Spiny keratoderma ‐ a demonstration of hair keratin and hair type keratinization

Abstract

Six cases of spiny keratoderma were analyzed with hair specific antikeratin antibodies (AE13, AE14) and by electron microscopy. The keratotic column exhibited a different keratin birefringence and the underlying viable epidermis was less eosinophilic than the surrounding epidermis. AE13, which is specific for hair cortex, was positive in the lower column and variably positive in the viable epidermis, often beyond the columnar lesion. AE14 was negative in the lesion. Electron microscopy demonstrated features of keratinization of normal hair cortex, i.e. by the accretion of keratin filaments without production of keratohyalin or trichohyalin granules. Cementsomes (lamellar granules) and marginal bands were not produced as they are not formed in normal cortical keratinization. It was suggested that spiny keratoderma represents an ectopic hair formation of palms and soles.

Spiny keratoderma: case series and review

“…18,22 Some cases note an increase in spines with manual labor. 2,3 In keeping with this finding, our patients had histories of hypertension and statin-controlled hyperlipidemia, with the additional associations of obesity, type 2 diabetes, and obstructive sleep apnea, all presentations of metabolic syndrome. 2,3 In keeping with this finding, our patients had histories of hypertension and statin-controlled hyperlipidemia, with the additional associations of obesity, type 2 diabetes, and obstructive sleep apnea, all presentations of metabolic syndrome.…”

“…[1][2][3] Numerous terms have been used to describe this clinical presentation including punctate porokeratotic keratoderma, 4,5 music box spine dermatosis, 4 multiple minute palmarplantar digitate hyperkeratoses, 5 palmar filiform parakeratotic hyperkeratosis, 6 and filiform hyperkeratosis. [1][2][3] Numerous terms have been used to describe this clinical presentation including punctate porokeratotic keratoderma, 4,5 music box spine dermatosis, 4 multiple minute palmarplantar digitate hyperkeratoses, 5 palmar filiform parakeratotic hyperkeratosis, 6 and filiform hyperkeratosis.…”

Multiple minute digitate hyperkeratosis: A proposed algorithm for the digitate keratoses

“…Electron microscopy may reveal a reduced number of keratohyaline granules and normal Odland bodies. Hashimoto et al 34 have shown immunohistochemical staining with AE13 (a hair type keratin), proposing that spiny keratoderma may represent ectopic hair formation. Partial response to treatment with topical keratolytics, topical retinoids, and topical 5-fluorouracil 27 has been reported.…”

Unilateral punctate porokeratosis - Case report

“…In 1999, Hashimoto et al suggested that spiny keratoderma is a disease of ectopic hair formation of palms and soles given that the keratotic column is stained with the AE13 (a hair type of keratin). 9 Moreover, although some reports point to a link with cancer this has not been conclusively established. 10 While some lesions of the palms and soles may be spiny in PP, underlying keratinocyte changes (vacuolation and dyskeratosis) target a correct diagnosis.…”