A Clinico-Histopathological Study of Acquired Palmoplantar Keratoderma in a Rural-Based Tertiary Hospital

Abstract

BACKGROUND: Palmoplantar keratodermas are a diverse group of dermatological disorders characterized by abnormal thickening of skin over palms and soles. It is classified into inherited and acquired disorders. A number of diseases have been implicated as the cause of this common and interesting group and not many studies have been done in the acquired subset of this disorder. We have undertaken this study for finding out the incidence of various etiological factors in a rural based tertiary hospital. OBJECTIVE: To evaluate the epidemiological, clinical, and histopathological confirmation of acquired palmoplantar keratodermas (PPKD). MATERIALS AND METHODS: The study population consists of 100 consecutive patients aged 10 years and above, with acquired palmoplantar keratodermas seen in Dermatology Outpatient Department in a rural based tertiary hospital. RESULTS: Age of the patients ranged from 11 to 75 years and the common age group was 41 -50 years. Male predominance (1.17:1) was seen in our study and farmers, manual laborers and house-wives were most commonly affected. The dermatoses causing PPKD in our study were palmoplantar psoriasis, eczema, lichen planus and warts. A rare case of acquired palmoplantar keratoderma secondary to lichenoid drug eruption was observed by us which was not reported in literature to best of our knowledge. Many cases could not be diagnosed by histopathology; systemic examination and other investigations were normal hence were classified under idiopathic PPKD. CONCLUSION: Psoriasis, eczemas, lichen planus and warts were the dermatoses causing PPKD in our study. A rare case of lichenoid drug eruption causing PPKD is being reported by us, which was not reported in literature to the best of our knowledge.

Clinico-Pathological Correlation of Acquired Palmoplantar Hyperkeratotic Disorders

“…This result was similar to other studies of Sandeep et al 10 (54%) and Mahajan et al 13 (64.63%). Similarly the study by Murthy et al also showed a male predominance of (62.35%) and male to female ratio was 1.3:1.…”

“…In the present study unilateral involvement was seen in case of fungal infection (12/13) which was similar to that seen by Chopra et al 12 In the present study itching was the predominant symptom in majority of cases (60%) followed by pain, seen in 44.00% of cases. This result was similar with the results of the study by Sandeep et al 10 where itching was the predominant symptom, followed by pain and fissuring (seen in 75% cases). Similarly the study by Murthy et al showed that itching was the most common presenting feature seen (seen in 43/85 patients).…”

“…Similar results were seen in the study by Sandeep et al 10 which showed bilateral symmetry in 91% of cases, but involvement of both palm and sole was seen in majority of cases (60%) in their study followed by only sole involvement in 25% cases. Palmoplantar psoriasis in our study was bilaterally symmetrical in 97.2% cases whereas eczema was bilaterally symmetrical in 100% cases.…”

“…This result differs slightly from the studies done by Sandeep et al 10 and Murthy et al 11 which showed highest incidence in the age group of 41-50 years. But differs greatly from the study by Mahajan et al 13 The highest incidence in the age group of 11-20 years by Mahajan et al might be due to inclusion of inherited cases by them.…”

“…This is in concordance with the result by Sandeep et al (mean age of 43.72 years). 10 But differs from that reported by Murthy et al which showed a mean age of 31.7 years.…”