Palmoplantar keratodermas (PPKs) are a diverse entity of disorders that are characterized by abnormal thickening of the skin on the palms and soles. What are the other Names for this Condition? (Also known as/Synonyms). Acquired Palmoplantar Keratoderma; Acquired PPK. Paraneoplastic palmoplantar keratoderma (PPK) is an acquired dermatosis that presents with hyperkeratosis of the palms and soles in association with visceral.

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Web Design – Mode Ten Designs. Any palmoplxntar suggestive of underlying conditions should be aggressively evaluated and treated. It usually affects the sole of the feet around the margins of the heel and under the metatarsal heads.

The first step should include a comprehensive history and a physical examination, including a complete skin examination. A painful paronychia develops with no evidence of bacterial or fungal infection.

Acquired keratoderma

In order to avoid the possibility of overlooking kerztoderma underlying etiology and to eliminate excessive testing, we present an algorithm for assessing patients presenting with acquired PPK. The vast majority are associated with adenocarcinoma of the stomach, but other malignancies sometimes found include acquirdd GI tract tumours, lung, uterus, ovaries, and urinary tract Tripe palms – the appearance differs to that of keratoderma with thickened velvety palms that have the appearance of tripe.

Some people with focal palmoplantar keratoderma also have abnormalities of the fingernails and toenails There are several inherited typeswhich are all rare. The palms of the hands may be affected with discrete, centrally placed lesions.


If no such etiology is evident, then conservative treatment options include topical keratolytics urea, salicylic acid, lactic acidrepeated physical debridement, topical retinoids, topical psoralen plus UVA, and topical corticosteroids.

Website author — Dr Tim Cunliffe read more.

Palmoplantar keratoderma | Primary Care Dermatology Society | UK

All named individuals and organisations maintain copyright for the relevant images. Occasionally keratoderma can affect other parts of the body It can be difficult to differentiate between the different types of keratoderma, however, the management principles are similarand as such the key diagnostic elements are to exclude the rare malignant or other systemic causes.

Palmoplantar keratoderma is a term used to define a marked thickening of the skin on the palms and soles, either as a focal entity, or diffuse. Any image downloaded must only be used for teaching purposes and not for commercial use.

Given the numerous possible underlying causes for acquired PPKs, evaluation of patients presenting with acquired PPK can be a perplexing task. Keratoderma can be inherited, acquired, and rarely, paraneoplastic ie secondary to an internal malignancy. Three stages have been described: This chapter provides a practical overview of keratoderma, and is set out as below: Please follow this link if you have keratodefma high-quality images that you can contribute to the website.

Notice and credit must be given to the PCDS or other named contributor. It is associated with squamous cell carcinoma of the upper aerodigestive tract oral cavity, pharynx, larynx, oesophagus. Aetiology Clinical findings Images Investigations Management. To facilitate such evaluations, this review categorizes the acquired PPKs as: In cases where tripe palms occur without AN, lung cancers are usually responsible.


Axial CT images showing multiple polypoidal enhancing mass lesions with surface calcifications, in the urinary bladder.

Acquired keratoderma | DermNet NZ

If no pertinent findings are identified after a history and a physical examination, laboratory and radiology studies should be undertaken in a systematic, logical fashion. Keratoderma may be hereditarywith symptoms presenting in early childhood, or acquired when it presents in later life. Clinical classification Palmoplantzr can be defined by its clinical appearance, although there is often overlap: This website is non-profit and holds the images for educational pakmoplantar only.

The cutaneous features usually pre-date the diagnosis of the cancer. Keratoderma of the soles and acanthosis nigricans of the hands in a patient with bladder carcinoma.

Palmoplantar keratoderma

If findings pa,moplantar consistent with a hereditary keratoderma, then a genetics consultation should be considered. Etretinate and acitretin have also shown some success as alternative treatments in recalcitrant cases. Palmoplantar keratodermas PPKs are a diverse entity of disorders that are characterized by abnormal thickening of the skin on the palms and soles.