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Keratosis punctata palmaris et plantaris Mohanty S, Gandhi V, Baruah M C - Indian J Dermatol Venereol Leprol
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  In this article
   Abstract
   Introduction
   Case Report
   Discussion
   References

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CASE REPORT
Year : 1999  |  Volume : 65  |  Issue : 2  |  Page : 90-91

Keratosis punctata palmaris et plantaris


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Correspondence Address:
Sandip Mohanty


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  Abstract  

A 30-year-old man presented with multiple keratotic papules on palms and soles. The lesions started at the age of 15 from soles. Family history was positive with members in preceding two generations being affected. Cutaneous examination revealed multiple discrete hyperkeratotic papules of variable size on palms and soles. Parakeratosis was absent in histopathology and this ruled out the diagnosis of porokeratosis punctata palmaris et plantaris.


Keywords: Keratosis, Palmo-plantar, Punctate keratosis


How to cite this article:
Mohanty S, Gandhi V, Baruah M C. Keratosis punctata palmaris et plantaris. Indian J Dermatol Venereol Leprol 1999;65:90-1

How to cite this URL:
Mohanty S, Gandhi V, Baruah M C. Keratosis punctata palmaris et plantaris. Indian J Dermatol Venereol Leprol [serial online] 1999 [cited 2014 Mar 11];65:90-1. Available from: http://www.ijdvl.com/text.asp?1999/65/2/90/4774



  Introduction   Top


Keratosis punctata palmaris et plantaris is a rare condition characterised by multiple discrete keratotic papules of variable size with a central conical plug which usually occur on palms and soles. The first recorded case was that of Davies Colley in 1879.[1]

The condition is often familial and transmitted as autosomal dominant with.variable penetrance.[2][3] The onset is late as compared to other keratodermas, lesions usually appearing between 15 to 30 years of age. Current opinion is that the condition formerly known as porokeratosis of Mantoux is not related to sweat ducts and should be considered as a small pattern punctate keratoderma.[2]


  Case Report   Top


A 30-year-old man presented with multiple keratotic papules on palms and soles. The lesions started at the age of 15 on soles followed a few years later by involvement of palms. No history suggestive of exposure to arsenic could be elicited. Family history was positive with members in preceding two generations being affected. General physical and systemic examination were within normal limits. Cutaneous examination revealed multiple discrete hyperkeratotic papules of variable size (0.1X0. lcm. to 0.5X0.5cm) on palms and soles. Lesions were also present on palmar aspects of fingers and plantar aspects of toes. Examination of hair, teeth, nails and mucous membranes revealed no abnormality. An excisional biopsy of a papule from the palm revealed a circumscribed area of cone-shaped hyperkeratosis in stratum corneum. No parakeratosis was seen in the conical plug.


  Discussion   Top


Punctate palmoplantar keratoderma is usually confused with porokeratosis punctata palmaris et plantaris. Parakeratosis was conspicuously absent in our patient and this essentially ruled out the diagnosis of porokeratosis punctata palmaris et plantaris. Family history revealed members in 3 successive generations being affected with onset of the disease at around 15 years of age. This suggests an autosomal dominant mode of inheritance with variable penetrance as noticed by other authors previously.[3][4][5] The age of onset in our index case has still not reached puberty (eldest being 10 years old). They are on regular follow up as a proportion of them may dvelop lesions after pubertal age. Our patient fulfils the clinical and histological features of familial keratosis punctata palmaris et plantaris.[2]

 
  References   Top

1. Scott MJ, Costello MJ, Simuango S. Keratosis punctata palmaris et plantaris. Arch Derm Syph 1951;64:301.  Back to cited text no. 1    
2. Griffiths W, Leigh IM, Marks R. Disorders of keratinisation. In: Textbook of Dermatology, 5th ed. Champion RH, Burton JL, Ebling FJG (Eds.), Blackwell Scientific Publications. 1380-1381.  Back to cited text no. 2    
3. Brown F C. Punctate keratoderma. Arch Derm 197;104:682-663.  Back to cited text no. 3    
4. Cockayne FA. Inherited abnormalities of the skin and its appendages. London, Oxford University Press, 1933;109.  Back to cited text no. 4    
5. Coups R. Usher B. Keratosis punctata palmaris et plantaris. Arch Derm 1963;87:91-95.  Back to cited text no. 5    




 

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