Keratosis circumscripta

Author: Dr Anthony Yung, Waikato Hospital, Hamilton, New Zealand, 2008.

What is keratosis circumscripta?

Keratosis circumscripta is a rare, harmless skin condition. The original cases were 11 African patients descended from the Yoruba tribe of Nigeria. Some authorities do not recognise keratosis circumscripta as a separate and distinct skin condition.

The cause of keratosis circumscripta is unknown.

Clinical features

Keratosis circumscripta occurs in children, usually appearing and developing over 2-3 weeks. It is characterised by circular patches consisting of aggregations of small skin colour papules (bumps) with a small plug of rough keratin protruding from the tip of the papule.

Keratosis circumscripta typically affects the elbows and knees, and very occasionally, the backs of the hands and feet, trunk, neck, base of the spine, shoulders and hips.

Conditions that may look like keratosis circumscripta include circumscribed juvenile pityriasis rubra pilaris (also called Type IV pityriasis rubra pilaris), psoriasis and lichen spinulosus.

What is the treatment?

Treatment of keratosis circumscripta is difficult as it usually fails to improve whatever is tried. Exfoliating agents containing urea, salicylic acid or alpha hydroxyacids may help remove the rough keratin plugs temporarily.

Keratosis circumscripta tends to increase in size over a few years and may persist long term.

Related information

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