Palmoplantar keratoderma

Author: Dr Amy Stanway, Dermatology Registrar, Nottingham, United Kingdom, 2005.

What is keratoderma?

‘Keratoderma’ is a term that means marked thickening of the skin.

‘Palmoplantar’ refers to the skin on the soles of the feet and palms of the hands; these are the areas keratoderma affects most often. Palmoplantar keratoderma is also sometimes known as ‘keratosis palmaris et plantaris’.

Classification of keratodermas depends on whether or not it is inherited, and its clinical features.

In some rare forms of keratoderma other organs in the body may be affected in addition to the skin, and the keratoderma can be a marker of this internal abnormality.

What causes palmoplantar keratoderma?

Keratoderma may be inherited (hereditary) or, more commonly, acquired.

The hereditary keratodermas are caused by a gene abnormality that results in abnormal skin protein (keratin). They may be inherited either by an autosomal dominant or autosomal recessive pattern.

Specific types of keratoderma

The table below lists the main types of hereditary palmoplantar keratoderma (PPK)

Diffuse hereditary palmoplantar keratodermas
  • Unna-Thost type (autosomal dominant)
  • Vorner's type (autosomal dominant)
  • Mal de Meleda type (autosomal dominant or recessive)
  • Huriez syndrome (autosomal dominant)
  • Olmsted syndrome (unknown inheritance pattern)
  • Vohwinkel syndrome (autosomal dominant)
  • PPK with sensorineural deafness (mitochondrial inheritance)
  • Bart-Pumphrey syndrome (autosomal dominant)
  • Hidrotic ectodermal dysplasia (autosomal dominant)
  • Papillon-Lefevre syndrome (autosomal recessive)
  • Diffuse PPK with woolly hair and arrythmogenic cardiomyopathy (autosomal recessive)
Focal hereditary palmoplantar keratodermas
  • PPK striata/areata type (autosomal dominant)
  • Hereditary painful callosities (autosomal dominant)
  • Howell-Evans syndrome or tylosis (autosomal dominant)
  • Richner-Hanhart syndrome (autosomal recessive)
  • Pachyonychia congenita (autosomal dominant)
  • Striate PPK with woolly hair and dilated cardiomyopathy (autosomal recessive)
Punctate palmoplantar keratodermas
  • Punctate keratoderma (autosomal dominant)
  • Filiform keratoderma (autosomal dominant)
  • Marginal keratoderma (autosomal dominant)

Acquired palmoplantar keratodermas may be focal or diffuse. They may arise in association with a variety of different skin and internal conditions:

Treatment of palmoplantar keratoderma

The following treatments soften the thickened skin and makes it less noticeable.

Related information

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