Keratosis Pilaris — SCE Dermatology MCQ

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EasyInflammatory DermatosesKeratosis PilarisSCE Dermatology

A 25-year-old man presents with keratosis pilaris affecting his upper outer arms and anterior thighs. He has small follicular keratotic papules giving the skin a rough 'goosebump' texture. He also has atopic eczema. What is the most appropriate management?

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Correct answer: B — Regular emollient containing urea or lactic acid

Keratosis pilaris (KP) is a very common condition (up to 40% prevalence) characterised by small follicular keratotic papules on the outer upper arms, anterior thighs, buttocks, and sometimes cheeks. It is strongly associated with atopy and ichthyosis vulgaris (both linked to FLG mutations). It is due to retention of keratin plugs in hair follicles. First-line treatment is regular emollients containing keratolytic agents — urea (5-10%) or lactic acid (5-12%) — to soften the plugs. Topical retinoids can be used for resistant cases but may cause irritation. KP often improves in summer and with age. It is entirely benign.

Reference: BAD 2019 Patient Information; NICE CKS