Drug-Induced Keratoderma

Drug-induced keratoderma is a skin condition that can result from various medications. It causes thickening and hardening of the skin on the palms of your hands and the soles of your feet, making them rough and uncomfortable. In this article, we will provide plain English explanations for what drug-induced keratoderma is, its types, common causes, symptoms, diagnostic tests, available treatments, and drugs that may trigger it.

Types of Drug-Induced Keratoderma

Drug-induced keratoderma can be categorized into several types, each with its own distinct characteristics:

• Punctate Palmoplantar Keratoderma (PPPK): This type leads to tiny, pinpoint-sized calluses on the palms and soles.
• Focal Palmoplantar Keratoderma (FPPK): FPPK causes localized patches of hardened skin on the palms and soles.
• Diffuse Palmoplantar Keratoderma (DPPK): DPPK results in a widespread thickening of the skin on the palms and soles.

Causes of Drug-Induced Keratoderma

Now, let’s explore some of the common medications and drugs that can trigger drug-induced keratoderma:

1. Retinoids: These are often used to treat acne, and they can lead to skin dryness and thickening.
2. Chemotherapy Drugs: Some cancer medications, like 5-fluorouracil, can cause skin changes, including keratoderma.
3. Calcineurin Inhibitors: Drugs like Tacrolimus and Cyclosporine, used to suppress the immune system, may result in this condition.
4. Protease Inhibitors: Used in HIV/AIDS treatment, these medications can lead to skin problems.
5. Chemical Exposures: Exposure to certain chemicals in the workplace can contribute to keratoderma.
6. Plantar Warts: Medications used for treating plantar warts can sometimes lead to keratoderma.
7. Antifungal Medications: Some antifungal drugs can cause skin thickening as a side effect.
8. Vitamin A Supplements: Excessive intake of vitamin A supplements can lead to skin changes.
9. Biological Therapies: Certain biological treatments for autoimmune diseases can cause keratoderma.
10. Radiation Therapy: Skin changes, including keratoderma, can occur after radiation treatment.

Symptoms of Drug-Induced Keratoderma

If you have drug-induced keratoderma, you may experience the following symptoms:

1. Thickened Skin: The skin on your palms and soles becomes thicker and harder.
2. Rough Texture: The affected areas feel rough and may develop calluses.
3. Discomfort: You may experience discomfort or pain, especially when walking or using your hands.
4. Redness: The skin can become red or inflamed.
5. Cracks: The hardened skin may crack, leading to painful fissures.

Diagnostic Tests for Drug-Induced Keratoderma

To diagnose drug-induced keratoderma, a dermatologist may perform the following tests:

1. Physical Examination: Your doctor will examine the affected areas and ask about your medical history and medication use.
2. Skin Biopsy: In some cases, a small skin sample may be taken for examination under a microscope to confirm the diagnosis.
3. Blood Tests: Blood tests may be conducted to rule out other underlying conditions or medication-related issues.

Treatment Options for Drug-Induced Keratoderma

The treatment for drug-induced keratoderma aims to relieve symptoms and manage the condition. Here are some options:

1. Discontinuing the Medication: If a drug is identified as the cause, your doctor may recommend discontinuing or changing the medication.
2. Topical Treatments: Creams or ointments containing urea, salicylic acid, or lactic acid can help soften and reduce the thickness of the skin.
3. Moisturizers: Regular use of moisturizers can prevent excessive dryness and cracking.
4. Corticosteroids: In some cases, corticosteroid creams may be prescribed to reduce inflammation and discomfort.
5. Oral Medications: Your doctor may prescribe oral medications, such as retinoids or immunosuppressants, to manage severe cases.
6. Physical Therapy: Physical therapy may help improve mobility and reduce pain if keratoderma affects your daily activities.
7. Custom Orthotics: For foot involvement, custom-made shoe inserts can alleviate pressure and discomfort.
8. Regular Foot Care: Maintaining good foot hygiene and using pumice stones or files to manage calluses can be beneficial.

Medications That Can Cause Drug-Induced Keratoderma

Here is a list of some medications and drugs known to trigger drug-induced keratoderma:

1. Isotretinoin (Accutane): Used for severe acne, it can cause skin dryness and thickening.
2. Methotrexate: A medication for various conditions, including psoriasis and rheumatoid arthritis, may lead to keratoderma.
3. Cyclosporine: An immunosuppressive drug used after organ transplantation or for autoimmune diseases.
4. Fluorouracil (5-FU): Used in cancer treatment, it can result in skin changes.
5. Tacrolimus: An immunosuppressant used in transplant patients.
6. Etretinate: A retinoid used for severe psoriasis.
7. Plantar Wart Medications: Salicylic acid or cryotherapy used to treat warts can sometimes cause keratoderma.
8. Voriconazole: An antifungal medication used in severe fungal infections.
9. Sorafenib: Used in cancer treatment, it can lead to skin side effects.
10. Efalizumab: An immunosuppressive drug used in psoriasis treatment.
11. Radiation Therapy: Skin changes, including keratoderma, can occur as a side effect.
12. D-penicillamine: Used for Wilson’s disease and rheumatoid arthritis.
13. Vitamin A Supplements: Excessive intake can result in skin problems.
14. Efudex (fluorouracil cream): Used for actinic keratosis, it can cause skin reactions.
15. Mycophenolate: An immunosuppressive medication used in transplant patients.
16. Adalimumab: A biological therapy used for autoimmune diseases.
17. Infliximab: Another biological therapy for autoimmune conditions.
18. Interferon: Used in hepatitis C treatment, it may cause skin changes.
19. Palmoplantar Pustulosis (PPP) Medications: Some drugs used for PPP can contribute to keratoderma.
20. Hydroxyurea: Used in various conditions, including sickle cell disease.

Conclusion

Drug-induced keratoderma is a skin condition that can result from the use of certain medications and drugs. It causes thickening and hardening of the skin on the palms of your hands and the soles of your feet, leading to discomfort and pain. If you suspect you have drug-induced keratoderma, consult a dermatologist for a proper diagnosis and treatment plan. It’s essential to communicate with your healthcare provider about your medications and any skin changes you experience to ensure appropriate management.

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.

References