Symmetrical acrokeratoderma: a case series in Indian patients

Area of Science:

• Dermatology
• Clinical Medicine

Background:

• Symmetrical acrokeratoderma is a recently identified dermatosis primarily affecting young adult males of Chinese descent.
• This report details five cases of symmetrical acrokeratoderma observed in India, expanding the known geographical distribution of the condition.

Observation:

• Patients presented with asymptomatic, brownish-black plaques symmetrically distributed on the dorsum of hands and feet.
• Lesions characteristically spared palms and soles, showed whitish maceration upon water immersion, and worsened in hot, humid climates.
• Variable involvement of wrists, forearms, elbows, ankles, shins, and knees was noted.

Findings:

• Histopathology revealed basket weave hyperkeratosis, irregular acanthosis, and mild perivascular lymphomononuclear infiltrate.
• Biopsies post-immersion demonstrated loosening of the stratum corneum.
• Acitretin offered short-term symptomatic relief but did not alter the long-term disease course.

Implications:

• This study broadens the understanding of symmetrical acrokeratoderma's clinical presentation and geographical occurrence.
• Further research is needed to elucidate the genetic and environmental factors contributing to the causation of this dermatosis.
• Identifying causative factors is crucial for developing targeted and effective long-term treatment strategies.