Palmoplantar keratodermas (PPKs) are a diverse entity of disorders that are characterized by abnormal thickening of the skin on the palms and soles. What are the other Names for this Condition? (Also known as/Synonyms). Acquired Palmoplantar Keratoderma; Acquired PPK. Paraneoplastic palmoplantar keratoderma (PPK) is an acquired dermatosis that presents with hyperkeratosis of the palms and soles in association with visceral.

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Palmoplantar keratoderma is a term used to define a marked thickening of the skin on the palms and soles, either as a focal entity, or diffuse. Keratoderma can be inherited, acquired, and rarely, paraneoplastic ie secondary to an internal malignancy.

Keratoderma may be hereditarywith symptoms presenting in early childhood, or acquired when it presents in later life.

Rarely keratoderma can be associated with malignancy. Please click on images to enlarge or download. All named individuals and organisations maintain keratodfrma for the relevant images.

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Acquired keratoderma | DermNet NZ

Keratoderma of the soles and acanthosis nigricans of the hands in a patient with bladder carcinoma. Axial CT images showing multiple polypoidal enhancing mass lesions with surface calcifications, in the urinary bladder.

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Acquired palmoplantar keratoderma.

This chapter provides a practical overview of keratoderma, and is set out as below: Occasionally keratoderma can affect other parts of the body Keratoderka can be difficult to differentiate between the different types of keratoderma, however, the management principles are similarand as such the key diagnostic elements are to keragoderma the rare malignant or other systemic causes.

Clinical classification Keratoderma can be defined by its clinical appearance, although there is often kfratoderma All are rare Epidermolytic keratoderma Vorner’s keratoderma and non-epidermolytic keratoderma Thost-Unna keratoderma are two of the best described forms Both are autosomal dominant Clinically the features can be indistinguishable with the development, usually in infancy, of diffuse, yellow, thickened skin affecting the palms and soles.

There is usually a well-defined erythematous border The two conditions vary in their histological features Several others types have been described. Some people with focal palmoplantar keratoderma also have zcquired of the fingernails and toenails There are several inherited typeswhich are all rare. It usually affects the sole of the feet around the margins of the heel and under the metatarsal heads.


The palms of the hands may be affected with discrete, centrally placed lesions.

The vast majority are associated with adenocarcinoma of the stomach, but other malignancies sometimes found include other GI tract tumours, lung, uterus, ovaries, and urinary tract Tripe palms – the appearance differs to that of keratoderma with thickened velvety palms that have the appearance of tripe. It is often associated with acanthosis nigricans AN. The cutaneous features usually pre-date the diagnosis of the cancer.

In cases where tripe palms occur without AN, lung cancers are usually responsible. It is associated with squamous cell carcinoma of the upper aerodigestive tract oral cavity, pharynx, larynx, oesophagus.

Acquired palmoplantar keratoderma.

Three stages have been described: A painful paronychia develops with no evidence of bacterial or fungal infection. They can be very effective for some patients, but cannot be used in fertile women due to their teratogenicity. Aetiology Clinical findings Images Investigations Management.