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Year : 2014  |  Volume : 5  |  Issue : 2  |  Page : 235  

A classical case of punctate palmoplantarkeratoderma: A rare entity


Department of Dermatology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Sattur, Dharwad, India

Date of Web Publication21-Apr-2014

Correspondence Address:
Kikkeri Narayanasetty Naveen
Department of Dermatology, No 10, Skin OPD, Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Sattur - 580 009, Dharwad
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.131153

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How to cite this article:
Naveen KN, Pai VV. A classical case of punctate palmoplantarkeratoderma: A rare entity. Indian Dermatol Online J 2014;5:235

How to cite this URL:
Naveen KN, Pai VV. A classical case of punctate palmoplantarkeratoderma: A rare entity. Indian Dermatol Online J [serial online] 2014 [cited 2019 Dec 12];5:235. Available from: http://www.idoj.in/text.asp?2014/5/2/235/131153

A 60-year-old female presented with asymptomatic, multiple crateriform papules over sole of the foot and palms since 15 years [Figure 1] and [Figure 2]. On sole, few lesions coalesced to form large crateriform plaques at the pressure points. There was no history of similar lesions in the family. Based on history and clinical picture, a diagnosis of punctate palmoplantar keratoderma (PPK) was made.
Figure 1: Multiple crateriform papules over sole of the foot. Note: fusion of few papules at pressure points

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Figure 2: Papules over palms

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PPK is a type of hereditary palmoplantar keratoderma with mention recessive or dominant inheritance characterized by tiny "raindrop" keratoses involving the palmoplantar surface. It is a rare entity with an estimated prevalence rate of about 1.17 per 100,000 in the Croatian population. It has a much later onset than other hereditary keratodermas, with lesions appearing in the 2 nd or 3 rd decade or later. [1]

The hereditary forms of punctate PPKs were classified into three types.Type I (Buschke-Fischer-Brauer disease, keratosis punctata, and keratosis papulosa) is a late onset autosomal dominant condition with onset between 12 and 30 years. The main clinical features include the presence of multiple small keratotic lesions on the palms and soles, with variable nail involvement. It is typical for these punctate lesions to coalesce on the soles, which are subjected to continuous high pressure. Type II (porokeratosis punctata palmaris et plantaris, or porokeratosis of Mantoux) is an autosomal dominant condition with onset between 12 and 50 years. There are numerous, tiny, keratotic spines, which resemble the spines of a music box. Type III (acrokeratoelastoidosis lichenoides of Costa, focal acral hyperkeratosis) is a late onset autosomal dominant condition. The disease is principally found in black races. There are oval or polygonal crateriform papules on the borders of the hands, feet, and wrists, as well as in the center of the palms and soles and also on the skin crease. [1]



 
   References Top

1.Pai VV, Kikkeri NN, Athanikar SB, Sori T, Rao R. Type I punctate palmoplantarkeratoderma (Buschke-Fisher-Brauer disease) in a family - A report of two cases. Foot (Edinb) 2012;22:240-2.  Back to cited text no. 1
    


    Figures

  [Figure 1], [Figure 2]



 

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