Punctate-type palmoplantar keratoderma

What are punctate keratodermas?

Punctuate keratodermas result in tiny bumps of thickened skin on the palms and soles and usually appears in late childhood or early adulthood.

What causes punctate keratodermas?

Punctate keratodermas are inherited by an autosomal dominant pattern (the abnormal gene is passed on from an affected parent). Some people with filiform keratoderma have no apparent family history of the condition.

What are the different types of punctate keratoderma?

There are three different types of punctuate-type keratoderma:

• Punctate keratoderma: tiny hard rounded bumps in the palms or soles. Some individuals are better classified as having porokeratosis palmaris et plantaris disseminata, in which
• Filiform keratoderma: tiny hard ‘spikes’ of skin growing out of the skin of the palms and soles and sometimes elsewhere on the skin.
• Marginal keratoderma: tiny bumps along the border of the palms and fingers, soles and toes.

Punctate keratoderma 

Punctate keratoderma 

Image from Dr Marcia Sonneveld 

What is the treatment of punctate keratoderma?

The following treatments soften the thickened skin and make them less noticeable.

• Emollients
• Keratolytics (eg, 6% salicylic acid in 70% propylene glycol)
• Topical retinoids
• Topical vitamin D ointment (calcipotriol)
• Systemic retinoids (acitretin)

What is the prognosis for punctate keratoderma?

Punctate keratoderma persists for life and may be passed on to the next generation. General health is not affected although the thickened skin can interfere with activity.