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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Three stages have been described: The vast majority are associated acuqired adenocarcinoma of the stomach, but other malignancies sometimes found include other 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.

This chapter provides a practical overview of keratoderma, and is set out as below: Palmoplantar keratodermas PPKs are a diverse entity of disorders that are characterized by abnormal thickening of the skin on the palms palmoplantzr soles.

Given the numerous possible underlying causes for acquired PPKs, evaluation of patients presenting with acquired PPK can be a perplexing task. Clinical classification Keratoderma can be defined acqulred its clinical appearance, although there is often overlap: Notice and credit must be given to the PCDS or other named contributor.

All are rare Epidermolytic keratoderma Vorner’s keratoderma and non-epidermolytic keratoderma Thost-Unna keratoderma are two of the best described forms Both are autosomal dominant Clinically the features can be indistinguishable with the development, usually in infancy, of diffuse, yellow, thickened skin affecting the palms and soles.

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. Some people with focal palmoplantar keratoderma also have abnormalities of the fingernails and toenails There are several inherited typeswhich are all rare. In cases where tripe palms occur without AN, lung cancers are usually responsible. If findings are consistent with a hereditary keratoderma, then a genetics consultation should be considered.


All named individuals and organisations maintain copyright for the relevant images. The palms of the hands may be affected with discrete, centrally placed lesions.

Acquired palmoplantar keratoderma.

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.

If no pertinent findings are identified after a history and a physical keratoder,a, laboratory and radiology studies should be undertaken in a systematic, logical fashion. 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.

Any findings suggestive of underlying conditions should be aggressively evaluated and treated.

Acquired keratoderma | DermNet NZ

The first step should include a comprehensive history and a physical examination, meratoderma a complete skin examination. It usually affects the sole of the feet around the margins of the heel and under the metatarsal heads. Keratoderma can be inherited, acquired, and rarely, paraneoplastic ie secondary to an internal malignancy. Please click on images to enlarge or download. Keratoderma may be hereditarywith symptoms presenting in early childhood, or acquired when it presents in later life.

There is usually a well-defined erythematous border The two conditions vary in their histological features Several others types have been described. Any image downloaded must keratodermq be used for teaching purposes and not for commercial use.


A painful paronychia develops with no evidence of bacterial or fungal infection. Rarely keratoderma can be associated with malignancy. Axial CT images showing multiple polypoidal enhancing mass lesions with surface calcifications, in the urinary bladder.

In order to avoid the possibility of overlooking an underlying etiology and to eliminate excessive testing, we present an algorithm palmoplahtar assessing patients presenting with acquired PPK. It is associated with squamous cell carcinoma of the upper aerodigestive tract oral cavity, pharynx, larynx, oesophagus. The cutaneous features usually pre-date the diagnosis of the cancer.

Website author — Dr Tim Cunliffe read more. It is often associated with acanthosis nigricans AN.

Aetiology Clinical pakmoplantar Images Investigations Management. Please follow this link if you have any high-quality images that you can contribute to the website. Etretinate and acitretin have also shown some success as alternative treatments in recalcitrant cases.

To facilitate such evaluations, this review categorizes the acquired PPKs as: They can be very effective for some patients, but cannot be used in fertile women due to their teratogenicity. Keratoderma of the soles and acanthosis nigricans of the hands in a patient with bladder carcinoma. This website is non-profit and holds the images for educational purposes only.