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Acquired palmoplantar keratoderma.

Shaily Patel¹, Matthew Zirwas, Joseph C English

¹Department of Dermatology, University of Pittsburgh, Pittsburgh, PA 15213, USA.

American Journal of Clinical Dermatology

|February 15, 2007

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Palmoplantar keratodermas (PPKs) involve abnormal skin thickening on palms and soles. This review categorizes acquired PPKs and offers an assessment algorithm to identify underlying causes and guide effective treatment strategies.

Area of Science:

Dermatology
Internal Medicine

Background:

Palmoplantar keratodermas (PPKs) are a group of disorders characterized by abnormal skin thickening on the palms and soles.
PPKs are traditionally classified as hereditary or acquired, differentiated by inheritance patterns, disease spread, comorbidities, and epidermal involvement (diffuse, focal, punctate).

Purpose of the Study:

To categorize acquired palmoplantar keratodermas (PPKs) to aid in patient evaluation.
To present an algorithm for assessing patients with acquired PPK to identify underlying etiologies and guide treatment.

Main Methods:

Categorization of acquired PPKs into: keratoderma climactericum, drug-related, malnutrition-associated, chemically induced, systemic disease-related, malignancy-associated, dermatoses-related, infectious, and idiopathic.
Development of an assessment algorithm starting with comprehensive history and physical examination, followed by laboratory and radiology studies if necessary.

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Main Results:

Acquired PPKs encompass a wide range of causes, necessitating a systematic diagnostic approach.
The proposed algorithm facilitates efficient evaluation, preventing overlooked etiologies and excessive testing.

Conclusions:

Accurate diagnosis of the underlying etiology is crucial for successful treatment of acquired PPKs.
Conservative treatments include topical keratolytics, debridement, topical retinoids, and corticosteroids; systemic retinoids may be used for recalcitrant cases.