Keratosis Pilaris and its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options

Abstract

Keratosis pilaris is a common skin disorder comprising less common variants and rare subtypes, including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and the spectrum of keratosis pilaris atrophicans. Data, and critical analysis of existing data, are lacking, so the etiologies, pathogeneses, disease associations, and treatments of these clinical entities are poorly understood. The present article aims to fill this knowledge gap by reviewing literature in the PubMed, EMBASE, and CINAHL databases and providing a comprehensive, analytical summary of the clinical characteristics and pathophysiology of keratosis pilaris and its subtypes through the lens of disease associations, genetics, and pharmacologic etiologies. Histopathologic, genomic, and epidemiologic evidence points to keratosis pilaris as a primary disorder of the pilosebaceous unit as a result of inherited mutations or acquired disruptions in various biomolecular pathways. Recent data highlight aberrant Ras signaling as an important contributor to the pathophysiology of keratosis pilaris and its subtypes. We also evaluate data on treatments for keratosis pilaris and its subtypes, including topical, systemic, and energy-based therapies. The effectiveness of various types of lasers in treating keratosis pilaris and its subtypes deserves wider recognition.

Clinical and dermoscopic evaluation of fractional carbon dioxide laser in management of keratosis pilaris in Egyptian type skin

“…Similarly, systemic retinoids have also been tried. However, medical treatment of keratosis pilaris is usually disappointing …”

“…Several reports in the literature have addressed the use of lasers either alone or combined with topical drugs in the treatment of KP . Different laser types were employed to target either one or more of the erythematous, pigmentary, or keratotic elements of the keratosis pilaris lesions.…”

“…Keratosis pilaris (KP), frequently referred to as “chicken skin,” by patients, is a common skin disorder that presents as a cosmetic complaint in the vast majority of cases . Clinically, KP presents as multiple small greyish‐white, follicular keratotic papules, resembling gooseflesh with variable degrees of perifollicular erythema and these papules usually contain fine‐coiled, brittle hairs.…”

Seasonal variability in public searches of keratosis pilaris: How the internet can illuminate a pattern in public interest

“…2 While it is an autosomal dominant condition, the exact pathophysiology is still unclear with current hypotheses stating a potential keratotic infundibular plug, an abnormal hair shaft, or absence of sebaceous glands causing aberrant keratinization. [1][2][3] KP falls under the category of follicular disorders, and often considered more of a cosmetic issue for patients. 2,4 However, the appearance can be bothersome to people due to the varying degree of perifollicular erythema present.…”

Comment on: Keratosis Pilaris and Its Subtypes: Associations, New Molecular and Pharmacologic Etiologies, and Therapeutic Options

“…I read with interest the review of keratosis pilaris, keratitis pilaris atrophica (KPA), and associated conditions by Wang and Orlow [1].…”