Keratosis pilaris

Keratosis pilaris (KP; also follicular keratosis, lichen pilaris, or colloquially chicken skin It most often appears on the outer sides of the upper arms (the forearms can also be affected), thighs, face, back, and buttocks; Often the lesions can appear on the face, which may be mistaken for acne or folliculitis.

The several types of KP have been associated with pregnancy, type 1 diabetes mellitus, obesity, dry skin, allergic diseases (e.g., atopic dermatitis), and rarely cancer.

KP is the most common disorder of the hair follicle in children. No single approach has been found to cure KP completely, but treatments can improve the cosmetic appearance of the condition. Treatment includes the application of topical preparations of moisturizers and medications such as glycolic acid, lactic acid, salicylic acid, urea, or retinoids to the skin. The symptoms may also worsen during pregnancy or after childbirth. Increased sun exposure might mitigate the symptoms of KP.

Pathophysiology

KP occurs when the human body produces excess amounts of the skin protein keratin, resulting in the formation of small, raised bumps in the skin, often with surrounding redness. The excess keratin, which is the same color as the person's natural skin tone, surrounds and entraps the hair follicles in the pore. This causes the formation of hard plugs (a process known as hyperkeratinization). Those with this condition are generally encouraged to contact a physician if the bumps are bothersome and do not improve with over-the-counter lotions.

Classification

The several different types of KP include KP rubra (red, inflamed bumps, which can be on arms, head, legs), KP alba (rough, bumpy skin with no irritation), KP rubra faceii (reddish rash on the cheeks), KP atrophicans, keratosis follicularis spinulosa decalvans, atrophoderma vermiculatum, KP atrophicans faciei, erythromelanosis follicularis faciei et colli, and papular profuse precocious KP. It is not related to goose bumps, which result from muscle contractions, except that both occur in the area where the hair shaft exits the skin.

Gallery

File:Keratosis Pilaris on Back.jpg|Keratosis Pilaris on Back

File:Keratosis Pilaris on Lower Extremity.jpg|Keratosis pilaris on lower extremity

File:KeratosisPilaris.jpg|Keratosis pilaris on the back of the upper arm

File:Keratosis pilaris arm.jpg|Keratosis pilaris on arm

File:Keratosis pilaris skin plugs.jpg|Skin plugs removed from a person with keratosis pilaris

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Treatment

Topical creams and lotions are currently the most commonly used treatment for KP, specifically those consisting of moisturizing or keratolytic treatments, including urea, lactic acid, glycolic acid, salicylic acid, vitamin D, fish oil, or topical retinoids such as tretinoin. Many products are available that apply abrasive materials, with alpha or beta hydroxy acids to assist with exfoliation.

Some cases of KP have been successfully treated with laser therapy, which involves passing intense bursts of light into targeted areas of the skin. Depending on the body's response to the treatment, multiple sessions over the course of a few months may be necessary.

Epidemiology

Worldwide, KP affects an estimated 30 to 50% of the adult population, and around 50 to 80% of all adolescents. It is more common in women than in men. It is often present in otherwise healthy individuals. The skin condition is prevalent in people of all ethnicities, and no particular ethnicity is at higher risk for developing KP. Although KP may manifest in people of any age, it usually appears within the first decade of life and is more common in young children.