palmoplantar keratosis

Palmoplantar Keratosis: A Description

Palmoplantar keratosis, also known as keratosis palmaris et plantaris, is a group of conditions characterized by the abnormal thickening of the skin on the palms of the hands and soles of the feet

Palmoplantar Keratosis Signs and Symptoms

Palmoplantar keratosis, also known as keratosis palmaris et plantaris, is a group of conditions characterized by abnormal thickening of the skin on the palms of the hands and soles of the feet. The signs and symptoms of palmoplantar keratosis can vary depending on the type of disease, but common features include:

• Skin thickening: A marked thickening of the skin on the palms and soles, which can be smooth and waxy or rough and scaly [10].
• Skin cracks: Skin cracks might appear, becoming painful and inflamed [12].
• Painful and inflamed skin: The skin thickening can be uncomfortable, painful, and it could lead to infections [12].
• Variability in symptoms: The severity of the symptoms can vary depending on the type of disease and individual factors.

In some cases, palmoplantar keratosis can also affect other areas of the body, such as the fingers and toes. It's essential to note that these conditions are rare and usually run in families [11].

References:

• [10] - The skin thickening in palmoplantar keratoma varies, depending on the type of disease.
• [12] - Skin cracks might appear, becoming painful and inflamed.

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Diagnostic Tests for Palmoplantar Keratosis

Palmoplantar keratosis, also known as palmoplantar keratoderma (PPK), is a group of dermal conditions characterized by thickening of the skin on the palms of the hands and soles of the feet. Diagnostic tests are essential to confirm the diagnosis and rule out other conditions.

• Biopsy: Taking a biopsy of a lesion followed by molecular identification of the gene mutation is imperative in filtering the diagnosis [3]. This test helps to identify the underlying cause of PPK.
• Genetic Testing: Broad panel testing allows for an efficient evaluation of several potential genes based on a single clinical indication. Genetic testing of these genes may provide a definitive diagnosis and help in identifying the genetic cause of PPK [7].
• Blood Tests: Regular blood tests may be required when using oral antifungals and retinoids, which are commonly used to treat PPK [10]. These tests help to monitor the effectiveness of treatment and detect any potential side effects.
• Medical History: An initial approach to PPK is to take a history asking about age of onset, palmoplantar pain and/or blistering, sweating and infection, and other symptoms [9]. This helps in understanding the severity and progression of the condition.

Additional Diagnostic Tests

• A 26 gene panel that includes assessment of non-coding variants is ideal for patients presenting with palmoplantar keratoderma [1].
• The test covers known genetic causes of PPK types/subtypes and a range of other genetically/phenotypically related disorders [4].

These diagnostic tests help in confirming the diagnosis of palmoplantar keratosis and identifying the underlying cause. Early detection and treatment can improve the quality of life for individuals affected by this condition.

References: [1] - A 26 gene panel that includes assessment of non-coding variants. [3] - Taking a biopsy of a lesion followed by molecular identification of the gene mutation is imperative in filtering the diagnosis. [4] - The test covers known genetic causes of PPK types/subtypes and a range of other genetically/phenotypically related disorders. [7] - Broad panel testing allows for an efficient evaluation of several potential genes based on a single clinical indication. [9] - An initial approach to PPK is to take a history asking about age of onset, palmoplantar pain and/or blistering, sweating and infection and other symptoms. [10] - Regular blood tests may be required when using oral antifungals and retinoids.

Treatment Options for Palmoplantar Keratosis

Palmoplantar keratosis, also known as palmoplantar keratoderma (PPK), is a group of rare skin disorders characterized by thickening of the skin on the palms and soles. While there is no specific cure for PPK, various treatment options can help manage symptoms and improve quality of life.

Topical Treatments

• Keratolytics: Topical creams or ointments containing salicylic acid, urea, or lactic acid can be used to soften and remove thickened skin. These treatments are often used in combination with other therapies.
• Emollients: Moisturizing creams or lotions can help keep the skin hydrated and reduce dryness.

Oral Medications

• Retinoids: Oral retinoids, such as acitretin, alitretinoin, and isotretinoin, may be prescribed to slow down skin cell growth and reduce thickening. These medications are often used in cases of severe PPK.
• Antimicrobials: Antibiotics or antifungal medications may be necessary to treat secondary infections.

Other Treatments

• Mechanical debridement: Removing dead skin cells through mechanical means, such as a scalpel or a chemical peel, can help reduce thickening.
• Physical scale removal: Using physical methods, like a pumice stone or a scrubber, to remove scales and crusts.

Emerging Treatments

• Topical gentamicin: This antibiotic cream has shown promise in treating Nagashima-type palmoplantar keratosis but requires further clinical evaluation.
• Low-dose acitretin: A combination of keratolytics and low-dose acitretin may be effective in treating palmoplantar arsenical keratosis.

Important Considerations

• Treatment options should be tailored to individual cases, taking into account the severity and type of PPK.
• Patients with PPK should consult a dermatologist or healthcare professional for proper diagnosis and treatment planning.

References:

[3] Nine patients with palmoplantar keratoderma were treated with vitamin A derivatives (retinoids) with good results. [8] Topical gentamicin for the treatment of Nagashima-type palmoplantar keratosis appears promising but needs clinical evaluation. [15] Successful treatment of palmoplantar arsenical keratosis with a combination of keratolytics and low-dose acitretin.

Note: The information provided is based on the search results within the context, which may not be comprehensive or up-to-date. It's essential to consult a healthcare professional for personalized advice and treatment planning.

Differential Diagnosis of Palmoplantar Keratosis

Palmoplantar keratosis, also known as palmoplantar keratoderma (PPK), is a group of conditions characterized by thickening of the skin on the palms and soles. When diagnosing PPK, it's essential to consider various differential diagnoses that can mimic or coexist with this condition.

Differential Diagnoses:

• Chronic eczema: Thick, hyperkeratotic lesions may appear on the palms and soles, which can be mistaken for PPK.
• Verrucae vulgaris (warts): Warts can present as thickened skin patches on the palms and soles, similar to PPK.
• Porokeratosis punctata: A type of focal palmoplantar keratoderma that can be confused with PPK.
• Warts or callosities: These conditions can also cause thickening of the skin on the palms and soles, making them a differential diagnosis for PPK.

Other Conditions to Consider:

• Hereditary PPK: A group of inherited disorders characterized by palmopl