eMedicine Specialties > Dermatology > Diseases of the Adnexa
Keratosis Pilaris: Differential Diagnoses & Workup
Updated: Oct 16, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
| Acne Vulgaris | Lichen Nitidus |
| Atopic Dermatitis | Lichen Spinulosus |
| Eruptive Vellus Hair Cysts | Milia |
| Erythromelanosis follicularis faciei et
colli | Perforating Folliculitis |
| Folliculitis | Pityriasis Rubra Pilaris |
| Keratosis Follicularis (Darier Disease) | Trichostasis Spinulosa |
| Keratosis pilaris atrophicans faciei | Ulerythema ophryogenes |
| Keratosis pilaris rubra | Xerosis |
| Kyrle Disease |
Other Problems to Be Considered
Keratosis pilaris (KP) may be associated with phrynoderma (vitamin A deficiency). Interestingly, a significant association has also been found between acquired ichthyosis and keratosis pilaris as common cutaneous manifestations in persons with type 1 diabetes.
Keratosis pilaris may resemble the following uncommon skin conditions:
- Lichen spinulosus
- Pityriasis rubra pilaris
- Ulerythema ophryogenes (u lerythema)
- Ichthyosis vulgaris
- Eruptive vellus hair cysts
- Erythromelanosis follicularis faciei et colli
- Keratosis follicularis (Darier disease)
- Kyrle disease
- Lichen nitidus
- Perforating folliculitis
- Trichostasis spinulosa
- Keratosis pilaris rubra
Workup
Laboratory Studies
No specific laboratory tests aid in the diagnosis of keratosis pilaris (KP). The diagnosis of keratosis pilaris is very straightforward and is based on a typical skin appearance in areas such as the upper arms. A family history of keratosis pilaris is also very helpful because keratosis pilaris has a strong genetic component. The diagnosis is confirmed on the basis of the physician’s clinical examination findings. A few other medical conditions look similar to keratosis pilaris, and these must be excluded.
Imaging Studies
Imaging studies are not indicated.
Procedures
Skin biopsy with histopathological examination may be useful in atypical cases.
Histologic Findings
Microscopic examination (histopathology) of keratosis pilaris (KP) lesions shows the triad of epidermal hyperkeratosis, hypergranulosis, and plugging of individual hair follicles. The upper dermis may have mild superficial perivascular lymphocytic inflammatory changes.
The individual papules in keratosis pilaris are thought to arise from excessive accumulation of keratin at the follicular orifice. The overlying epidermis shows mild thickening and plugging of the small follicular orifice.
More on Keratosis Pilaris |
| Overview: Keratosis Pilaris |
Differential Diagnoses & Workup: Keratosis Pilaris |
| Treatment & Medication: Keratosis Pilaris |
| Follow-up: Keratosis Pilaris |
| Multimedia: Keratosis Pilaris |
| References |
| « Previous Page | Next Page » |
References
Sardana K, Relhan V, Garg V, Khurana N. An observational analysis of erythromelanosis follicularis faciei et colli. Clin Exp Dermatol. May 2008;33(3):333-6. [Medline].
Augustine M, Jayaseelan E. Erythromelanosis follicularis faciei et colli: relationship with keratosis pilaris. Indian J Dermatol Venereol Leprol. Jan-Feb 2008;74(1):47-9. [Medline].
Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol. Jun 2007;56(6):901-16; quiz 917-20. [Medline].
Poskitt L, Wilkinson JD. Natural history of keratosis pilaris. Br J Dermatol. Jun 1994;130(6):711-3. [Medline].
Arnold AW, Buechner SA. [Keratosis pilaris and keratosis pilaris atrophicans faciei]. J Dtsch Dermatol Ges. Apr 2006;4(4):319-23. [Medline].
Mevorah B, Marazzi A, Frenk E. The prevalence of accentuated palmoplantar markings and keratosis pilaris in atopic dermatitis, autosomal dominant ichthyosis and control dermatological patients. Br J Dermatol. Jun 1985;112(6):679-85. [Medline].
Jackson JB, Touma SC, Norton AB. Keratosis pilaris in pregnancy: an unrecognized dematosis of pregnancy?. W V Med J. Jan-Feb 2004;100(1):26-8. [Medline].
Kragballe K, Steijlen PM, Ibsen HH, et al. Efficacy, tolerability, and safety of calcipotriol ointment in disorders of keratinization. Results of a randomized, double-blind, vehicle-controlled, right/left comparative study. Arch Dermatol. May 1995;131(5):556-60. [Medline].
Kaune KM, Haas E, Emmert S, Schon MP, Zutt M. Successful treatment of severe keratosis pilaris rubra with a 595-nm pulsed dye laser. Dermatol Surg. Oct 2009;35(10):1592-5. [Medline].
Clark SM, Mills CM, Lanigan SW. Treatment of keratosis pilaris atrophicans with the pulsed tunable dye laser. J Cutan Laser Ther. Sep 2000;2(3):151-6. [Medline].
Novick NL. Practical management of widespread, atypical keratosis pilaris. J Am Acad Dermatol. Aug 1984;11(2 Pt 1):305-6. [Medline].
Lateef A, Schwartz RA. Keratosis pilaris. Cutis. Apr 1999;63(4):205-7. [Medline].
Further Reading
Keywords
keratosis pilaris, keratosis pilaris treatment, KP, hyperkeratosis, folliculocentric keratotic papules, follicular keratotic papules, atopic dermatitis, ichthyosis vulgaris, excessive accumulation of keratin, benign skin lesion, Ulerythema ophryogenes, keratosis pilaris atrophicans faciei, gooseflesh appearance, erythema, chickenskin bumps, chicken skin, goosebumps.
Differential Diagnoses & Workup: Keratosis Pilaris