Follicular keratosis is a genetic disorder that causes hard, oily, yellow or brown patches on the skin and broken nails. It can be managed with topical medications and dermabrasion techniques. Regular use of moisturizing lotions and loose-fitting clothing can prevent flare-ups.
Follicular keratosis is a rare disease that causes widespread skin lesions and broken nails. It is a genetic disorder that typically emerges during adolescence or early adulthood. During a flare-up, hard, oily, yellow or brown patches develop on the skin that may emit a strong odor. Most cases of follicular keratosis are relatively minor and cause no health problems other than their physical appearance. A dermatologist can usually shorten the course of an episode with topical medications and clinical dermabrasion techniques.
Recent genetic studies have been able to pinpoint the genetic mutation that causes follicular keratosis. A child is likely to inherit the disorder if one or both parents have a mutated copy of the ATP2A2 gene. A faulty gene affects the ability of skin and nail cells to stick together and hold themselves together.
A follicular keratosis rash can appear anywhere on the body, but is most common on the chest, face, neck, or back. Areas susceptible to sweat buildup and irritation, such as the groin, armpits, and buttocks, may also be affected. The lesions are usually hard and wart-like and do not itch or hurt. When fingernails or toenails are involved, they often break and discolor. Very rarely, patients experience lesions or abscesses within the mucous membranes including in the nostrils, mouth and throat.
Follicular keratosis is very rare, but its presentation is so unique that most dermatologists can easily diagnose the condition. A doctor may decide to take a skin biopsy for microscopic analysis. Once the diagnosis is confirmed, the dermatologist can explain the disorder and offer advice on how best to keep it under control.
Most patients with mild skin problems and rare exacerbations do not require aggressive treatment. Regular use of moisturizing lotions and applying sunscreen before going outdoors can usually prevent recurring episodes. Additionally, dermatologists recommend wearing loose-fitting, breathable clothing to help prevent sweat buildup and irritation that could trigger a flare-up. Scratching or pinching the skin lesions is discouraged to reduce the chances of a secondary bacterial infection.
If a person experiences widespread or frequent skin problems, a high-strength topical cream may be prescribed. A clinical procedure called dermabrasion, which involves manually removing the outer layers of hard lesions, can help shorten healing time on large patches of skin. For nail problems, oral and topical medications containing retinoids are usually effective in strengthening nails. With proper management and regular checkups, most people are able to go several years between flares.
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