Spiny keratoderma of the palms and soles L85.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 11.11.2022

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Synonym(s)

Palmar filiform hyperkeratosis

Definition
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Very rare, acquired, chronically progressive, disseminated, filiform (spike-like) hyperkeratoses of the palms of the hands and/or soles of the feet, often accompanied by malignancies of internal organs or even of the skin (described is a malignant melanoma).

Manifestation
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LJ 50-70; no gender preference.

Localization
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Palms, soles of the feet.

Clinical features
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Mostly multiple, 0.1-0.2 cm large, up to 0.3 cm long, filiform, coarse (spike-like), skin-coloured, indolent papules.

Histology
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Sharply limited, columnar hyperkeratosis which may be focally parakeratotic. The underlying epidermis is slightly thinned, otherwise without pathological findings. Dermis without inflammatory infiltrates.

Differential diagnosis
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Small papular palmoplantar keratoses; porokeratosis plantaris, palmaris et disseminata.

Note(s)
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The clinical picture is considered a paraneoplastic syndrome and has been described in connection with the existence of bronchial carcinoma, renal cell carcinoma, rectal carcinoma, malignant melanoma and chronic terminal renal insufficiency.

Literature
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  1. Bonnecaze AK et al (2016) Keratosis punctata of the palmar creases in a 68-year-old African-American man. BMJ Case Rep bcr2016216050.

  2. Grillo E et al (2012) Spiky keratotic projections on the palms and fingers. Spiny keratoderma. Dermatol Online J 18:8.

  3. Kaddu S et al (1995) Palmar hyperkeratosis: a new paraneoplastic syndrome? J Am Acad Dermatol 33: 337-340.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 11.11.2022