Keratosis Pilaris

Keratosis pilaris is a harmless, common dry skin condition frequently referred to as "goosebumps" or "chicken skin." Keratosis pilaris typically begins in childhood and is not contagious.

Cause

Keratosis pilaris is due to abnormal keratinization of the hair follicle, where keratin fills the follicle rather than exfoliating. It is believed to have a genetic association and can be more noticeable in the winter months.

Clinical Features

This condition can present as small skin-colored, red, or brown bumps. The skin typically feels rough and dry. Areas of involvement vary from the upper arms to the chest and face. Keratosis pilaris is typically seen in children, teenagers (50-70%), and adults (40%). This condition has been associated with other diseases like eczema and ichthyosis.

Complications

Keratosis pilaris can cause itchiness, atrophy, scarring, and possibly hair loss.

Diagnosis

Diagnosis is typically made through clinical evaluation. Providers may use a dermatoscope to assess for abnormalities of the hair shaft. If diagnosis is not clear, a punch biopsy can help characterize the condition.

Treatment

There is no cure for keratosis pilaris, however there are ways to help alleviate symptoms. Generally, it is good practice to gently exfoliate the affected skin when bathing. It is important to use moisturizing creams that contain urea, salicylic acid, lactic acid, or alpha hydroxy acids. Topical retinoids could also be beneficial for treatment.

Differential Diagnosis

Conditions with similar signs and symptoms include atopic dermatitis, folliculitis, milia, lichen nitidus, lichen spinulosus, and phrynoderma due to nutritional deficiencies.

Citation: Winter, S., & Motley, R. (2022). Keratosis pilaris. DermNet. https://dermnetnz.org/topics/keratosis-pilaris.

Written by Mariah Kalma, APRN

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