Palmoplantar involvement may be characteristic of this syndrome fig. Epidermolytic hyperkeratosis is a skin disorder that is present at birth. 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. Because stratum corneum is thicker in palmoplantar region, yellowish lesions are seen instead of classic purplish papules. 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. 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. Our purpose was to discuss all treatment modalities proposed and tested for palmoplantar lichen planus in the literature.
It may first occur during a period of psychosocial stress. Treatment modalities of palmoplantar lichen planus. Palmoplantar lesions of lichen planus sinha s, sarkar r, garg vk. The current case describes palmoplantar lichen planus, a rare variant of this disease that can easily be misdiagnosed. Palmoplantar lichen planus is a rare localized variant of lichen planus. Palmoplantar refers to the skin on the soles of the feet and palms of the hands. 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. 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. The patient was diagnosed as a case of ppl by skin biopsy, and treated with acitretin. Lichen planus can be described as a recurrent rash which occurs from inflammation. Pdf hyperkeratotic palmoplantar lichen planus in a child. Transient palmoplantar keratoderma has also been described as a marker of a distinct, severe subtype of.
The aim was to study and classify the clinical variants into distinct easily recognisable categories for quick recognition and early treatment initiation. How to diagnose and manage hereditary palmoplantar. Palmoplantar lichen planus presenting with vesiclelike papules. This chronic, frustrating, recalcitrant disease may lead to disability in manual workers. Childhood lichen planus with palmoplantar involvement. Hyperkeratotic palmoplantar lichen planus in a child. Palmoplantar lichen planus ppl is an uncommon type of lichen planus lp that exclusively affects the palms and soles. Lichen sclerosus et atrophicus is an uncommon disease with small, white areas on the skin. A variety of morphological types has been described in literature. Differential diagnosis genetic disease dilate cardiomyopathy general disease numerous variant. Palmoplantar lichen planus lp, hyperkeratotic variant. The term actinic keratosis can be literally understood as a disorder of epidermal keratinocytes that is induced by ultraviolet uv light exposure.
Rarely a patient with the above clinical presentation may have mycosis fungoides and much more rarely a paraneoplastic disorder. In type 1a buschkefischerbrauer type, the papules will worsen upon exposure to water. Is there any natural treatment for palmoplantar keratoderma. In our cases, there was only a single plaque lichen planus on the foot, a rather rare variant of lichen planus 7. Progressive symmetric erythrokeratoderma presenting as. Ppk can be either acquired during the lifetime more commonly or inherited. These growths are more common in fairskinned people and those who are frequently in the sun.
Lichen planus is a common skin disease, affecting 0. 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. Palmoplantar lichen planus is a rare, localized variant of lichen planus. Case study palmoplantar keratoderma as a variant of lichen. Lichen nitidus is a chronic papular eruption of the skin that most commonly affects children and young adults but has been reported. Classification of keratodermas depends on whether or. Younger age at onset is associated with more severe disease and a family history affecting more family members. Eczematous, hyperkeratotic, lichen planus, palmoplantar, psoriasiform. Palmoplantar lichen planus is a localized and uncommon variant of lichen planus which is mostly resistant to treatment. 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. Ppk and nail dystrophy have been seen in lichen nitidus. Punctate palmoplantar keratoderma type i is a rare condition that affects the skin. Here you can see if there is any natural remedy andor treatment that can help people with palmoplantar keratoderma. Update on lichen planus and its clinical variants sciencedirect.
Hypertrophic variant with symmetric lesions on bilateral palms. Lichen planus is a benign, inflammatory and itchy dermatosis that is incurred by skin, skin extensions and mucosa. Lichen planus lp is a unique inflammatory disorder of unknown etiology that affects the skin, mucous membranes, nails and hair. Certain medications, particularly lithium, may be associated with the onset of flares. Palmoplantar keratoderma is also sometimes known as keratosis palmaris et plantaris. Lichen nitidus is a relatively rare, chronic skin eruption that is characterized clinically by asymptomatic, flattopped, skincolored micropapules see image below. Palmoplantar lp has varied morphological presentations apart from classically described yellowish hyperkeratotic papules and plaques. Biopsy from lesion showing typical features of lichen planus viz, hyperkeratosis, acanthosis. 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 keratodermas are a common clinical finding and thus addressed in this chapter. 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. Pdf palmoplantar keratoderma as a variant of lichn planus. It is most common on the vulvar and perianal areas but may be seen anywhere, with the mo.
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 lichen planus, hyperkeratotic variant. Palmoplantar lichen planus is an uncommon limited variant of lichen planus. We report a case of a 50yearold man who had palmoplantar hyperkeratotic papules and plaques. 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. Lichen planus lp and lichen nitidus ln present with varied morphology on the palms and soles. Hyperkeratotic plaques on the palms and solesdiagnosis. Punctate palmoplantar keratoderma type i genetic and. Palmar and plantar manifestations of lp alone might. Classic lp typically presents as pruritic, polygonal, violaceous flattopped papules and plaques. Clinical differential diagnosis of palmoplantar red hyperkeratosis includes palmoplantar plaque psoriasis, chronic hand dermatitis, chronic hyperkeratotic eczema che, and tinea. Palmoplantar lesions of lichen planus lp are uncommon and may not always have classical clinical features of lp. 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. Autoantibodies to melanocytes and characterization of melanophages in patients affected by a new variant of endemic pemphigus foliaceus.
Squamous cell carcinoma arising in lichen planus hypertrophicus. Psoriasis is a chronic inflammatory disease, with a reported prevalence of 1% to 3% in europe and the us. Lichen planus lp involving the palms and soles is uncommon and usually does not have. The extragenital cutaneous lesions of lsd consist of flat topped, white macules that tend to coalesce to form white patches.
It is characterized by violaceous, scaly, flattopped, polygonal papules commonly involving. Pdf lichen planus is a benign, inflammatory and itchy dermatosisthat is incurred. 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.
Lichen planus is an autoimmune, itching disorder that involves t lymphocytes, which may. Pathology of keratodermas, cornification disorders. The tendency to psoriasis is inherited, but what causes it to localise on the palms and soles is unknown. It is a subtype of punctate palmoplantar keratoderma. Palmoplantar lichen sclerosus et atrophicus aggarwal k. Acrokeratoelastoidosis ake is a rare, benign skin condition, wherein there is warty papules affecting the hands and feet, typically on the sides.
Some patients may display a variant of lp called twentynail dystrophy wherein. Highly pruritic thick hyperkeratotic plaques chronic venous stasis contributes to development average duration is 6 years. 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. Palmoplantar keratoderma genetic and rare diseases. Because it is different from the clinical morphology of the classic form of the lichen planus, palmoplantar type cause problems in. Pdf lichen planus lp is a common idiopathic inflammatory disorder that affects. Lichen planus may cause an erythematous, scaly ppk or a punctate, yellow, warty keratosis. A biopsy from the patient, however, was diagnostic of lichen planus. Lichen nitidus mainly affects children and young adults. The various forms of ppk can be divided into hereditary forms with only skin problems, hereditary syndromes. We present four unusual cases of palmoplantar lp and ln manifesting as hyperkeratotic plaques with pits. Epidermolytic hyperkeratosis genetics home reference nih. Frontal fibrosing alopecia is a variant elderly women, along frontal hairline grahamlittlepiccardilassueur syndrome. Lichen planus rarely show palmoplantar involvement.
Hyperkeratotic palmoplantar lichen planus in a child article pdf available in indian journal of dermatology 585. Otherwise, she enjoyed good past health with normal development. Druginduced lichen planus, or lichenoid drug eruption, is frequently photo distributed but may. 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.
Affected babies may have very red skin erythroderma and severe blisters. In some cases, the presence of a positive family history is not observed. 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. Palmoplantar lichen planus is a localized and uncommon variant of. 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. Palmoplantar psoriasis refers to a localized psoriasis variant. Actinic keratosis ak, sometimes called solar keratosis or senile keratosis, is a precancerous area of thick, scaly, or crusty skin. Palmoplantar keratoderma as a variant of lichen planus. Links abreu velez am, yi h, googe pb jr, mihm mc jr, howard ms. Lichen planus is a common inflammatory papulosquamous disorder affecting skin, mucous membranes, nails and hairs variably. Lastly, the punctate palmoplantar keratodermas are autosomal dominant, rare and manifest from late childhood to adulthood. Because palmoplantar lesions are uncommon 57 and do not present with the classic violaceous, flattopped, polygonal papules and wickham striae that are typical. In rare forms of ppk, organs other than the skin may also be affected. Are there natural treatments that may improve the quality of life of people with palmoplantar keratoderma.
Hyperkeratotic eczema psoriasis of the palms springerlink. Palmoplantar lesions of lichen planus sinha s, sarkar r. Subtle features like presence of violaceous border suggests lp and plugs within the pits suggest ln. Palmoplantar keratodermas foundation for ichthyosis.