Cohen Philip R, Anderson Caesar A
San Diego Family Dermatology, National City, CA, USA.
University of California San Diego Hyperbaric Medicine and Wound Healing Center, Encinitas, CA, USA.
Dermatol Ther (Heidelb). 2018 Dec;8(4):639-646. doi: 10.1007/s13555-018-0259-9. Epub 2018 Sep 10.
Hyperkeratosis presents as thickened skin. It can be congenital or acquired. Typically, it affects the palms and soles; the distribution of epidermal involvement is either diffuse, focal, or punctate. Microscopically, the pathologic signature of hyperkeratosis is marked orthokeratosis of the stratum corneum. Topical treatments provide the mainstay of therapy for hyperkeratosis. These include keratolytics (such as urea, salicylic acid, and lactic acid) and retinoids; physical debridement, topical corticosteroids, and phototherapy (using topical psoralen and ultraviolet A phototherapy) are other local therapeutic modalities. Selenium is a non-metallic essential element; its water-insoluble salt, selenium sulfide, is an active ingredient that is used (in either a foam, lotion, or shampoo) to treat not only seborrheic dermatitis but also tinea versicolor. Three individuals with hyperkeratosis involving their palms and/or soles are described; the hyperkeratosis was successful treated with topical selenium sulfide in either a 2.5% lotion/shampoo or a 2.75% foam. The response to topical selenium sulfide was not only rapid but also complete and sustained; none of the patients experienced any adverse events secondary to the therapy. In conclusion, we recommend that topical selenium sulfide be added to the therapeutic armamentarium for congenital or acquired hyperkeratosis-particularly for those patients with involvement of their palms and soles.
角化过度表现为皮肤增厚。它可以是先天性的，也可以是后天获得的。通常，它会影响手掌和脚底；表皮受累的分布可以是弥漫性、局灶性或点状的。在显微镜下，角化过度的病理特征是角质层明显的正角化。局部治疗是角化过度治疗的主要手段。这些包括角质剥脱剂（如尿素、水杨酸和乳酸）和维甲酸；物理清创、局部皮质类固醇和光疗（使用局部补骨脂素和紫外线A光疗）是其他局部治疗方式。硒是一种非金属必需元素；其水不溶性盐硫化硒是一种活性成分，用于（以泡沫、洗剂或洗发水的形式）治疗不仅是脂溢性皮炎，还包括花斑癣。描述了三名手掌和/或脚底有角化过度的患者；角化过度用2.5%洗剂/洗发水或2.75%泡沫的局部硫化硒成功治疗。对局部硫化硒的反应不仅迅速，而且完全且持续；没有患者经历治疗引起的任何不良事件。总之，我们建议将局部硫化硒添加到先天性或后天性角化过度的治疗手段中——特别是对于那些手掌和脚底受累的患者。
