Palmoplantar lichen planus is an uncommon limited variant of lichen planus. Links abreu velez am, yi h, googe pb jr, mihm mc jr, howard ms. Hypertrophic variant with symmetric lesions on bilateral palms. Is there any natural treatment for palmoplantar keratoderma. Punctatetype palmoplantar keratoderma is a type of palmoplantar keratoderma that is caused by genetic abnormalities that may be inherited in an autosomal dominant or autosomal recessive manner. Here you can see if there is any natural remedy andor treatment that can help people with palmoplantar keratoderma. Lichen planus lp is a unique inflammatory disorder of unknown etiology that affects the skin, mucous membranes, nails and hair. The patient was diagnosed as a case of ppl by skin biopsy, and treated with acitretin. Eczematous, hyperkeratotic, lichen planus, palmoplantar, psoriasiform. Palmoplantar psoriasis refers to a localized psoriasis variant. Punctate palmoplantar keratoderma type i genetic and. The term actinic keratosis can be literally understood as a disorder of epidermal keratinocytes that is induced by ultraviolet uv light exposure.
Autoantibodies to melanocytes and characterization of melanophages in patients affected by a new variant of endemic pemphigus foliaceus. Palmoplantar keratoderma as a variant of lichen planus. The topic punctate palmoplantar hyperkeratosis type 3 you are seeking is a synonym, or alternative name, or is closely related to the medical condition acrokeratoelastoidosis. Palmoplantar lesions of lichen planus sinha s, sarkar r, garg vk. Ppk can also be a feature of various underlying syndromes. Certain medications, particularly lithium, may be associated with the onset of flares. Palmoplantar lichen planus is a rare, localized variant of lichen planus. Palmoplantar lichen planus is a localized and uncommon variant of. Frontal fibrosing alopecia is a variant elderly women, along frontal hairline grahamlittlepiccardilassueur syndrome. It is characterized by violaceous, scaly, flattopped, polygonal papules commonly involving the flexural areas of the wrists, legs, and oral and genital mucous membranes of those 3060 years old, but it is uncommon in children. Lichen sclerosus et atrophicus is an uncommon disease with small, white areas on the skin. Epidermolytic hyperkeratosis is a skin disorder that is present at birth.
Lichen planus lp involving the palms and soles is uncommon and usually does not have. Palmoplantar lichen planus is a localized and uncommon variant of lichen planus which is mostly resistant to treatment. Lichen planus is a common skin disease, affecting 0. Update on lichen planus and its clinical variants sciencedirect. Palmar and plantar manifestations of lp alone might. The current case describes palmoplantar lichen planus, a rare variant of this disease that can easily be misdiagnosed. Palmoplantar lichen planus presenting with vesiclelike papules. Palmoplantar keratodermas are a heterogeneous group of disorders characterized by abnormal thickening of the palms and soles autosomal recessive and dominant, xlinked, and acquired forms have all been described. Keratinization disorder which presents at birth with generalized erythema, widespread bullae and desquamation resulting in denuded skin form of ichthyosis, an abnormality of epidermal maturation resulting in skin fragility epidermolytic hyperkeratosis is a descriptive term which refers to specific microscopic features i.
Palmoplantar keratodermas are a group of disorders characterized by thickening of the skin on the palms of the hands and soles of the feet of affected individuals. In rare forms of ppk, organs other than the skin may also be affected. Squamous cell carcinoma arising in lichen planus hypertrophicus. Subtle features like presence of violaceous border suggests lp and plugs within the pits suggest ln. Involvement of palm and soles is thought to be uncommon in lp. Classification of keratodermas depends on whether or. Initially lichenoid infiltrate very similar to lichen planus. It may be triggered by an injury to the skin, an infection, or another skin condition such as hand dermatitis. We report a case of a 50yearold man who had palmoplantar hyperkeratotic papules and plaques.
The tendency to psoriasis is inherited, but what causes it to localise on the palms and soles is unknown. Since stratum corneum in palmoplantar lichen planus is extremely thick, lesions can be yellow colored instead of the purple colored papules that are classic lesions. Rarely a patient with the above clinical presentation may have mycosis fungoides and much more rarely a paraneoplastic disorder. A case of palmoplantar lichen planus mimicking secondary. Biopsy from lesion showing typical features of lichen planus viz, hyperkeratosis, acanthosis. Lichen planus lp and lichen nitidus ln present with varied morphology on the palms and soles. Progressive symmetric erythrokeratoderma presenting as hyperkeratotic plaques in a young girl mym wat, kh yeung, kc yau case report a 15yearold young girl presented with multiple hyperkeratotic plaques since 4 years old. Case study palmoplantar keratoderma as a variant of lichen. The extragenital cutaneous lesions of lsd consist of flat topped, white macules that tend to coalesce to form white patches.
Lichen nitidus mainly affects children and young adults. Acrokeratoelastoidosis costa 10 arsenic keratoses 4 congenital dyskeratosis 12 focal acral hyperkeratosis 12 hyperkeratotic fissured hand and foot eczema 8 lichen planus 102 pachyonychia congenita hereditaria 10 pityriasis rubra pilaris devergie 44 progeria adultorum 3 psoriasis palmoplantaris 12 sezary syndrome 15 verruca. Some patients may display a variant of lp called twentynail dystrophy wherein. A biopsy from the patient, however, was diagnostic of lichen planus. It is a subtype of punctate palmoplantar keratoderma.
The rashes created by the infection are characterized with flat topped and manysided bumps which grow together to form scaly patches on the skin. Palmoplantar lichen planus lp, hyperkeratotic variant. The aim was to study and classify the clinical variants into distinct easily recognisable categories for quick recognition and early treatment initiation. Lastly, the punctate palmoplantar keratodermas are autosomal dominant, rare and manifest from late childhood to adulthood. Ppk and nail dystrophy have been seen in lichen nitidus.
Lichen planus rarely show palmoplantar involvement. This chronic, frustrating, recalcitrant disease may lead to disability in manual workers. Palmoplantar involvement may be characteristic of this syndrome fig. Palmoplantar keratoderma genetic and rare diseases. In our cases, there was only a single plaque lichen planus on the foot, a rather rare variant of lichen planus 7. Treatment modalities of palmoplantar lichen planus. A variety of morphological types has been described in literature.
In some cases, the presence of a positive family history is not observed. Keratosis pilaris kp is a common, frequently inherited disorder of follicular hyperkeratosis buildup of dead skin, where dead skin cells known as keratinocytes form hard plugs within the hair follicle and. Because newborns with this disorder are missing the protection provided by normal skin, they are at risk of becoming dehydrated and developing infections in the skin or throughout the body sepsis. Highly pruritic thick hyperkeratotic plaques chronic venous stasis contributes to development average duration is 6 years. Lichen planus lp is an inflammatory skin condition with characteristic clinical and histopathological findings. Palmoplantar lichen planus ppl is an uncommon type of lichen planus lp that exclusively affects the palms and soles. Lichen planus is a common inflammatory papulosquamous disorder affecting skin, mucous membranes, nails and hairs variably.
Palmoplantar keratoderma ppk is a group of skin conditions characterized by thickening of the skin on the palms of the hands and soles of the feet. Younger age at onset is associated with more severe disease and a family history affecting more family members. Symptoms of palmoplantar keratoderma including 2 medical symptoms and signs of palmoplantar keratoderma, alternative diagnoses, misdiagnosis, and correct diagnosis for palmoplantar keratoderma signs or palmoplantar keratoderma symptoms. Pdf lichen planus is a benign, inflammatory and itchy dermatosisthat is incurred.
Lichen planus may cause an erythematous, scaly ppk or a punctate, yellow, warty keratosis. These growths are more common in fairskinned people and those who are frequently in the sun. Because palmoplantar lesions are uncommon 57 and do not present with the classic violaceous, flattopped, polygonal papules and wickham striae that are typical. Pathology of keratodermas, cornification disorders. Affected babies may have very red skin erythroderma and severe blisters. Childhood lichen planus with palmoplantar involvement. Palmoplantar lichen planus is a clinical variant, rarely.
Psoriasis is a chronic inflammatory disease, with a reported prevalence of 1% to 3% in europe and the us. Punctate palmoplantar keratoderma type i is a rare condition that affects the skin. Differential diagnosis genetic disease dilate cardiomyopathy general disease numerous variant. Palmoplantar lichen planus, hyperkeratotic variant. Lichen planus is an autoimmune, itching disorder that involves t lymphocytes, which may.
Because it is different from the clinical morphology of the classic form of the lichen planus, palmoplantar type cause problems in. Hyperkeratotic eczema of the palms, a common yet somewhat neglected entity, is characterized by chronic, scaly, hyperkeratotic, fissureprone, erythematous plaques on the palms and palmar surfaces of the fingers. Lichen planus can be described as a recurrent rash which occurs from inflammation. Palmoplantar lesions of lichen planus lp are uncommon and may not always have classical clinical features of lp. It is characterized by violaceous, scaly, flattopped, polygonal papules commonly involving. This case describes a patient that presented with multiple papules on his hands and plantar feet that had previously been diagnosed as tinea manum and psoriasis. The various forms of ppk can be divided into hereditary forms with only skin problems, hereditary syndromes. Pdf hyperkeratotic palmoplantar lichen planus in a child. Acrokeratoelastoidosis ake is a rare, benign skin condition, wherein there is warty papules affecting the hands and feet, typically on the sides. The disease can be associated with many clinical forms, including predominantly pustular lesions to thick scaly, hyperkeratotic plaques, or an overlapping of both of them. Palmoplantar lichen planus is a rare localized variant of lichen planus. Are there natural treatments that may improve the quality of life of people with palmoplantar keratoderma. Pdf lichen planus lp is a common idiopathic inflammatory disorder that affects. Actinic keratosis ak, sometimes called solar keratosis or senile keratosis, is a precancerous area of thick, scaly, or crusty skin.
Palmoplantar lichen sclerosus et atrophicus aggarwal k. Progressive symmetric erythrokeratoderma presenting as. Palmoplantar keratodermas are a common clinical finding and thus addressed in this chapter. Lichen planus is a benign, inflammatory and itchy dermatosis that is incurred by skin, skin extensions and mucosa.
Epidermolytic hyperkeratosis genetics home reference nih. Transient palmoplantar keratoderma has also been described as a marker of a distinct, severe subtype of. Palmoplantar lesions of lichen planus sinha s, sarkar r. Palmoplantar lp has varied morphological presentations apart from classically described yellowish hyperkeratotic papules and plaques.
Hyperkeratotic plaques on the palms and solesdiagnosis. Palmoplantar refers to the skin on the soles of the feet and palms of the hands. Classic lp typically presents as pruritic, polygonal, violaceous flattopped papules and plaques. In type 1a buschkefischerbrauer type, the papules will worsen upon exposure to water. Hyperkeratotic palmoplantar lichen planus in a child article pdf available in indian journal of dermatology 585. Lichen nitidus is a relatively rare, chronic skin eruption that is characterized clinically by asymptomatic, flattopped, skincolored micropapules see image below. It may first occur during a period of psychosocial stress. Clinical differential diagnosis of palmoplantar red hyperkeratosis includes palmoplantar plaque psoriasis, chronic hand dermatitis, chronic hyperkeratotic eczema che, and tinea. Palmoplantar keratodermas foundation for ichthyosis. Palmoplantar keratoderma is also sometimes known as keratosis palmaris et plantaris. Hyperkeratotic palmoplantar lichen planus in a child. Hyperkeratotic pitted plaques on the palms and soles. It is most common on the vulvar and perianal areas but may be seen anywhere, with the mo.
Otherwise, she enjoyed good past health with normal development. Lichen nitidus is a chronic papular eruption of the skin that most commonly affects children and young adults but has been reported. Dermis keratosis palmoplantaris information on the. How to diagnose and manage hereditary palmoplantar. Although several clinical features of palmoplantar lichen planus may be seen, the erythematous scaly form is most common. Because stratum corneum is thicker in palmoplantar region, yellowish lesions are seen instead of classic purplish papules. Hyperkeratotic eczema psoriasis of the palms springerlink. Druginduced lichen planus, or lichenoid drug eruption, is frequently photo distributed but may. We present four unusual cases of palmoplantar lp and ln manifesting as hyperkeratotic plaques with pits. Our purpose was to discuss all treatment modalities proposed and tested for palmoplantar lichen planus in the literature.