Case report
Hereditary Diffuse Transgradient Palmoplantar Keratoderma in a 57-year-old Male: A Case Report
WD01-WD03
Correspondence
Dr. K Suresh Kumar,
RL Jalappa Hospital, Tamaka, Kolar-563103,
Karnataka, India.
E-mail: skindrsureshk@sduaher.ac.in
Palmoplantar keratoderma refers to a heterogeneous group of disorders characterised by abnormal thickening of the stratum corneum of the palms and soles. Transgradient palmoplantar keratoderma is a distinctive subtype in which the hyperkeratosis extends beyond the palmar and plantar margins onto the adjoining dorsal surfaces of hands and feet, wrists, ankles, or adjacent skin. Present case is that of a 57-year-old male farmer who presented with thickening of the skin over both palms and soles, associated with fissuring and pruritus. The lesions were first noted in early childhood, initially involving the soles and gradually progressing to the palms over a few years. A positive family history was noted, with similar complaints in his elder brother, suggesting a hereditary pattern. On examination, diffuse palmoplantar hyperkeratosis with transgradient extension onto the dorsal surfaces was observed. Histopathology revealed compact orthokeratotic hyperkeratosis, prominent hypergranulosis, and acanthosis with elongated rete ridges. Transgradient palmoplantar keratoderma should be suspected in patients presenting with early-onset diffuse palmoplantar hyperkeratosis extending onto the dorsal surfaces, especially with a positive family history.