Diagnosis
Keratosis pilaris
A common, asymptomatic disorder of keratinization causing keratinization of hair follicles presenting as follicular plugs on thighs and upper arms.
Also known as: Lichen pilaris
Etiology
Cause [hnb]
Unknown
Possibly caused by mutations of chromosome 18 causing keratinization of hair follicles
Pathophysiology [hnb]
Abnormal follicular epithelial keratinization causing a plug
These keratotic plugs lead to erythema and scaling around the follicle opening
The keratin plugs also result in inflammatory papules,
Coiled hairs within the lesions may play a role in the inflammation and keratinization
Risk factors [hnb]
Xerosis (abnormally dry skin)
Atopic dermatitis
Ichthyosis
Diabetes
Obesity
Malnutrition
A family history of keratosis pilaris
Epidemiology
Incidence per 100.000 [ibs][7ib]
Symptoms & findings
Symptoms
None listed.
Clinical findings
None listed.
Anamneses
None listed.
Localized findings
Approach
Dermatoscope
Skin biopsy
Treatment
A cosmetic condition. There's no known cure for keratosis pilaris.
It usually clears up on its own with age [ibs]
Prevent dry skin: moisturising creams
Remove dead skin cells: [7ib]
Gentle skin exfoliation
Keratolytic agents (cream with urea, lactic acid, alpha hydroxy/salicylic acid)
Phototherapy [hnb]
Laser treatment
Differential diagnoses
Acne, Eczema, Folliculitis, Keratosis follicularis, Milia, Psoriasis, Scurvy, Seborrheic dermatitis, Vitamin deficiency
References
[1] Pennycook KB, McCready TA. Keratosis Pilaris. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546708/
[2] Poskitt L, Wilkinson JD. Natural history of keratosis pilaris. Br J Dermatol. 1994 Jun;130(6):711-3.
[3] Kootiratrakarn T, Kampirapap K, Chunhasewee C. Epidermal permeability barrier in the treatment of keratosis pilaris. Dermatol Res Pract. 2015;2015:205012.
[4] [Clinical Dermatology 4.th Edition by Weller, Hunter, Savin and Dahl]
[5] Cohen L, Seminario-Vidal L, Lockey RF. Dermatologic Problems Commonly Seen by the Allergist/Immunologist. The Journal of Allergy and Clinical Immunology: In Practice Volume 8, Issue 1, January 2020, Pages 102-112.