Keratosis pilaris
- most often seen on the arms and legs but might also occur on the face, buttocks, or torso
- patches of skin that appear bumpy, slightly red, and feel rough
- may get worse in dry weathe
- Prevalence:
- Common in children and young adults.
- 50-70% of teenagers and 40% of adults affected.
- Associated with atopic eczema and ichthyosis.
- Causes:
- Abnormal keratinization in hair follicles.
- Genetic link, possibly autosomal dominant.
- Mutations in filaggrin gene implicated.
- Worsens in dry, winter conditions.
- Clinical Features:
- ‘Goosebump’ or ‘chicken skin’ appearance.
- Bumps can be skin-colored, red, or brown.
- Rough, dry skin, occasionally itchy.
- Commonly on upper arms, thighs, buttocks, trunk, chest, face.
- Variants: erythromelanosis follicularis, ulerythema ophryogenes, atrophoderma vermiculatum.
- Skin Type Variation:
- Bumps match patient’s skin color.
- Red on white skin; brown/black on darker skin.
- Complications:
- Atrophy.
- Scarring and hair loss.
- Diagnosis:
- Clinical evaluation, dermoscopy, punch biopsy.
- Differential Diagnosis:
- Atopic dermatitis, folliculitis, milia, lichen nitidus, lichen spinulosus, phrynoderma.
- Treatment:
- Exfoliating techniques.
- Moisturizers with urea, salicylic acid, lactic acid, alpha hydroxy acids.
- Topical retinoids, short courses of topical steroids for itch.
- Pulse dye laser, intense pulsed light for erythema, laser hair removal for ingrown hairs.
- Outcome:
- No cure but often improves in adulthood.
- Management improves condition; atrophy or scarring may be permanent.
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