Xeroderma results from delayed shedding of the superficial cells of the skin, yielding fine white scale. Risk factors for xerosis include the following:
Severe dry skin on the hands may become inflamed, leading to hand dermatitis (hand eczema).
Diagnosis of xeroderma is based on clinical evaluation. Xeroderma can usually be differentiated by inflammatory disorders such as atopic dermatitis and psoriasis by the absence of erythema in xeroderma. Unlike the fine white scales of xeroderma, ichthyosis is characterized by fish-like scales.
Treatment of xeroderma is focused on keeping the skin moist:
Frequency of bathing should decrease and tepid, rather than hot, water should be used.
Skin moisturizers should be used frequently, particularly immediately after bathing, to decrease transepidermal water loss. Thicker moisturizers such as petrolatum- or oil-based moisturizers are more effective than water-based lotions, although water-based lotions may be better tolerated in warmer climates. Moisturizers with additives such as ceramides, alpha-glycolic acids (eg, lactic, glycolic, and pyruvic acids), and beta-glycolic acids (eg, salicylic acid) are very commonly used.
Increasing fluid intake and using humidifiers also help.
Patients who develop hand dermatitis sometimes require topical corticosteroids to decrease inflammation and maintain the skin barrier.