By Gary M. White, MD

Mal de Meleda (MDM) is an autosomal recessive palmoplantar keratoderma characterized by erythema and hyperkeratosis of the palms and soles with sharp demarcation, extending to the dorsal aspects of hands and feet (known as transgrediens).


Diffuse keratoderma of the hands and feet in a glove and sock distribution (transgrediens) with malodor and hyperhidrosis occurs in MDM. Onset is soon after birth. Lesions on the elbows and knees also occur. Other abnormalities include nail thickening, koilonychia, and pseudoainhum. This disease is inherited in an autosomal recessive fashion. A concomitant fungal infection should be excluded.


Oral retinoids are useful, e.g. acitretin, etretinate.


A 15-year-old girl, born of second-degree consanguineous marriage, with transgradient palmoplantar keratoderma with onset at 6 months of age. Indian J Dermatol 2012;57:390-3


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