What is acquired keratoderma?
Acquired keratoderma is a palmoplantar keratoderma that is NOT inherited as a primary genetic condition. It may occur as part of a generalised skin condition (some of which may be inherited) or as a result of another illness.
How does acquired keratoderma present?
Acquired palmoplantar keratoderma is more likely to present in adulthood (compared with inherited keratodermas which usually present in childhood). It presents with thickening of the skin of the palms and/or soles which may be diffuse (involving most of the palms and soles) or focal (localised mainly to pressure areas).
What causes acquired keratoderma?
Inflammatory skin conditions
- Reactive arthropathy
- Dermatophyte fungal infection (tinea)
- Crusted scabies
- Extensive viral warts (usually in immunosuppressed patients)
Secondary to inherited conditions that may not usually result in keratoderma
Medications and toxins
- Halogenated weed-killers
- Chemotherapeutic agents used in cancer treatment
- Targeted cancer therapy for BRAF+ melanoma with vemurafenib or dabrafenib
- Myxoedema (thyroid disease)
- Internal malignancy (cancer) has been associated with the development of acquired keratoderma
- Keratoderma climactericum is a keratoderma or hyperkeratotic hand dermatitis that usually develops in middle-aged woman. It has been suggested that this is related to the menopause.
Treatment of acquired keratoderma
The following treatments soften the thickened skin and make them less noticeable.
- Keratolytic agents (e.g. 6% salicylic acid in 70% propylene glycol)
- Topical retinoids
- Topical vitamin D ointment (calcipotriol)
- Oral retinoids (acitretin)