Hyperkeratosis of the skin and in gynecology

Hyperkeratosis is a thickening of the outermost layer of the epidermis (stratum corneum of the epidermis).
The epidermis contains a hard protein called keratin.
This thickening of the skin has a protective function under normal friction, pressure and other local irritations. Hyperkeratosis causes corns and calluses on the hands and feet.

It can also cause whitish areas inside the mouth.
Other forms of hyperkeratosis may occur as a protective effect of the skin against:
1. chronic inflammation (long-lasting),
2. infection, 3. sunlight,

4. irritating chemicals.
Rarely, hyperkeratosis forms on non-irritated skin. This form of hyperkeratosis can be caused by a hereditary disease.
It can occur immediately after birth and affect the skin over extensive areas of the body.



The top layer of skin is called the stratum corneum and is formed by dead cells lying on top of each other.
These cells do not have a nucleus, but contain a lot of keratin.
Keratin is a protein that preserves the moisture of the skin.
The retention of fluid keeps the skin supple and firm and also protects the underlying body tissue. Over time, the dead skin cells fall off and are replaced by new cells that develop in the deeper layers of the skin.
This continuous cycle of renewal keeps the skin healthy.

In people with parakeratosis, the cells in the stratum corneum retain their nucleus and are not completely keratinized.
As a consequence, the skin becomes dry and the body loses moisture.
In the further course, dry scales form, which can become deep cracks.
The skin lesions consist of reddened, inflamed and painful skin that may sweat.
Usually, the dry scales peel off easily.

There are many examples of hyperkeratosis, including:

Warts. The wart is a small skin elevation caused by infection with the human papillomavirus (HPV).
Plantar warts grow on the sole of the foot.
Usually, HPV is transmitted by direct contact.
Generally, these wart neoplasms spread by touching or shaking hands with someone who already has a wart.
It can also be spread by touching a contaminated surface.
For example, by walking barefoot on the floor of a gym or swimming pool or when using someone else’s shoes.

Chronic eczemaEczema (or atopic dermatitis) is an inflammation of the skin. This condition can be triggered by an allergy, chemical irritation and other factors.
The symptoms of eczema are itching on the skin, redness and small blisters.
If inflammation is difficult to control, chronic eczema can develop:
1. Hyperkeratosis
2. Dry and cracked skin 3. Flaking
4. Color change of the skin
5. Local hair loss

lichen planus. This disease can appear as a white, net-like spot on the oral mucosa.
It can appear as an itchy, purple and scaly patch on other areas of the skin.
Lichen planus can be caused by an abnormal immune system response.

Actinic keratosis. This condition causes a rash that resembles red spots on the skin and is flat and rough like sandpaper.
The skin lesions can be only a few millimeters in size.
The spots are caused by ultraviolet rays during excessive exposure to the sun.
They occur on areas of skin that have been exposed to the sun.
Hyperkeratosis is not a serious or dangerous disease, with the exception of actinic keratosis, which can develop into skin cancer.

Seborrheic keratosis. These are small, non-tumorous skin growths.
They can be dark and of brown or black color.
Seborrheic keratosis appears on the face, trunk, arms and legs.
Seborrheic hyperkeratosis is very common, but its cause is still a mystery.

Subungual hyperkeratosis. It forms in the nail bed and in the thickened layer of the epidermis, which is located under the free part of the nail. In this area, the skin thickens and can lead to the lifting of the nail (oncholysis).

Corns and calluses. Corns and calluses develop in areas of the skin exposed to friction and prolonged pressure (frictional hyperkeratosis).
As a result, thick layers of dead skin cells accumulate and harden.

Usually, corns form on irritated toes.
The soft corn is a thickening of skin between the toes and is also called “crow’s eye”.
Calluses form on the soles of the feet and palms.

For many people, corns and calluses are merely an aesthetic nuisance.
In certain cases, they can cause pain and discomfort.
Biomechanical hyperkeratosis occurs when the thickening of the skin is caused by too much pressure for too long.
Corneal formation should not be confused with bursitis of the ball of the ball. This disorder consists of swelling that forms between the inside of the big toe and the shoe due to hallux valgus.

Cracks in the heel area are fissures that form at the back of the heel and may be caused by hyperkeratosis.

Follicular keratosis or keratosis pilaris is caused by keratinine accumulation at the opening of the hair follicle. On the skin you can see small pimples.

Hereditary diseases. Various hereditary diseases are associated with keratosis.
They cause diffuse scaling and thickening of the skin.
The symptoms appear in infants and young children.

Types of hyperkeratosis

Hyperkeratosis in gynecology
If cells of dry skin appear in a Pap test, the result indicates hyperkeratosis.
It is a thickened layer of cells that resembles cornea and is located on the surface of the cervix or vulva.
During a routine gynecological examination, damage can sometimes be hidden behind cellular thickening.
Hyperkeratosis can prevent the doctor from taking an adequate sample of cells for laboratory analysis.

Often the causes of the cell changes in the uterus are:
1. chronic irritation, 2. vaginal infection, 3. the use of a diaphragm,

4. the human papillomavirus (HPV).
In order to avoid nasty surprises, a thorough check is advisable.

Pap test Doctors perform the Pap test
by taking a swab from the uterus and cervix during a gynecological exam. They then send this material to a laboratory that prepares the sample for microscopic examination.
The Pap test is used to detect any abnormalities of the cervix.
If repeating the Pap test after six months shows that the hyperkeratosis is still present, the doctor has two options.
He may order another Pap test after three or six months, or order an exam called colposcopy.
It is a procedure by which the cause of the abnormality can be explained in more detail from the Pap test.

What is epidermolytic hyperkeratosis?

Epidermolytic hyperkeratosis is a disease that has existed since birth.

Epidermolytic hyperkeratosis is part of a group of diseases called ichthyosis. This genetic condition causes dry, flaky and very thick skin.
However, in epidermolytic hyperkeratosis, the skin is only thickened, but not scaly, as in the other forms of ichthyosis.

Affected infants may have severe blistering and severely reddened skin (erythroderma).

Since children with this condition do not have normal protection through the skin, they are exposed to the risk of dehydration and develop infections of the skin or the whole body (sepsis).
As patients with epidermolytic hyperkeratosis age, blistering becomes less frequent, erythroderma decreases, and the skin thickens (hyperkeratosis), especially above the joints, in areas of skin contact, on the neck and on the scalp.
This thickened skin is much darker than the rest of the skin.
Bacteria can grow on the skin and cause a peculiar odor.

Types of epidermolytic hyperkeratosis People with a “palmo-plantar” form of epidermolytic hyperkeratosis
have thickened skin on the palms, soles of the feet (palmoplantar hyperkeratosis) and other areas of the body.
People with the “non-palmo-plantar” type do not have extensive palmoplantar hyperkeratosis, but have hyperkeratosis in other areas of the body.

Orthokeratotic hyperkeratosis

Orthokeratotic hyperkeratosis consists of a thickening of the stratum granulosum of the epidermis. An example of this is seborrheic keratosis.

Symptoms of hyperkeratosis

Many forms of mild hyperkeratosis proceed painlessly.
However, corns, calluses and plantar warts can cause great discomfort.

Diagnosis of hyperkeratosis

Depending on the specific symptomatology, the doctor needs to know whether the patient:

  • has a family history of skin problems,
  • suffered from an allergy in the past,
  • spends a lot of time in the sun,
  • in case of hyperkeratosis of the oral mucosa, uses dentures or orthodontic braces,
  • chews unconsciously on the cheek, lips, gums or tongue,
  • Chewing tobacco chews.

Sometimes the doctor can diagnose the cause of hyperkeratosis based on the clinical form, symptoms and skin examination. This is often the case with corns, calluses, warts and chronic eczema.
If someone suffers from chronic eczema due to an allergy, the doctor may advise an allergy test.
In some cases, a biopsy may be performed to confirm the diagnosis.

Therapy of hyperkeratosis

Treatment of hyperkeratosis depends on its type and cause.

Corns and calluses. Attach foam pads around the affected area to reduce pain.
Always wear well-adapted shoes and avoid unnecessary rubbing.
Do not remove a callus or corn yourself. Seek professional advice and treatment.

Warts. The doctor may remove warts.
Warts are removed using one of the following methods:

  • icing with liquid nitrogen (cryosurgery),
  • laser vaporization,
  • surgical removal.

If the treatment does not cover the skin layer infected by the virus, a wart can develop again at this point.
In this case, re-treatment may be necessary.
Warts can be treated by natural remedies that are available without a doctor’s prescription.
Self-treatment takes longer to heal a wart than medical therapy.
However, self-treatment can be effective after medical treatment. This is especially true if a wart is large or deep.
If the patient suffers from diabetes or circulatory disorders, treatment should be carried out by a doctor.
This prevents injuries and infections.

Chronic eczema. Usually, the doctor prescribes corticosteroids in the form of ointments or creams.
It is also very important to keep the skin moist.

lichen planus. Like chronic eczema, lichen planus is treated exclusively with local corticosteroids. This avoids the side effects of cortisone tablets.

Actinic keratosis. The doctor may proceed cryosurgically to eliminate a single actinic keratosis. Several keratosis foci can be treated by skin peeling, laser therapy or dermabrasion.

Seborrheic keratosis. These skin lesions can be removed by cryosurgery or with a scalpel.

Hereditary diseases. There is no cure for these diseases. To treat large-scale scaling of the skin, the doctor may recommend special emollients for the skin.

Does hyperkeratosis heal? Prognosis

Usually, hyperkeratosis is a local skin problem with a good prognosis.
Actinic keratosis can turn into squamous cell carcinoma of the skin.

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