Keratoderma climactericum (Haxthausen’s Disease): Clinical Signs, Laboratory Findings and Etretinate Treatment in 10 Patients

Deschamps, P; Leroy, Daniela C; Pédaillès, S; Mandard, J. C.

doi:10.1159/000249351

Cited by 35 publications

(19 citation statements)

References 8 publications

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“…Lowdose maintenance therapy with etretinate at approximately 10-20 mg/day is needed for long-term treatment in order to prevent relapse [4,5], Recently, some new data demonstrated that keratoderma climactericum of Haxthausen's responded well to etretinate [6], In keratosis lichenoides chronica [7], Kyrlc's disease [8] and con fluent and reticulated papillomatosis [9], some rare hyper-and dyskcratotic diseases, etretinate has been reported to produce good results within 3-4 weeks. Concerning its mechanism of action, etretinate inhibits the migration of neutrophilic and eo sinophilic granulocytes by a direct effect on cell motility [10], probably by changing the cells' capability to respond to chemoattrac tants or by modulating components of the epidermis or basal membrane zone to act as chemoattractants.…”

Section: Etretinatementioning

confidence: 99%

New Indications and New Retinoids

Gollnick¹

1987

Dermatology

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In addition to well-accepted indications, etretinate has a beneficial effect in a variety of other dermatoses such as the hyperkeratotic eczema of the palms and soles, prurigo nodularis, and other nonpsoriatic, sterile, pustular eruptions. Due to its influence on dermal inflammatory processes and immunomodulation of the tissue response, etretinate is effective in cutaneous lupus erythematosus, certain bullous disorders like pemphigus herpetiformis, the persistent variant of Grover’s disease, dermatitis herpetiformis, and bullous pemphigoid. Isotretinoin is reported to be effective in cutaneous sarcoidosis, disseminated granuloma annulare, systemic sclerosis and tumors of the cutaneous appendages. New synthetic retinoids have been developed. Etretin, the main metabolite of etretinate, was shown to be effective and to have a short elimination half-life of – 50 h. Arotinoid ethyl ester and arotinoid-free carboxylic acid are effective in minimal doses 500-fold lower than etretinate. Arotinoid ethyl ester was shown not to increase serum lipids. Arotinoid ethyl sulfone is the first retinoid without bone toxicity in animal experiments. Motretinide is the ethylamide of tretinoin and is reported to be effective in the local treatment of acne. Some of the new poly-aromatic retinoids appear to have sebosuppressive, antikeratinizing and/or anti-inflammatory effects via topical application.

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Section: Etretinatementioning

confidence: 99%

New Indications and New Retinoids

Gollnick¹

1987

Dermatology

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“…Thus, impaired permeability barrier recovery and weakened integrity of the SC could cause so‐called dry skin in postmenopause in combination with reduced hydration of the SC, although these were not analysed in women at menopause and postmenopause. The abnormalities of the SC, particularly impaired integrity, might be related to keratoderma climactericum, in which palmar and plantar keratosis appear on the sites experiencing mechanical pressure. This disease is found in not only postmenopausal women but also in young women who were castrated by surgery, and their symptom disappeared after HRT …”

Section: Discussionmentioning

confidence: 99%

Physiological and functional changes in the stratum corneum restored by oestrogen in an ovariectomized mice model of climacterium

Chen

Yokozeki

Katagiri

2017

Experimental Dermatology

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Significant decreases in hormonal levels at menopause induce physiological and functional discomfort in the skin. Representative changes at menopause are based on so-called dry skin. However, there is no evidence to explain the mechanism, even though hydration of the stratum corneum (SC) in women at menopause is comparable with that at premenopause but is enhanced by hormone replacement therapy. This study objective was to evaluate structural and functional changes in the SC in ovariectomized mice model of menopause. Hydration of the SC, recovery of the permeability barrier function, integrity and cohesion of the SC, and irritant dermatitis were analysed in mice that underwent ovariectomy with or without replacement of 17ß-estradiol. In ovariectomized mice, hydration of the SC was reduced, recovery of permeability barrier function after acute disruption was impaired, and integrity of the SC was weakened and was associated with increased cohesion and increased levels of irritant dermatitis. Oestrogen replacement treatment restored all changes. Immunohistochemistry revealed reduced levels of expression of desmoglein-1 and differentiation markers of epidermis in ovariectomized mice compared with control mice and mice with oestrogen replacement treatment. These changes might be directly associated with weakened integrity and impaired permeability barrier function of the SC in ovariectomized mice. This study results reveal that so-called dry skin at menopause is caused by not only lower hydration of the SC but also complicated structural and functional changes in the SC and skin.

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“…Кератодермия климактерическая (болезнь Хакст-хаузена) -одна из самых распространенных форм приобретенной диффузной кератодермии, развива-ется у 10-15% женщин в климактерическом перио-де, чаще в местах давления и трения, обычно сочета-ется с метаболическим синдромом, гипертониче-ской болезнью, деформирующим артрозом [30]. Основным триггерным фактором в развитии этой кератодермии считается дефицит эстрогенов, про-гестерона, тестостерона, развивающийся в процессе возрастной инволюции репродуктивной системы.…”

Section: клиническая дерматология и венерология 2 2015unclassified

“…Жжение, зуд и боли при физической нагрузке связа-ны с наличием трещин. Заболевание имеет прогрес-сирующее течение, протекает волнообразно с пери-одами обострения, чаще в зимнее время [30]. Дости-жение полной ремиссии наблюдается редко.…”

Section: клиническая дерматология и венерология 2 2015unclassified

Pathogenetic aspects underlying palmoplantar keratodermas. Current therapies

Круглова¹,

Жукова²,

Fineshina³

2015

Klin. dermatol. venerol.

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Ладонно-подошвенные кератодермии (ЛПК) (кератоз ладонно-подошвенный) составляют доста-точно гетерогенную группу болезней наследствен-ного или приобретенного характера, в клинической картине которых присутствуют диффузные или оча-говые утолщения рогового слоя эпидермиса пре-имущественно в области ладоней и подошв, реже в сочетании с кератозами другой локализации. Харак-терна эктодермальная дисплазия и воспаление [1][2][3]. Ладонно-подошвенные кератодермии представляют собой гетерогенную группу болезней наследственного или приобретенного характера, в клинической картине которых присутствуют диффузные или очаговые утолщения рогового слоя эпидермиса преимущественно в области ладоней и подошв, реже в сочетании с кератозами другой локализации. Для них характерны эктодермальная дисплазия и воспаление. В статье представлены общие сведения об эпидемиологии, этиологии и патогенезе данной патологии; дана классификация наследственных кератодермий, представлена связь генетических мутаций с проявлениями основных синдромов. Описаны клинические проявления кератодермий как приобретенного, так и наследственного характера. Авторы обращают внимание на то, что терапевтические мероприятия при кератодермиях чаще носят симптоматический характер. Для общего лечения всех форм кератодермий показано применение ретиноидов, предпринимаются попытки применения заместительной гормональной терапии. Наружное лечение кератодермий включает бальнеолечение, использование кератолитических и увлажняющих топических средств. В комплексе с наружной терапией с успехом применяются физиотерапевтические методы. Учитывая, что кератодермии в ряде случаев могут выступать симптомами паранеопластических процессов и других заболеваний, необходимо продолжить диагностический поиск и дифференцированный подход к терапевтическим мероприятиям. Ключевые слова: ладонно-подошвенные кератодермии, этиология, патогенез, клиника, лечение.Palmoplantar keratodermas are a heterogeneous group of diseases of the hereditary or acquired nature whose clinical picture includes diffuse or focal thickening of the horny layer of the epidermis, mainly in the palms and soles and sometimes in combination with keratoses in other areas. They are characterized by ectodermal dysplasia and inflammation. This article presents general information on the epidemiology, etiology, and pathogenesis of this disease, provides a classification of hereditary keratodermas, and shows the relationship between genetic mutations and manifestations of basic syndromes. The clinical manifestations of keratodermas of both acquired and hereditary nature are described. The authors point out at the fact that therapeutic procedures for keratodermas are usually aimed at treating symptoms. Application of retinoids is recommended for general treatment of all forms of keratoderma. Hormone replacement therapy is also used. Topical treatment of keratodermas includes balneotherapy and the use of keratolytic and moiorsturizing topical agents. Physiotherapy techniques are successfully used in combination with topical treatment. G...

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Keratoderma climactericum (Haxthausen’s Disease): Clinical Signs, Laboratory Findings and Etretinate Treatment in 10 Patients

Cited by 35 publications

References 8 publications

New Indications and New Retinoids

New Indications and New Retinoids

Physiological and functional changes in the stratum corneum restored by oestrogen in an ovariectomized mice model of climacterium

Pathogenetic aspects underlying palmoplantar keratodermas. Current therapies

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