Keratotic

Keratotic is an adjective used in dermatology and pathology to describe tissue or lesions related to keratin, the primary protein of the epidermis. It often refers to areas where keratin production is increased, leading to thickened, horn-like skin known as hyperkeratosis.

Histologically, keratotic changes involve thickening of the stratum corneum, a process called hyperkeratosis. The keratin layer may be orthokeratotic, with no cell nuclei present in the outermost layer, or parakeratotic, where nuclei persist. The surrounding epidermis may show additional changes such as acanthosis, depending on the condition.

Keratotic lesions occur in a variety of disorders, including calluses and corns from mechanical friction, seborrheic keratosis, warts (verrucae), actinic keratosis, keratosis pilaris, and genetic ichthyoses. Some conditions feature keratotic scales or plugs within hair follicles or ducts, giving a characteristic texture or appearance.

Diagnosis is typically clinical, with histopathology used for confirmation or when melanoma or other neoplasia is a concern. Treatment targets the underlying condition and may include keratolytic agents such as salicylic acid or urea, moisturizers, and measures to reduce friction. Lesions caused by infection or neoplasia require specific therapies; actinic keratosis, for example, may be treated with topical chemotherapeutics, cryotherapy, or photodynamic therapy.