Like Pitted Keratlysis but not

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Hi Folkes,

12 year old boy presented in my office with plantar and palmer hyperkeratosis which lookes very much like pitted keratlysis, but has not responded to Erythromycin cream. on second visit the parent told me that it has already been diagnised by a dermatologist as something other than pitted keratlysis but they can´t remember the name! Any advice on diagnosis and treatment?

 

Hi Philip,

It is nigh impossible to assist with a dermatological diagnosis without a picture, could you upload one by any chance?

To save going round the houses, it would be sensible to contact the dermatologist directly for confirmation of the initial diagnosis.

Cheers,
Bel

 

OK, you got me guessing (against my better judgement ) punctate palmoplantar keratoderma? Ask the parents if that rings any bells.....

Hope that helps!
Bel

 

Punctate-type palmoplantar keratoderma

What are punctate keratodermas?

Punctuate keratodermas result in tiny bumps of thickened skin on the palms and soles and usually appears in late childhood or early adulthood.


What causes punctate keratodermas?

Punctate keratodermas are inherited by an autosomal dominant pattern (the abnormal gene is passed on from an affected parent). Some people with filiform keratoderma have no apparent family history of the condition.

What are the different types?

There are three different types of punctuate-type keratoderma:
■ Punctate keratoderma: tiny hard rounded bumps in the palms or soles.
■ Filiform keratoderma: tiny hard ‘spikes’ of skin growing out of the skin of the palms and soles and sometimes elsewhere on the skin.
■ Marginal keratoderma: tiny bumps along the border of the palms and fingers, soles and toes.








Punctate keratoderma

Treatment of punctate keratoderma

The following treatments soften the thickened skin and make them less noticeable.
■Emollients
■ Keratolytics (e.g. 6% salicylic acid in 70% propylene glycol)
■Topical retinoids
■ Topical vitamin D ointment (calcipotriol)
■ Systemic retinoids (acitretin)

What is the prognosis?

These conditions persist for life and may be passed on to the next generation. General health is not affected although the thickened skin can interfere with activity.


Related information

References:
■OMIM – Online Mendelian Inheritance in Man (search term Punctate-type palmoplantar keratoderma)

On DermNet NZ:
■Palmoplantar keratoderma (introduction)