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Keratosis pilaris

Megan N Landis, MD
Section Editor
Joseph Fowler, MD
Deputy Editor
Rosamaria Corona, MD, DSc


Keratosis pilaris (KP) is a common disorder of follicular keratinization characterized by keratotic follicular papules with variable perifollicular erythema. Lesions involve predominantly the extensor aspects of proximal arms, thighs, and cheeks (picture 1A-C). KP is often seen in association with atopic dermatitis and ichthyosis vulgaris [1].

This topic will review KP. Other follicular keratotic syndromes are discussed separately. (See "Lichen planopilaris" and "Pityriasis rubra pilaris" and "Darier disease".)


Onset of KP typically occurs in children or adolescents without sex predilection. It is seen in all ethnic groups, with an estimated prevalence of 2 to 12 percent in pediatric populations [2-4].


The cause of KP is not fully understood. It is thought to be a genetic disorder of keratinization that results in the formation of horny plugs in the hair follicle orifices. The mode of inheritance has not been determined, although in many cases it fits into an autosomal dominant pattern with incomplete penetrance. Patients with a generalized form of KP have been found to have a chromosome 18p deletion [5,6]. There are a few reports of KP induced by nilotinib, a second-generation tyrosine kinase inhibitor approved for the treatment of imatinib-resistant chronic myeloid leukemia [7-9].


An orthokeratotic keratin plug, which may contain one or more twisted hairs, fills and dilates the infundibulum of the hair follicle and protrudes above the skin surface (picture 2). There may be a mild perivascular lymphocytic infiltrate in the upper dermis [10].

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Literature review current through: Oct 2017. | This topic last updated: Nov 09, 2017.
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