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Subject: Keratosis Pilaris
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Keratosis pilaris (KP) is a benign skin disorder resulting in hyperkeratinization of the hair follicles.
Generally asymptomatic, often improving with age
The abrasive (“sandpaper-like,” “chicken skin-like,” or “goose bump-like”) texture of the skin is caused by excess buildup of keratin. An underlying hair may be found in some of the papules. In the inflammatory variant, mild perifollicular erythema is present.
Autosomal dominant inheritance, with incomplete penetrance. KP is more frequent in obese patients.
Patients often complain about a “rough” skin, sometimes with pruritus (which indicates inflammation).
Most patients are asymptomatic, but some are concerned about their cosmetic appearance.
Family history is positive in up to 50% of cases.
Firm, minimally rough, 1- to 2-mm, follicle-based papules, some with perilesional erythema. Distribution is frequently symmetric.
Most common on the lateral-proximal aspects of the arms and thighs; less common on the cheeks and gluteal areas
Rare dermatologic conditions (e.g., keratosis follicularis, lichen spinulosus, lichen nitidus, perforating folliculitis)
Lactic acid 12% creams/lotions (e.g., ammonium lactate: AmLactin Ultra, Lac-Hydrin)
Urea (in 40–50% topical preparations)
Topical retinoids: tretinoin (Retin-A), adapalene (Differin), tazarotene (Tazorac)
Tacrolimus (Protopic) ointment
757.39 Other specified anomalies of skin
701.1 Keratoderma, acquired
KP is frequently mistaken for acne.
Patients often self-manage with over-the-counter acne treatment products/medications originally prescribed for their facial acne.
Daily measures to prevent dry skin, such as using mild cleansers, along with moisturizers, are the mainstay of treatment.
Stop patients from exfoliating.