Farhana Muzaffar, Ijaz Hussain.
Continual Peeling Skin Syndrome: A case report and review of literature.
J Pak Assoc Derma Jan ;10(2):52-4.

A 12-years-old boy presented to the Department of Dermatology, Children Hospital/Institute of Child Health, Lahore with focal areas of peeling since the age of 1 year. The peeling occurred without any pain or bleeding. It was neither preceded by any blister formation nor related to trauma. The condition worsened during summer. He was born to a consanguineous couple by spontaneous vaginal delivery. His skin was normal at the time of birth. On examination, there were discrete patches of peeling skin with slight erythema, unrelated to pressure and trauma-prone areas. The palms and soles, teeth and mucosae, nails and hair were unaffected. He was of normal I.Q. for his age. Systemic examination did not reveal any abnormality. A biopsy specimen from the margin showed a subcorneal split. Other changes included orthokeratosis with areas of parakeratosis, mild acanthosis and a superficial perivascular lymphocytic infiltrate. His blood counts, urinalysis, liver function tests, blood urea nitrogen and serum creatinine were normal. His plasma and urinary amino acid levels and electron microscopy of the lesional skin could not be carded out because of unavailability. The constellation of peculiar history of peeling, exacerbation during summer, and pathological changes led to the diagnosis of continual skin peeling skin syndrome was prescribed simple emollients.

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