Circumscribed Palmar or Plantar Hypokeratosis 10 Years After the First Description: What Is Known and the Issues Under Discussion

Abstract

This review of the literature on palmoplantar hypokeratosis, a process that was first indentified only 10 years ago, discusses the current state of our understanding, the therapeutic options available, and the debate about etiology. Forty-four publications reporting 69 cases were found. Palmar or plantar hypokeratosis occurs mainly in women (76.8%) and age at the time of a first visit to a physician ranges from 42 to 84 years. Most cases present between the ages of 51 and 70 years. The majority of patients have had solitary lesions usually located on the right palm, particularly in the regions of the thenar (in 44/79 lesions [55.7%]) or hypothenar eminences (in 11/79 lesions [13.9%]). In only 8 cases was there a history of prior trauma at the site. Studies using polymerase chain reaction techniques to identify human papillomavirus involvement were negative in most cases. These hypokeratotic lesions are localized epidermal depressions formed by an abrupt thinning of the stratum corneum, providing a singular histopathologic feature. This condition can currently be considered a localized keratinization disorder affecting zones where there is a thick stratum corneum. The precipitating cause is unknown and a definitive treatment remains to be found. The mechanism would be the localized failure of a clone of keratinocytes during differentiation toward normal palmoplantar hyperkeratinization. Palmas y plantas; Hipoqueratosis circunscrita palmar o plantar. Conocimientos y controversias tras 10 años de su descripciónResumen Se revisa el estado actual de un nuevo proceso y los avances que han ido apareciendo en la literatura respecto a su estudio, posibilidades terapéuticas y controvertida etiología, tras ଝ Please cite this article as: Urbina F, Pérez A, Requena L, Rütten A. Hipoqueratosis circunscrita palmar o plantar. Conocimientos y controversias tras 10 años de su descripción. Actas Dermosifiliogr. 2014;105:574---582.Palmar or Plantar Hypokeratosis 575 Palmoplantar; Queratinización; Queratinocito justo una década de su descripción inicial. Hemos encontrado 44 publicaciones al respecto, con 69 casos. Predomina en mujeres (76,8%), con edades entre los 42 y 84 años para toda la casuística en el momento de la consulta, siendo el rango más frecuente de aparición de las lesiones entre los 51 y 70 años. La gran mayoría de las veces fueron lesiones únicas y se localizaron predominantemente en la palma derecha, preferentemente en la región tenar, con 44/79 lesiones (55,7%) y luego en la hipotenar, con 11/79 lesiones (13,9%). Solo en 8 casos se obtuvo el antecedente de un traumatismo previo. Los estudios mediante PCR en búsqueda de papiloma virus humano han sido negativos la gran mayoría de las veces. Las lesiones consistieron en una depresión focalizada de la epidermis producida por una brusca disminución de espesor de la capa córnea, delimitando un singular concepto histolopatológico. En la actualidad puede ser considerada como un trastorno focalizado de la queratinización, que afecta zonas con un estrato córneo grueso, cuya c...

Well-circumscribed erythematous depressed annular patches on palm

“…Since the first description of CPH in 2002, further cases have been reported with similar clinical and histological features. According to a recent review, most reported lesions were single, mainly located on the right palm, particularly the thenar region, and had been present for a long period, with a mean duration of 12.8 years. Only 10 (13.0%) of the 69 identified cases had multiple (two or three) lesions.…”

Circumscribed Hypokeratosis

“…Lesions had an erythematous surface with clear-cut edges. 2 Up to now, 86 cases have been published in the literature (Table 3). No one had history of trauma (Fig.…”

“…2,4,11,20,29,41 The most common locations are: palms (thenar and hypothenar regions) and soles. 2,4,11,20,29,41 The most common locations are: palms (thenar and hypothenar regions) and soles.…”

Circumscribed plantar hypokeratosis responding to topical calcipotriol

“…Nevertheless, due to the frequent lack of efficacy of these treatments and the benignancy of this entity, the observational attitude is an adequate option. 9 erythematous lesion on the metatarsal region of his right sole (Fig. 1A).…”