Punctate palmoplantar keratoderma (PPK)
Punctate palmoplantar keratoderma (PPK) is a disorder characterized by hyperkeratotic papules confined to the palms and soles, and it’s known as an autosomal dominant genetic disorder.
The typical onset age ranges from 10-30, and although it exhibits a genetic predisposition, it can sporadically occur without any family history. PPK type 1A is associated with mutations in the AAGAB gene, while type 1B is linked with COL14A1 mutations.
Most patients are asymptomatic, but the size of the papules may gradually increase after puberty, resembling corns, and causing discomfort. Therefore, it is necessary to differentiate this condition from corns, warts, and verrucas.
The histopathological findings are not distinctive, but hyperkeratosis and acanthosis can be observed. Most patients remain asymptomatic and live without special treatment, however, once symptoms appear, they persist throughout life.
In symptomatic cases, topical treatments such as Urea ointment or Vitamin A Steba ointment can be beneficial, and removal with a CO2 laser is also an option.
Today we have discussed ‘Punctate Palmoplantar Keratoderma’, a condition not highly prevalent, generally asymptomatic, and often overlooked due to its small size. However, it can raise curiosity, being occasionally present on the palms and soles.
It would be good to remember that it manifests as skin-colored papules confined to the palms and soles. Though it often has a family history, it is generally observed without symptoms.