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Palmoplantar Keratoderma (PPK) constitutes a heterogeneous group of disorders characterized by severe skin scalding as a result of thickening of the palms and the soles of affected individuals. They are divided based on whether they are inherited or acquired. The inherited forms are classified into three distinct clinical patterns of epidermal involvement.

  • Diffuse PPK: Uniform involvement of the palmoplantar surface. The age of onset of the disease is within the first few months of life.

  • Focal and Striate PPK: Consisting of localized areas of hyperkeratosis located mainly on pressure points and sites of recurrent friction.

  • Punctate Keratoderma: Characterized by multiple small, hyperkeratotic papules, spicules, or nodules on the palms and soles. These tiny keratoses may involve the entire palmoplantar surface or may be restricted to certain locations (eg, palmar creases).

It is also divided into a subclassification of which variants are based on the presence of simple keratoderma or isolated PPK. Others involve lesions of nonvolar skin, hair, teeth, nails, or sweat glands and/or with abnormalities of other organs.

Finally, the acquired forms of PPK are divided into keratoderma climactericum, keratoderma associated with internal malignancy, PPK due to inflammatory and reactive dermatoses, PPK caused by infections, drug-related PPK, and systemic disease-associated PPK.

Diffuse hereditary palmoplantar keratoderma types without associated features are summarized in Table K-1.

TABLE K-1Diffuse Hereditary Palmoplantar Keratoderma without Associated Features

Diffuse hereditary palmoplantar keratoderma types with associated features are summarized in Table K-2.

TABLE K-2Diffuse Hereditary Palmoplantar Keratoderma with Associated Features

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