PALMOPLANTAR KERATODERMA

By Gary M. White, MD

Keratoderma
Diffuse inherited keratoderma of Unna-Thost.


Palmoplantar keratoderma (PPK) refers to diffuse hyperkeratotic thickening of the palms and soles. For treatment, see here.

Epidermolytic Hyperkeratosis. Diffuse palmoplantar keratoderma inherited in an autosomal dominant fashion, which on biopsy shows epidermolytic hyperkeratosis, may occur. It is also called epidermolytic palmoplantar keratoderma of Vörner.
Epidermolytic  Hyperkeratosis

Adult Onset, Idiopathic.  Palmoplantar keratoderma without any family history may rarely occur in adults, often with onset in the 40-60's. Obesity is a predisposing factor.

Greither's disease PPK, inherited AD, that extends onto the dorsa of the hands and feet is characteristic. Onset is from 8 to 10 years of age and the severity may increase into the adult years. The elbows and knees are commonly involved. It is clinically similar to Mal de Melade but differs in its inheritance and tends to be milder.

Punctate Keratoderma
Punctate Keratoderma

Hidrotic Ectodermal Dysplasia

Howel-Evans syndrome (HES). HES is the association of PPK with esophageal cancer.

Hypothyroidism.  Mild, acquired hyperkeratosis or keratoderma has been described with hypothyroidism.

Mal de Meleda. Diffuse keratoderma of the hands and feet in a glove and sock distribution (transgrediens) with malodor and hyperhidrosis occurs in mal de Meleda. Onset is soon after birth. Lesions on the elbows and knees also occur.

Olmsted Syndrome. Periorificial red, scaly plaques, a mutilating, congenital palmoplantar keratoderma, nail dystrophy, and scattered keratotic papules occur in Olmsted syndrome.

Loricrin Keratoderma

Pachyonychia Congenita
Pachyonychia Congenita

Papillon-Lefèvre Syndrome

Richner-Hanhart Syndrome, aka Tyrosinemia, Type II. For a picture, see Indian J Dermatol Venereol Leprol 2015;81:303-5

Spiny Keratoderma
Spiny Keratoderma

STRIATE PALMOPLANTAR KERATODERMA

Unna-Thost Disease

Vohwinkel Syndrome

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