User:BrigitteB1/Keratosis pilaris

Differential Diagnosis
Several medications that can cause a skin eruption similar to KP include cyclosporine, BRAF inhibitors, and tyrosine kinase inhibitors. Moreover, conditions that present similar to keratosis pilaris are lichen spinulosus, phrynoderma, and keratosis pilaris atrophicans. Lichen spinulosus appears as follicular papules each with a keratotic spine commonly found on the neck, shoulders, extensor surface of the arms, back of the knee, abdomen, and buttocks. The papules are skin-colored and are in a symmetrical pattern. It is asymptomatic and usually affects children and young adults. Phrynoderma means “toad skin”. Its presentation is similar to keratosis pilaris, but it is associated with vitamin A deficiency and/or malnutrition. Lastly, keratosis pilaris atrophicans includes subtypes such as keratosis pilaris atrophicans faciei, atrophoderma vermiculatum, and keratosis pilaris spinulosa decalvans. These conditions usually affect the face, and present initially as follicular hyperkeratosis then followed by atrophy, scarring, and alopecia.

Treatment
KP is medically harmless, but many individuals may seek treatment, as the condition can cause emotional distress. Topical creams and lotions are currently the most commonly used treatment for KP, specifically those consisting of moisturizing or keratolytic treatments, including urea, lactic acid, glycolic acid, salicylic acid, vitamin D, fish oil, or topical retinoids such as tretinoin. Improvement of the skin often takes months, and the bumps are likely to return. Limiting time in the shower and using gentle exfoliation to unplug pores can help. Many products are available that apply abrasive materials, with alpha or beta hydroxy acids to assist with exfoliation.

Keratolytic agents such as alpha hydroxy acid, lactic acid, salicylic acid, and urea are first line agents used in the management of keratosis pilaris. They help remove dead skin cells leading to reduced bumpiness and roughness of the skin. These come in formulations such as lotions, creams, and ointments that can be bought over the counter. If the first line agents do not sufficiently manage keratosis pilaris, second line agents can be used. This includes topical retinoids such as tretinoin, adapalene and tazarotene creams. These agents prevent hair follicles from being plugged as it enhances the epidermal cell turnover rate. Furthermore, low- to medium-potency topical corticosteroids can be used short-term to manage significant inflammation.

Some cases of KP have been successfully treated with laser therapy, which involves passing intense bursts of light into targeted areas of the skin. Depending on the body's response to the treatment, multiple sessions over the course of a few months may be necessary.