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Ashy skin xerosis - Skin
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Ashy skin xerosis - Skin

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Contributors: Nasir Aziz MD, Paul Kelly MD, Lowell A. Goldsmith MD, MPH, Lynn McKinley-Grant MD, Aída Lugo-Somolinos MD
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Synopsis

Xerosis (dry skin, asteatosis) is also known as "ashy skin," a term originating in the African American community. In many individuals, the stratum corneum of the epidermis fails to retain moisture, manifesting clinically as dry, cracked, and powdery skin. Xerosis causing ashiness reduces the skin's shine and presents as white patches in dark skin. It may be pruritic.

Multiple studies have shown that transepidermal water loss is greater in people with dark skin complexion, thereby predisposing them to xerosis. Significant differences in the level of ceramides in the stratum corneum have been found, with the lowest levels in individuals of African descent, followed by whites, Hispanics, and Asians. One study found that ceramide levels were inversely correlated with transepidermal water loss and directly related to water content. While the evidence regarding differences in corneocyte desquamation is scant, some observers have noted that individuals of African descent have a 2.5 times greater spontaneous desquamation rate compared with whites and Asians, which could explain the higher frequency of xerosis seen. The difference in sebaceous gland activity between "white" and "black" skin remains disputed. One study measuring sebaceous gland activity in 649 male and female patients, 67 of whom were characterized as black, found no difference in sebaceous gland activity between the white and black participants. Other studies have found increased sebum production, pore size, and skin microflora in individuals of African descent.

Xerosis is associated with a number of environmental factors and/or disease states, such as low humidity, frequent bathing, harsh soaps, ichthyoses, atopic dermatitis, hypothyroidism, Down syndrome, renal failure, malnutrition and malabsorptive states, HIV, lymphoma, liver disease, Sjögren syndrome, carcinomatosis, and certain drugs. The incidence of xerosis increases with age.

Codes

ICD10CM:
L85.3 – Xerosis cutis

SNOMEDCT:
89105000 – Asteatosis cutis

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Last Updated: 06/04/2013
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Ashy skin xerosis - Skin
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Ashy skin xerosis : Dry skin, Fine scaly plaque, Symmetric extremities, White scaly plaque
Clinical image of Ashy skin xerosis
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