CLINICAL CASES   

Giornale Italiano di Dermatologia e Venereologia 2000 April;135(2):209-12

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Palmoplantar keratoderma. A case report

D’Onghia F. S., Chieregato C., Leoni A., Rosina P.

Università degli Studi - Verona Istituto di Dermatologia e Venereologia

Hereditary palmoplantar keratoderma (PPK) are relatively rare forms of genodermatosis characterised by focal or widespread thickening of the stratum corneum. They are divided into two broad groups depending on the mode of genetic transmission: recessive autosomal and dominant PPK. PPK punctata is a rare dominant autosomal pathology characterised by the presence of numerous yellowish or yellow-brown keratotic papules, with a diameter of 2-10 mm, often with a central hollow, usually asymtomatic and with an uneven palmoplantar distribution focused in particular in the pressure sites. The authors report the case of a 74-year-old man, who had noted the appearance of multiple keratotic papules in the palmoplantar regions since the age of the 50. The latter were asymptomatic, yellowish in colour, slightly raised at the cutaneous level, edged by a circular rim and measuring 2-3 mm. The lesions were larger (5-8 mm) and more numerous and presented a greater infiltrative and keratotic component in the plantar region, above all at the metatarsus and the heel. Histological analysis confirmed compact orthokeratotic hyperkeratosis, hypergranulosis and acanthosis, with no sign of either parakeratosis or epidermic vacuolar alterations which are typical in common warts. Family medical history revealed the presence of similar lesions in both the mother and a brother. The main characteristics of this pathology are discussed togheter with the elements for differential diagnosis.