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Clinical Solutions in Practice

Examining An Emerging Treatment Option For Hyperkeratotic Conditions

Jennifer Spector, DPM, FACFAS

May 2021
Might a promising prescription-strength topical exfoliant have an impact on hyperkeratotic conditions that podiatrists treat on a regular basis in the foot and ankle?

Keralyt® (6% salicylic acid) is a uniquely formulated topical treatment in an elegant gel base to penetrate and address flaking, scaling and plaques associated with challenging-to-treat conditions such as psoriasis, seborrheic dermatitis, thickened plaques, keratosis pilaris, corns and calluses, says Summers Laboratories (Collegeville, PA), the manufacturer of the product. According to the company, Keralyt 6% may act through multiple pathways that then lead to desquamation of corneocytes. They add that although salicylic acid was once considered to be a keratolytic agent, its activity is instead better characterized as a desmolytic agent, due to the ability to disrupt cellular junctions as opposed to disrupting intercellular keratin filaments. Podiatrists may specifically look to Keralyt 6% gel for the foot and ankle hyperkeratotic conditions they treat.

Formulated to penetrate difficult-to-treat hyperkeratotic areas, Summers Laboratories shares that the primary ingredient in Keralyt 6% gel (salicylic acid) reduces scaling and can speed and enhance shedding of scale in hyperkeratotic skin. Additionally, they add that salicylic acid 6% can improve penetration of topical steroids when applicable in areas of hyperkeratosis.

Keralyt 6% gel comes in a 100 gram tube and is also part of a family of other 6% salicylic acid products, including a 160 mL shampoo and a 60 gram scalp gel. Patients can obtain these products through their pharmacy of choice by prescription only from their health care provider. Summers Laboratories also created the Summers Direct Affordable Access Program to provide access to Keralyt 6% products when prescribed by their providers in an easy and affordable transaction.

Rebecca Smith, MD, both a board-certified dermatologist and pediatric dermatologist, feels that Keralyt 6% gel is an ideal option for physicians to use in patients with any hyperkeratotic condition, such as psoriasis, keratoderma, calluses and corns. In her experience, she agrees that the product can also enhance efficacy and penetration of topical steroids for diseases such as plantar psoriasis.

Tracey C. Vlahovic, DPM, FFPM RCPS (Glasg) also uses Keralyt 6% gel as part of her treatment regimen for psoriatic plaques and goes on to say that she also finds utility for patients with focal hyperkeratosis.

“The gel format is easy to use and dries quickly,” adds Dr. Vlahovic. “The formulation makes it easy to use on the feet.”

Dr. Smith points out that the unique formulation of salicylic acid is designed to optimize exfoliation in a few different ways:

“Salicylic acid is a beta-hydroxy acid that disrupts the attachment of desmosomes, decreasing corneocyte cohesion, so it is a desmolytic agent,” Dr. Smith explains. “Salicylic acid also reduces the pH of the stratum corneum, which enhances hydration and softens the outer layers of skin, mitigating scaling and xerosis.”

Dr. Vlahovic, who is a Clinical Professor in the Department of Podiatric Medicine at the Temple University School of Podiatric Medicine in Philadelphia, shares that she has found Keralyt 6% gel to be particularly impactful for patients that deal with punctate keratoses and also those with genodermatoses.

In her practice, Dr. Smith relates that patients suffering from several concomitant hyperkeratotic conditions often benefit from this product. One example she cites is a patient with some degree of keratoderma in addition to calluses and stucco keratoses.

“I have also successfully used Keralyt 6% gel as an adjunctive treatment in between procedural visits for myrmecia verrucae,” says Dr. Smith, the founder of Fort Mill Dermatology in Fort Mill, S.C.

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