Keratosis pilaris in Child
Alerts and Notices
Synopsis
Keratosis pilaris tends to worsen during winter months, and it usually decreases after puberty. It is typically asymptomatic, but if treatment is attempted, the affected areas are often refractory.
Keratosis pilaris is seen with increased incidence in several syndromes and disease states. In addition to atopic dermatitis, these include ichthyosis vulgaris, erythromelanosis follicularis faciei et colli (erythema, brown pigmentation, and keratosis pilaris), Graham-Little-Piccardi-Lassueur syndrome (cicatricial alopecia of the scalp, loss of pubic and axillary hairs, and keratosis pilaris), cardiofaciocutaneous syndrome, Noonan syndrome, diabetes, Down syndrome, woolly hair, and obesity.
Clinical Variants
- Nonatrophic variant with background erythema – keratosis pilaris rubra
- Atrophic variants – keratosis pilaris atrophicans faciei (ulerythema ophryogenes), atrophoderma vermiculatum, and keratosis follicularis spinulosa decalvans
Codes
ICD10CM:L85.8 – Other specified epidermal thickening
SNOMEDCT:
5132005 – Keratosis pilaris
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Atopic dermatitis
- Lichen nitidus – Small, dome-shaped, smooth-surfaced, nonfollicular papules on the extremities, abdomen, and penis; koebnerization is present.
- Acne vulgaris
- Facial lesions may be confused with milia or acne – Milia are yellow-white, chalky, nonfollicular, hemispherical, smooth-surfaced papules. Acne is characterized by comedones, inflammatory papules, and pustules.
- Folliculitis – Inflammatory tender follicular papules / pustules (with perilesional erythema).
- Miliaria – Inflammatory follicular papules, vesicles, or pustules on the trunk or proximal extremities; keratosis pilaris is noninflammatory.
- Pityriasis rubra pilaris
- Lichen spinulosus – Grouped keratotic spiny follicular papules coalescing to form nummular or circular plaques on the trunk and extremities.
- Phrynoderma (vitamin A deficiency) – Large individual keratotic horny papules on the buttocks, shoulders, and around the elbows and knees; there may be an underling nutritional deficiency.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:01/31/2017
Last Updated:02/12/2020
Last Updated:02/12/2020
Keratosis pilaris in Child