Case of punctate palmoplantar keratoderma type I treated with combination of low‐dose oral acitretin and topical salicylic acid and steroid

Abstract

Palmoplantar keratodermas (PPK) are heterogeneous disorders characterized by abnormal keratinization. Especially, punctate PPK (PPPK), one of the subtypes of hereditary PPK, is a rare punctate keratoderma characterized by tiny "raindrop" keratoses having a tendency to coalesce on the edge of soles, which are exposed to sustained pressure. If typical punctate lesions are confined to the palms and soles and the patient has a family history and late onset, it can be considered as PPPK type I (PPKP1), also called Buschke-Fisher-Brauer disease. The exact etiology of PPPK has not been fully understood. Furthermore, no standardized treatment for PPPK has been established and treatment options are limited. Above all, traditional systemic retinoids have been used in several cases, but dose-related adverse effects are common. Therefore, combination of low-dose systemic retinoids and adjuvant topical therapy can be an alternative treatment option for PPPK. Herein, we report a case of PPKP1 treated with combination of low-dose oral acitretin (10 mg/day) and topical salicylic acid and steroid. Despite low capacity, low-dose acitretin showed excellent regression of the lesions by combined use of topical ointments. The supplementary topical therapy may be useful in reducing the dose of systemic retinoids and preventing potential toxicity.

Punctate Palmoplantar Keratoderma: A Case Report of Type 1 (Buschke-Fischer-Brauer Disease)

“…However, our patient has none of these malignancies. No standardized treatment for PPPK has yet been established [9].…”

“…Some papules may form a keratotic core and detachment of the core may lead to a characteristic central depression [2]. Patients generally remain asymptomatic but rarely, pain can be caused by pressure [9]. Herein we report a rare case of type 1 PPPK on both palms.…”

Painless Horny Keratotic Spines on the Palms: A Quiz

“…Clinicopathological correlation was consistent with a diagnosis of porokeratosis punctata. Porokeratosis punctata palmaris et plantaris (PK) is a subtype of punctuate keratoderma, a subgroup of palmoplantar keratodermas, which consist in abnormal keratinization on the palms and soles (1,2). It is characterized by multiple small horny keratotic spines a few mm in size, arising on palms, soles or both, and flexor aspects of the digits (1-3).…”

The third‐generation retinoid adapalene triggered DNA damage to induce S‐phase arrest in HaCat cells

“…In addition, retinoids were also widely used for the experiments of diverse human cancers due to their influences on the cell proliferation and apoptosis of multiple tumor cells . Currently, the commonly used retinoids were all‐trans‐retinoic acid (ATRA), acitretin, isotretinoin, and tazarotene . However, repeated and long‐term use of these drugs often caused a lot of adverse reactions like allergic reaction, dry skin, piercing, photosensitivity, and skin infection.…”