Hyperkeratosis

Hyperkeratosis
Micrograph showing hyperkeratosis. H&E stain.
Classification and external resources
Pronunciation	/ˌhaɪpərkɛrəˈtoʊsᵻs/ (hyper- + kerato- + -osis)
Specialty
ICD-10	L85.9
ICD-9-CM	701.1
DiseasesDB	20624
Patient UK	Hyperkeratosis

Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin, and also usually accompanied by an increase in the granular layer. As the corneum layer normally varies greatly in thickness in different sites, some experience is needed to assess minor degrees of hyperkeratosis.

It can be caused by vitamin A deficiency or chronic exposure to arsenic.

Hyperkeratosis can also be caused by B-Raf inhibitor drugs such as Vemurafenib and Dabrafenib.

It can be treated with urea-containing creams, which dissolve the intercellular matrix of the cells of the stratum corneum, promoting desquamation of scaly skin, eventually resulting in softening of hyperkeratotic areas.

Types

Follicular

Follicular hyperkeratosis dass (also called phrynoderma) is a skin condition characterized by excessive development of keratin in hair follicles, resulting in rough, cone-shaped, elevated papules. The openings are often closed with a white plug of encrusted sebum.

This condition has been shown in several small-scale studies to respond well to supplementation with vitamins and fats rich in essential fatty acids. Deficiencies of vitamin E, vitamin A and B complex vitamins have been implicated in causing the condition.

By other specific site

• Plantar hyperkeratosis is hyperkeratosis of the sole of the foot. It is recommended to surgically remove the dead skin, to provide symptomatic relief.
• Hyperkeratosis of the nipple and areola is an uncommon benign, asymptomatic, acquired condition of unknown pathogenesis.

Hereditary

• Epidermolytic hyperkeratosis (also known as "Bullous congenital ichthyosiform erythroderma," "Bullous ichthyosiform erythroderma," or "bullous congenital ichthyosiform erythroderma Brocq") is a rare skin disease in the ichthyosis family affecting around 1 in 250,000 people. It involves the clumping of keratin filaments.
• Multiple minute digitate hyperkeratosis, a rare cutaneous condition, with about half of cases being familial
• Focal acral hyperkeratosis (also known as "Acrokeratoelastoidosis lichenoides,") is a late-onset keratoderma, inherited as an autosomal dominant condition, characterized by oval or polygonal crateriform papules developing along the border of the hands, feet, and wrists.
• Keratosis Pilaris appears similar to gooseflesh, is usually asymptomatic and may be treated by moisturizing the skin.

Other

• Hyperkeratosis lenticularis perstans (also known as "Flegel's disease") is a cutaneous condition characterized by rough, yellow-brown keratotic, flat-topped papules.

Hyperkeratosis of mucous membranes

The term hyperkeratosis is often used in connection with lesions of the mucous membranes, such as leukoplakia. Because of the differences between mucous membranes and the skin (e.g. keratinizing mucosa does not have a stratum lucidum and non keratinizing mucosa does not have this layer or normally a stratum corneum or a stratum granulosum), sometimes specialized texts give slightly different definitions of hyperkeratosis in the context of mucosae. Examples are "an excessive formation of keratin (e.g., as seen in leukoplakia)" and "an increase in the thickness of the keratin layer of the epithelium, or the presence of such a layer in a site where none would normally be expected."

Etymology

The word hyperkeratosis uses combining forms of hyper- + kerato- + -osis, conveying "the condition of too much keratin".

See also

• Skin lesion
• Skin disease
• Keratin disease
• List of skin diseases