this, then you can find out what works for you and then implement a management regime (and change if needed, and try new things sometimes).  Maybe this will result in a cure, and maybe it may last a lifetime.

My hands do not blister - they used to, but they have not done so since the condition started many many years ago.  I believe that this lack of blistering and some associated problem with the natural healing processes in the particular skin type that EK affects, is the core of the issue.

At its worst my hands would be completely 'stripped' of 'good' skin - the fact that I used to play so many bat and ball sports did not help (life is too short).  I wish I had learned my management regime a lot earlier - but that's how it goes.

My EK gets worse when the weather is hot or after periods of excessive hand contact activity (eg hammering nails, fixing cars).  In winter where I live now, it gets down to -10C (15F) and my EK all but disappears.  If someone was to go somewhere really cold for 2-3 days and expose their hands to the cold, and if they get better and the EK dissipates, then they on the same page as myself. I believe the cold helping is due to the healing process working better when the skin temperature is lower and less moisture is lost than when the skin temperature is high.

EK is not due to stress - but stress can initially bring it on (it would come sooner or later anyway) and stress can make it worse.

Topical steroids/cortisone and injections are not the answer for me - they 'repair' the damage, but EK always comes back (sometimes worse).  There are many other prescription drugs and natural options/cure available, and for me they all do the same.  Going down this path lead to a cycle of repair and damage, but no cure.  However, I have learned that EK may 'burn out' for some people who take this  course of action.

The EK condition is somehow related to moisture loss in the specific epidermis layer of skin that is only on two parts of the body and the natural healing mechanism of the skin.  I believe that this is why EK is only on the hands and sometimes on the feet.  The skin on the hands and feet is unique and is designed to be damaged and to heal quickly.  To counter the problem, I keep my hands moisturised, avoid damaging my hands (eg do not hammer nails), and keep those things away from my hands that make EK worse.  These are some of the things I do and that work for me, and maybe for others.

Wear light cotton gloves when doing light work with hands at home/work (am doing so now as typing can affect the finger ends), and wear heavy gloves over them when needing to do hard work (gardening, lifting furniture, etc).  Do not wear the cotton gloves for too long as they will after 20-30 mins start to dry out the skin.  Use a Urea based ‘repair’ cream 4-6 times daily when the condition flares, and 2 times a day when it has abated (after a shower/bath is best absorption time).  

Get a non-greasy quick absorbing hand moisturiser (for when greasy hands are a problem eg meeting people) - make sure it has no added chemicals or perfumes. Keep a clean dry cloth in car/desk (you never know when you need to quickly dry the greasy hands).  Sometimes I wear the cotton gloves when driving long distances – cream underneath and re-apply at least every hour.

Never let any ‘normal’ soaps, chemicals or solvents touch the hands - wear elastic/rubber gloves when in shower/bath (seal with tape around wrists), when applying things like hair products or after shave, and when doing the washing/cleaning.  Wash hands in a dermatological chemical free handwash, and/or use special non-soap soaps.

When seriously bad (usually due to being slack with my management regime) I smother  the hands thickly with the Urea based cream before going to bed and cover hands with a new unwashed pair of cotton socks (gives a quick repair) – this aids the healing processes and makes it better.  If desperate for a serious ‘makeover’ (job interview, wedding, etc), I use a steroid/cortisone ointment (not cream) and apply (not thickly) to hands at night and cover with non-allergenic medical gloves (very thin plastic type material specifically for the application of creams/ointments to the hands – not the rubber gloves).  This usually ‘fixes up‘ the hands for a day or two, but I know the condition will flare again later (has to be worth it to do it).

Basically, the key for me is to manage the condition by avoiding as much as possible anything that makes it worse, and to provide the skin with the right assistance to help it heal. Hopefully, like for some others, the condition will run its course and go away.  Until then I use my management regime to minimise the negative affects EK can have (has had in the past) on my day to day life.

PS - Photochemotherapy is an option I have not tried (yet).  It is a new treatment and new treatments always have their bugs - the technicians and doctors need experience to work out what works best (and more importantly what doesn't).  I have decided to wait a few years for the technique to become more 'mainstream' and will be keeping my eye on it.






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Hi, I am 30 years old and am so happy to have found this post. Your post makes so much sense. A question though? Do your fingers ever swell? I find mine are tight and inflamed (and I have always felt that there is an inability for them to heal themselves) right before they really start a bad peel cycle. Thoughts?

Thanks!
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that guy hit the EK nail on the head.

I'm only 21, my grandmother had this problem and so does her brother.

I worked as a sumer student in an assemby plant, throwing batteries into trucks, wow did it ever get bad. Lucky I live in canada, b/c the post above me is right about the temp. effects
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I'm a 45 yr female and I feel so bad for you all. But glad I stumbled onto this Forum. I've only been suffering from this "EK" contidion on palms of hands for just over 3 yrs. But you mention everything that I have done to make this condition bearable to include prayer. However I have only thought about showering with gloves on and I think I will go ahead and do that regimine too because every type of cleaner causes pain and you gotta shower and wash your hair!

Other skin and life conditions could be & are worse and so I count my blessings.

I too researched every avenue and talked to all kinds of doctors and no one could tell me what is wrong with my hands and/or what has caused this condition. But they stated that because it is not anywhere else on my body, they were all 110% certain that it is NOT contagious. That is a plus!!

As you stated the steroids; (I used the dosepak 4 times in a 10 mth period) help temporarly but the side effects to the rest of your body are not worth it to use of steroid based drugs on a long term basis and the EK comes back. I've found that it isn't stress that triggers  my outbreaks as is the things I do or eat that may cause inflammation in my body; to include my hands, that I have to monitor.

After 3+ yrs I found a New Zealand website that put a name on this condition and for the first time I heard of the treatment called 'Photochemotherapy'. I'm with you; wait and see before trying this procedure. I haven't been able to log on again since that first time after finding site just a week ago...but I printed out the "authoritative facts" that stated other hand creams containing lactic acid or silicone my be helpful in releaving condition; so I'm going back to the nutrition center were I found out about Urea  and see what else they have available with all these ingredients. Could you name the Urea based cream you are using?

I've found that an aloe vera extract with colloidal silver helps in healing the deep lesions and cuts and if bad enough anti-biotic oinment and bandaid to help with the really deep, bleeding, painful cuts.

Typing is one thing, but I enjoy working in the yard/vegitable garden and my husband and I are building our house with our own 4 hands so I (with gloves) hammer and saw and haul heavy stuff frequently as well as all the other things associated with building a house: caulk, silicone, paint, plaster, and though painful I don't and can't let it stop me from living.

The peeling is not as bad as it used to be, but the superficial air-filled skin that callouses and then cracks and peels leaving new raw skin that is painful for couple of days gives me a sign of a break before the whole cycle starts again. Lately however, most of what I suffer from is the superficial air-filled skin that callouses and then cracks leaving cuts and lesions that come and go over and over and over again.

My Thanks goes out to you all for posting your pain, thoughts and suggestions.
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i have just noticed the peeling away and air bubbles on my palms, ive never had it before now (16 yrs )

i hope it goes away but your comments about stress not being the cause is the complete antithesis of me,

i have just completed my GCSEs which are big exams in england (is this an english forrum) and yeh the Ek started about 2 weeks into 5 weeks of exams, coincidence...i think not.

dan its annoying, i always have played loads of sports such as golf tennis hockey which are all hand/fingr based doubt they helped.

i also have seeveral allergies, nuts pollun (horses dunno y?)


and yeh if there is ever a complete remedy or maybe a cream which i can pick up plesae email me

***@****

many thanks
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wtf?


G S T 5 @ H O T M A I L .C O . U K
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Does anyone know any online resources about EK with a good gallery. I've been trying to figure out what has been going on with my skin for a very long time now but i just keep running into dead ends. My palms and soles look alot like the pictures i've seen of EK but my major issue is all the peeling that happens on the tops of my hands, feet lower arms and legs. Could this somehow be related to EK or is this condition centralized only on the palms and soles? I'm not looking for a cure or tips on keeping the peeling at bay, i just want to know what it is so i know what to do when i have an especially bad outbreak.  
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Hello fellow EK sufferers.  I'm a 48 year old male and have suffered from EK for approx. 10 years.  I too had to self diagnose as no doctor ever offered.  I've been to countless doctors, dermatologists including the Mayo Clinic.  Needless to say "no help" any where.  I've also tried countless prescription ointments , etc.

Mine starts up in late winter (Minnesota) or early spring every year.  Then by late October clears up, and I mean clears up to the point where all winter you'd never guess I had the condition.  I always just thought it was seasonal and that's the way it is.  Then it dawned on me that every August and late September I get an injection of Depo Medrol for severe fall hayfever allergies.

I am convinced that this injection, which is a form of steroid gets in my system, clears up my EK and then by late winter begins wearing off and condition returns.  Depo Medrol is, as my doctor tells me also available in a topical ointmnent, which I have not yet tried.

Please, if anyone else has had the same injection I'd like to hear from you.
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Great information.  I have been trying to figure out what is going on with my son's fingertips for a few years now.  It seems to happen during the summer months and last summer my husband and I thought it was from the swimming lessons he was taking (the Chlorine) but this year he isn't taking swimming lessons and again his fingers are peeling.  It seems to clear up as soon as summer is over.  One comment above (from geofrey2) caught my eye - he mentioned that it seemed his fingernails grew faster during the outbreak.  I swear my older sons finger nails grow twice as fast as his younger brother.  Does anyone else notice that?  I am also very thankful for the information from Scala500 was awesome.  Have any of you been diagnosed with EK from a doctor - or just self diagnosed (like I too have done)?  I would love to know the name of the Urea based handcream you are using too.  I am going to take my son back to the doctor next week and ask about EK and see what they say.  They haven't ever diagnosed my son either.  Again, thank you for the info.
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I am seeing my doctor again this week and am also going to inquire about the Urea based creams.  I've tried countless creams but not sure if any were ever Urea based?  Isn't it crazy that I keep going to doctors and why because nothing but the Dep Medrol steroid injections help.  I guess I keep trying because it is so miserable having this condition, especially over the active summer months.  It affects so many activities from typing on the keyboard to opening a can of pop, which becomes terribly painful.

I know what you mean about the finger nails.  I'm not sure if they are actually growing that much faster or if it's because when the finger tip skin keeps peeling the connected area kind of works back further on the finger tip.

Scala500 did offer some great and extensive advice but holy cow following that regime wouldn't be easy.
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