By Gary M. White, MD

Richner-Hanhart syndrome, also known as tyrosinemia type II, is caused by a defect in hepatic tyrosine aminotransferase and elevated levels of tyrosine are found in the urine, blood, and feces.


Initially, the young child develops bulla and erosions of the soles which progress to sharply demarcated, yellowish plaques limited to pressure points. Intense pain is an important diagnostic clue. It may be significant enough to necessitate crawling or walking with crutches. Rarely, cutaneous changes may occur without ocular changes and thus, any patient with painful callosities should have tyrosine levels measured.


A diet low in tyrosine and phenylalanine can induce clearing. Such a diet must be low in foods such as meat, fish, and eggs. Oral retinoids have also been used with some success.


An 11-year-old girl, born to a consanguineous marriage, presented with painful plantar hyperkeratosis that made it difficult to walk from 2 years of age. Indian J Dermatol Venereol Leprol 2015;81:303-5


Homepage | FAQs | Contact Dr. White

It is not the intention of to provide specific medical advice, diagnosis or treatment. only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.