Sudden Keratosis Pilaris Exacerbation

[BioDiesel]

My KP has been mild the past several years w/ only a small number of the larger red raised plugs, but a few weeks ago I noticed an abrupt increase over a period of a few days. My skin went from being fairly smooth to being covered w/ these elevated hard red bumps over nearly every folicule. This is a much more extreme outbreak than I've ever experienced, and the most extensive. I also noticed that new eruptions would appear over night - I could see slightly lighter, raised areas, like minor welts, sort of like a new insect bite before the erythema has had time to develop; And this was surrounding a skin-colored plug, which later on often became larger & red. Some areas itch very mildly, which is another deviation from my past experiences with KP, but otherwise the lesions appear the same as one's I've always had. Is this presentation abnormal for KP? Could stress or an allergy cause a KP exacerbation? I have been under a lot of stress lately, and have been wearing a new pair of slacks, which I did not, "wash before wearing". There has been no change in the KP on my upper arms however, which would seem to rule out stress. Here are a couple pictures of it in it's current state:

http://wildmacaw.com/temp/kp1.jpg
http://wildmacaw.com/temp/kp2.jpg  

Thank you.

[Alan Rockoff, MD]

The pictures do indeed look like keratosis pilaris.  Frankly, I've never been able to make sense of flares of this condition, or why it subsides either, for that matter.  It doesn't seem to correlate with dryness, temperature, and so forth, and it certainly is not allergic.  I wouldn't think about it too much.  If it bothers you, have the druggist give you a moisturizer containing ammonium lactate or urea, then take a Buf Puf or loofah and exfoliate after showering and applying the lotion.  Do this 20 seconds a day for as many days as it takes to smooth the skin out.

Best.

Dr. Rockoff