Keratolysis exfoliativa (KE), also known as dyshidrosis lamellosa sicca, lamellar dyshidrosis, or recurrent focal palmar peeling, is a common palmoplantar blistering disorder of unknown pathogenesis. The notion that KE represents a mild form of dyshidrotic eczema has been challenged by a recent study of over twenty patients that showed the lack of eczematous features on histopathology.

In KE, annuli of erythema progress to air-filled superficial bullae that rupture to leave fine, expanding collarettes of scale. Bullae may coalesce and lead to desquamation of the entire volar surface; dorsal surfaces are less commonly involved.

While generally asymptomatic, KE can cause a mild, initial burning or tingling sensation and pain upon blister rupture. Chronically, thinning of the skin can cause local sensitivity. Involved surfaces are often associated with hyperhidrosis. Blistering is exacerbated by friction and moist, warm environments.