角質増生
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| Hyperkeratosis |
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| Micrograph showing hyperkeratosis. H&E stain. |
| Pronunciation |
(hyper- + kerato- + -osis)
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| Classification and external resources |
| Specialty |
dermatology |
| ICD-10 |
L85.9 |
| ICD-9-CM |
701.1 |
| DiseasesDB |
20624 |
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[edit on Wikidata]
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Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin,[1] and also usually accompanied by an increase in the granular layer. As the corneum layer normally varies greatly in thickness in different sites, some experience is needed to assess minor degrees of hyperkeratosis.
It can be caused by vitamin A deficiency or chronic exposure to arsenic.
Hyperkeratosis can also be caused by B-Raf inhibitor drugs such as Vemurafenib and Dabrafenib.[2]
It can be treated with urea-containing creams, which dissolve the intercellular matrix of the cells of the stratum corneum, promoting desquamation of scaly skin, eventually resulting in softening of hyperkeratotic areas.[3]
Contents
- 1 Types
- 1.1 Follicular
- 1.2 By other specific site
- 1.3 Hereditary
- 1.4 Other
- 2 Hyperkeratosis of mucous membranes
- 3 Etymology and pronunciation
- 4 See also
- 5 References
Types
Follicular
Follicular hyperkeratosis dass (also called phrynoderma) is a skin condition characterized by excessive development of keratin in hair follicles, resulting in rough, cone-shaped, elevated papules. The openings are often closed with a white plug of encrusted sebum.
This condition has been shown in several small-scale studies to respond well to supplementation with vitamins and fats rich in essential fatty acids. Deficiencies of vitamin E,[4] vitamin A, and B complex vitamins have been implicated in causing the condition.[5]
By other specific site
- Plantar hyperkeratosis is hyperkeratosis of the sole of the foot. It is recommended to surgically remove the dead skin, to provide symptomatic relief.
- Hyperkeratosis of the nipple and areola is an uncommon benign, asymptomatic, acquired condition of unknown pathogenesis.[6]:636
Hereditary
- Epidermolytic hyperkeratosis (also known as "Bullous congenital ichthyosiform erythroderma,"[7] "Bullous ichthyosiform erythroderma,"[8]:482 or "bullous congenital ichthyosiform erythroderma Brocq"[9]) is a rare skin disease in the ichthyosis family affecting around 1 in 250,000 people. It involves the clumping of keratin filaments.[6]:562[10]
- Multiple minute digitate hyperkeratosis, a rare cutaneous condition, with about half of cases being familial
- Focal acral hyperkeratosis (also known as "Acrokeratoelastoidosis lichenoides,") is a late-onset keratoderma, inherited as an autosomal dominant condition, characterized by oval or polygonal crateriform papules developing along the border of the hands, feet, and wrists.[8]:509
- Keratosis pilaris appears similar to gooseflesh, is usually asymptomatic and may be treated by moisturizing the skin.[11]
Other
- Hyperkeratosis lenticularis perstans (also known as "Flegel's disease"[7]) is a cutaneous condition characterized by rough, yellow-brown keratotic, flat-topped papules.[6]:639[7]
Hyperkeratosis of mucous membranes
The term hyperkeratosis is often used in connection with lesions of the mucous membranes, such as leukoplakia. Because of the differences between mucous membranes and the skin (e.g. keratinizing mucosa does not have a stratum lucidum and non keratinizing mucosa does not have this layer or normally a stratum corneum or a stratum granulosum), sometimes specialized texts give slightly different definitions of hyperkeratosis in the context of mucosae. Examples are "an excessive formation of keratin (e.g., as seen in leukoplakia)"[12] and "an increase in the thickness of the keratin layer of the epithelium, or the presence of such a layer in a site where none would normally be expected."[13]
Etymology and pronunciation
The word hyperkeratosis () uses combining forms of hyper- + kerato- + -osis, conveying "the condition of too much keratin".
See also
- Skin lesion
- Skin disease
- Keratin disease
- List of skin diseases
- Calluses
References
- ^ Kumar, Vinay; Fausto, Nelso; Abbas, Abul (2004) Robbins & Cotran Pathologic Basis of Disease (7th ed.). Saunders. Page 1230. ISBN 0-7216-0187-1.
- ^ Niezgoda, Anna; Niezgoda, Piotr; Czajkowski, Rafal (2015) Novel Approaches to Treatment of Advanced Melanoma: A Review of Targeted Therapy and Immunotherapy BioMed Research International
- ^ drugs.com > Urea Cream (Prescribing Information) Revised: 04/2010 by Stratus Pharmaceuticals
- ^ Nadiger, HA (1980). "Role of vitamin E in the aetiology of phrynoderma (follicular hyperkeratosis) and its interrelationship with B-complex vitamins". British Journal of Nutrition. 44 (3): 211–4. PMID 7437404. doi:10.1079/bjn19800033.
- ^ "Hyperkeratosis". Dorland's Medical Dictionary for Health Consumers. 2007.
- ^ a b c James, William D.; Berger, Timothy G.; Elston, Dirk M.; et al. (2006). "Clinical diagnosis by laboratory methods". Andrews' diseases of the skin: clinical dermatology (10th ed.). Saunders Elsevier. ISBN 0-7216-2921-0.
- ^ a b c Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- ^ a b Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- ^ synd/1036 at Who Named It?
- ^ Cheng J, Syder AJ, Yu QC, Letai A, Paller AS, Fuchs E (September 1992). "The genetic basis of epidermolytic hyperkeratosis: a disorder of differentiation-specific epidermal keratin genes". Cell. 70 (5): 811–9. PMID 1381287. doi:10.1016/0092-8674(92)90314-3.
- ^ Hwang, Schwartz (Sep 2008). "Keratosis pilaris: a common follicular hyperkeratosis.". Cutis. 82 (3): 177–80. PMID 18856156.
- ^ Mosby's Dental Dictionary
- ^ Tyldesley WR, Field A, Longman L (2003). Tyldesley's Oral medicine (5th ed.). Oxford: Oxford University Press. ISBN 0192631470.
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Clinical and histological nomenclature for skin lesions
|
| Macroscopic |
| Primary lesions |
- flat
- elevated
- fluid
- Ulcer
- Erosion
- Telangiectasia
- Special initial lesions : Burrow
- Comedo
- Scutulum
- Target lesion
- Herald patch
- Wheal
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| Secondary lesions |
- Scale
- Crust
- Lichenification
- Excoriation
- Induration
- Atrophy
|
|
| Microscopic |
- keratin: Hyperkeratosis
- Parakeratosis
- Dyskeratosis
- Hypergranulosis
- Acanthosis
- Papillomatosis
- Acantholysis
- Spongiosis
- Hydropic swelling
- Exocytosis
- Vacuolization
- Erosion
- Ulceration
- Lentiginous
|
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Cutaneous keratosis, ulcer, atrophy, and necrobiosis (L82–L94, 700–701.5)
|
| Epidermal thickening |
- keratoderma: Keratoderma climactericum
- Paraneoplastic keratoderma
- Acrokeratosis paraneoplastica of Bazex
- Aquagenic keratoderma
- Drug-induced keratoderma
- Paraneoplastic keratoderma
- psoriasis
- Keratoderma blennorrhagicum
- keratosis: Seborrheic keratosis
- Clonal seborrheic keratosis
- Common seborrheic keratosis
- Irritated seborrheic keratosis
- Seborrheic keratosis with squamous atypia
- Reticulated seborrheic keratosis
- Dermatosis papulosa nigra
- Keratosis punctata of the palmar creases
- other hyperkeratosis: Acanthosis nigricans
- Confluent and reticulated papillomatosis
- Callus
- Ichthyosis acquisita
- Arsenical keratosis
- Chronic scar keratosis
- Hyperkeratosis lenticularis perstans
- Hydrocarbon keratosis
- Hyperkeratosis of the nipple and areola
- Inverted follicular keratosis
- Lichenoid keratosis
- Multiple minute digitate hyperkeratosis
- PUVA keratosis
- Reactional keratosis
- Stucco keratosis
- Thermal keratosis
- Viral keratosis
- Warty dyskeratoma
- Waxy keratosis of childhood
- other hypertrophy: Keloid
- Hypertrophic scar
- Cutis verticis gyrata
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| Necrobiosis/granuloma |
| Necrobiotic/palisading |
- Granuloma annulare
- Perforating
- Generalized
- Subcutaneous
- Granuloma annulare in HIV disease
- Localized granuloma annulare
- Patch-type granuloma annulare
- Necrobiosis lipoidica
- Annular elastolytic giant cell granuloma
- Granuloma multiforme
- Necrobiotic xanthogranuloma
- Palisaded neutrophilic and granulomatous dermatitis
- Rheumatoid nodulosis
- Interstitial granulomatous dermatitis/Interstitial granulomatous drug reaction
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| Foreign body granuloma |
- Beryllium granuloma
- Mercury granuloma
- Silica granuloma
- Silicone granuloma
- Zirconium granuloma
- Soot tattoo
- Tattoo
- Carbon stain
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| Other/ungrouped |
|
|
Dermis/
localized CTD |
Cutaneous lupus
erythematosus |
- chronic: Discoid
- Panniculitis
- ungrouped: Chilblain
- Lupus erythematosus–lichen planus overlap syndrome
- Tumid
- Verrucous
- Rowell's syndrome
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Scleroderma/
Morphea |
- Localized scleroderma
- Localized morphea
- Morphea–lichen sclerosus et atrophicus overlap
- Generalized morphea
- Atrophoderma of Pasini and Pierini
- Pansclerotic morphea
- Morphea profunda
- Linear scleroderma
|
Atrophic/
atrophoderma |
- Lichen sclerosus
- Anetoderma
- Schweninger–Buzzi anetoderma
- Jadassohn–Pellizzari anetoderma
- Atrophoderma of Pasini and Pierini
- Acrodermatitis chronica atrophicans
- Semicircular lipoatrophy
- Follicular atrophoderma
- Linear atrophoderma of Moulin
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| Perforating |
- Kyrle disease
- Reactive perforating collagenosis
- Elastosis perforans serpiginosa
- Perforating folliculitis
- Acquired perforating dermatosis
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| Skin ulcer |
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| Other |
- Calcinosis cutis
- Sclerodactyly
- Poikiloderma vasculare atrophicans
- Ainhum/Pseudo-ainhum
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|
UpToDate Contents
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English Journal
- Ataseven A, Ozturk P, Kucukosmanoglu I, Kurtipek GS.Author information Konya Training and Research Hospital, Konya, Turkey.AbstractKyrle's disease (KD) is a dermatosis which was first described by Kyrle as "hyperkeratosis follicularis et parafollicularis in cutem penetrans" in 1916. Perforating dermatoses are a heterogeneous disorder group characterised by transepithelial elimination. KD has been seen in association with multiple disorders, including diabetes mellitus, renal and liver diseases, congestive heart failure, hyperlipidaemia, infective diseases and abnormal metabolism of vitamin A. This case report presents two patients with KD with associated systemic disease.
- BMJ case reports.BMJ Case Rep.2014 Jan 15;2014. pii: bcr2013009905. doi: 10.1136/bcr-2013-009905.
- Kyrle's disease (KD) is a dermatosis which was first described by Kyrle as "hyperkeratosis follicularis et parafollicularis in cutem penetrans" in 1916. Perforating dermatoses are a heterogeneous disorder group characterised by transepithelial elimination. KD has been seen in association with multip
- PMID 24429045
- Cutaneous Injury-Related Structural Changes and Their Progression following Topical Nitrogen Mustard Exposure in Hairless and Haired Mice.
- Tewari-Singh N1, Jain AK1, Orlicky DJ2, White CW3, Agarwal R1.Author information 1Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Denver, Aurora, Colorado, United States of America.2Department of Pathology, School of Medicine, University of Colorado Denver, Aurora, Colorado, United States of America.3Department of Pediatrics, School of Medicine, University of Colorado Denver, Aurora, Colorado, United States of America.AbstractTo identify effective therapies against sulfur mustard (SM)-induced skin injuries, various animals have been used to assess the cutaneous pathology and related histopathological changes of SM injuries. However, these efforts to establish relevant skin injury endpoints for efficacy studies have been limited mainly due to the restricted assess of SM. Therefore, we employed the SM analog nitrogen mustard (NM), a primary vesicating and bifunctional alkylating agent, to establish relevant endpoints for efficient efficacy studies. Our published studies show that NM (3.2 mg) exposure for 12-120 h in both the hairless SKH-1 and haired C57BL/6 mice caused clinical sequelae of toxicity similar to SM exposure in humans. The NM-induced cutaneous pathology-related structural changes were further analyzed in this study and quantified morphometrically (as percent length or area of epidermis or dermis) of skin sections in mice showing these lesions. H&E stained skin sections of both hairless and haired mice showed that NM (12-120 h) exposure caused epidermal histopathological effects such as increased epidermal thickness, epidermal-dermal separation, necrotic/dead epidermis, epidermal denuding, scab formation, parakeratosis (24-120 h), hyperkeratosis (12-120 h), and acanthosis with hyperplasia (72-120 h). Similar NM exposure in both mice caused dermal changes including necrosis, edema, increase in inflammatory cells, and red blood cell extravasation. These NM-induced cutaneous histopathological features are comparable to the reported lesions from SM exposure in humans and animal models. This study advocates the usefulness of these histopathological parameters observed due to NM exposure in screening and optimization of rescue therapies against NM and SM skin injuries.
- PloS one.PLoS One.2014 Jan 8;9(1):e85402. doi: 10.1371/journal.pone.0085402.
- To identify effective therapies against sulfur mustard (SM)-induced skin injuries, various animals have been used to assess the cutaneous pathology and related histopathological changes of SM injuries. However, these efforts to establish relevant skin injury endpoints for efficacy studies have been
- PMID 24416404
- Prevalence of inherited ichthyosis in France: a study using capture-recapture method.
- Dreyfus I, Chouquet C, Ezzedine K, Henner S, Chiavérini C, Maza A, Pascal S, Rodriguez L, Vabres P, Martin L, Mallet S, Barbarot S, Dupuis J, Mazereeuw-Hautier J.Author information Reference Centre for Rare Skin Diseases, Dermatology Department, Larrey Hospital, CHU Toulouse, Toulouse, France. dreyfus.i@chu-toulouse.fr.AbstractBACKGROUND: Inherited ichthyoses represent a group of rare skin disorders characterized by scaling, hyperkeratosis and inconstant erythema, involving most of the tegument. Epidemiology remains poorly described. This study aims to evaluate the prevalence of inherited ichthyosis (excluding very mild forms) and its different clinical forms in France.
- Orphanet journal of rare diseases.Orphanet J Rare Dis.2014 Jan 6;9(1):1. doi: 10.1186/1750-1172-9-1.
- BACKGROUND: Inherited ichthyoses represent a group of rare skin disorders characterized by scaling, hyperkeratosis and inconstant erythema, involving most of the tegument. Epidemiology remains poorly described. This study aims to evaluate the prevalence of inherited ichthyosis (excluding very mild f
- PMID 24393603
Japanese Journal
- 糖尿病足潰瘍予防を目的とした足白癬・爪白癬のアセスメントとケア
- 症例 Hyperkeratosis of Nipple and Areolaの1例
- 色素失調症（Bloch-Sulzberger Syndrome）の 1 例
Related Links
- Hyperkeratosis - an easy to understand guide covering causes, diagnosis, symptoms, treatment and prevention plus additional in depth medical information. ... Drugs.com provides accurate and independent information on more than ...
- Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin, [1] and also usually accompanied by an increase in the granular layer.
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真皮貫通性毛包性毛包周囲性角質増殖症 キルレ病