Introduction
Dieter Metze, Kira Süßmuth and Vinzenz Oji Palmoplantar Keratodermas 58
Key features
Palmoplantar keratodermas can be inherited or acquired
The three major patterns of involvement are diffuse, focal, and punctate
The clinical presentation may be different on the hands and feet, e.g. diffuse on the soles and focal on the palms
Additional distinguishing features include an erythematous border, transmigration to areas beyond the palmoplantar skin, and digital constrictions (pseudoainhum)
Patients may also suffer from hyperhidrosis, maceration, blistering, fungal infections, malodor, and pain
It is important to determine whether other features are present, e.g. nail dystrophy, hypotrichosis, oral lesions, hyperkeratosis of non-volar skin, impaired hearing, ocular findings, cardiomyopathy (in patients with woolly hair)
Histologic examination sometimes shows findings such as epider- molytic hyperkeratosis that provide diagnostic clues