Mutilating Palmoplantar Keratoderma

Mutilating Palmoplantar Keratoderma (MPPK) is a rare skin condition that affects the palms of the hands and the soles of the feet. In this article, we will provide you with simple explanations for the types of MPPK, its causes, symptoms, diagnostic tests, treatment options, and medications.

Types of Mutilating Palmoplantar Keratoderma:

  1. Diffuse Epidermolytic Palmoplantar Keratoderma (EPPK): This type causes thick, scaly skin on the palms and soles, usually starting in childhood.
  2. Focal Non-Epidermolytic Palmoplantar Keratoderma: It leads to hard, calloused patches on the palms and soles, with no blistering.

Common Causes of MPPK:

  1. Genetic Mutations: Most cases of MPPK are caused by genetic mutations inherited from parents.
  2. Infections: Certain infections can trigger MPPK in some individuals.
  3. Autoimmune Disorders: Conditions like psoriasis or lupus may lead to MPPK.
  4. Medications: Some medications may cause skin thickening, leading to MPPK.
  5. Hormonal Changes: Hormonal imbalances can contribute to the development of MPPK.
  6. Trauma: Repeated friction or pressure on the palms and soles can lead to keratoderma.
  7. Chemical Exposure: Contact with certain chemicals can cause skin thickening.
  8. Nutritional Deficiencies: Lack of essential vitamins and minerals may play a role.
  9. Allergies: Allergic reactions can lead to skin issues, including MPPK.
  10. Inflammatory Skin Conditions: Conditions like eczema can worsen MPPK.
  11. Climate: Extreme weather conditions may exacerbate symptoms.
  12. Obesity: Being overweight can put more pressure on the palms and soles.
  13. Diabetes: People with diabetes may be more prone to MPPK.
  14. Neurological Disorders: Some neurological conditions can affect skin health.
  15. Circulation Problems: Poor blood flow to the extremities can contribute.
  16. Occupational Factors: Certain jobs with repetitive hand or foot use can increase the risk.
  17. Stress: High-stress levels can worsen MPPK symptoms.
  18. Excessive Sweating: Profuse sweating can lead to skin thickening.
  19. Smoking: Smoking can harm skin health and exacerbate MPPK.
  20. Alcohol Consumption: Excessive alcohol intake can worsen the condition.

Symptoms of MPPK:

  1. Thickened Skin: Palms and soles become thick and hard.
  2. Cracked Skin: The skin can crack, leading to pain and discomfort.
  3. Pain: The condition may cause pain and discomfort, especially when walking or using hands.
  4. Scaling: Skin may flake or peel off in layers.
  5. Redness: Affected areas may appear red and inflamed.
  6. Itching: Itchy skin is a common symptom.
  7. Blisters: In some cases, blisters filled with fluid may develop.
  8. Bleeding: The skin may bleed if it cracks severely.
  9. Difficulty Walking: Thickened soles can make walking difficult.
  10. Impaired Hand Function: Thickened palms may limit hand dexterity.
  11. Nail Changes: Nails may become thickened or deformed.
  12. Discomfort in Shoes: It may be painful to wear shoes.
  13. Sweating: Excessive sweating can occur in affected areas.
  14. Infection: Cracked skin can be prone to infection.
  15. Emotional Impact: MPPK can affect self-esteem and mental health.
  16. Social Isolation: Some individuals may withdraw due to embarrassment.
  17. Painful Joints: In severe cases, joints may become painful.
  18. Skin Discoloration: Skin may become discolored or darkened.
  19. Numbness: Reduced sensation in affected areas is possible.
  20. Worsening Over Time: Symptoms may worsen if left untreated.

Diagnostic Tests for MPPK:

  1. Physical Examination: A doctor can often diagnose MPPK by examining the skin.
  2. Genetic Testing: To identify specific genetic mutations causing MPPK.
  3. Skin Biopsy: A small skin sample is examined under a microscope.
  4. Blood Tests: To rule out underlying conditions.
  5. X-rays: To check for bone abnormalities in severe cases.
  6. MRI or CT Scan: To assess deeper tissue involvement.
  7. Allergy Testing: To identify potential triggers.
  8. Skin Scraping: To rule out fungal infections.
  9. Nail Clipping: To examine nail changes.
  10. Electromyography (EMG): To assess nerve function.
  11. Skin Cultures: To check for bacterial or fungal infections.
  12. Dermoscopy: A skin specialist examines skin patterns.
  13. Patch Testing: To identify contact allergies.
  14. Sweat Test: Measures sweat production in affected areas.
  15. Histopathology: Detailed microscopic analysis of skin tissue.
  16. Biophysical Measurements: To assess skin hydration and elasticity.
  17. Nerve Conduction Studies: Evaluates nerve function.
  18. Autoimmune Panels: To detect autoimmune markers.
  19. Skin Imaging: Using specialized equipment to assess skin layers.
  20. Clinical Assessment: Monitoring changes over time.

Treatment Options for MPPK:

  1. Topical Emollients: Moisturizers to soften and hydrate the skin.
  2. Topical Retinoids: To reduce skin thickness.
  3. Topical Corticosteroids: To reduce inflammation and itching.
  4. Salicylic Acid: To help exfoliate thickened skin.
  5. Urea Creams: Soften and remove dead skin.
  6. Oral Retinoids: Prescription medications to control symptoms.
  7. Oral Steroids: Short-term use to reduce inflammation.
  8. Biologics: For severe cases with autoimmune involvement.
  9. Physical Therapy: To improve hand and foot function.
  10. Custom Orthotics: Shoe inserts for better support.
  11. Surgical Debridement: Removing thickened skin.
  12. Laser Therapy: To reduce skin thickness.
  13. Cryotherapy: Freezing off thickened skin.
  14. Iontophoresis: Reducing sweating in affected areas.
  15. Occupational Therapy: For hand function improvement.
  16. Psychological Support: For emotional well-being.
  17. Foot Soaks: Softening thickened skin.
  18. Warm Compresses: To relieve pain and discomfort.
  19. Hydration: Drinking enough water for skin health.
  20. Avoiding Triggers: Identifying and avoiding allergens.
  21. Physical Exercise: To improve blood circulation.
  22. Stress Management: Reducing stress can help.
  23. Medications for Pain: Over-the-counter pain relievers.
  24. Anti-fungal Medications: If fungal infection is present.
  25. Wearing Appropriate Footwear: Comfortable shoes with proper support.
  26. Insoles: Custom insoles for better foot support.
  27. Gentle Exfoliation: Removing dead skin with care.
  28. Avoiding Irritants: Preventing contact with harsh chemicals.
  29. Sun Protection: Using sunscreen on exposed skin.
  30. Regular Follow-up: Monitoring and adjusting treatment.

Medications for MPPK:

  1. Tretinoin: A topical retinoid to reduce skin thickness.
  2. Clobetasol: A strong topical corticosteroid to reduce inflammation.
  3. Salicylic Acid Cream: An over-the-counter option for exfoliation.
  4. Urea Cream: To soften and remove dead skin.
  5. Isotretinoin: An oral retinoid for severe cases.
  6. Methotrexate: An immunosuppressive drug for autoimmune involvement.
  7. Cyclosporine: Suppresses the immune system in severe cases.
  8. Acitretin: An oral retinoid option.
  9. Tacrolimus: An immunosuppressive ointment.
  10. Adalimumab: A biologic drug for autoimmune-related MPPK.
  11. Etanercept: Another biologic option.
  12. Coal Tar: A topical treatment for scaling.
  13. Keratolytic Creams: To soften and remove thickened skin.
  14. Hydrocortisone Cream: A milder topical corticosteroid.
  15. Naproxen: An over-the-counter pain reliever.
  16. Itraconazole: For fungal-related MPPK.
  17. Fluconazole: Another antifungal option.
  18. Gabapentin: For pain relief in some cases.
  19. Lidocaine Cream: Topical numbing for discomfort.
  20. Amoxicillin-Clavulanate: Antibiotic for skin infections.

Conclusion:

Mutilating Palmoplantar Keratoderma is a complex condition with various causes, symptoms, and treatment options. If you suspect you have MPPK, it’s crucial to consult a healthcare professional for a proper diagnosis and personalized treatment plan. With the right approach, many individuals with MPPK can manage their symptoms and lead fulfilling lives.

 

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.

  1. https://medlineplus.gov/skinconditions.html
  2. https://www.aad.org/about/burden-of-skin-disease
  3. https://www.usa.gov/federal-agencies/national-institute-of-arthritis-musculoskeletal-and-skin-diseases
  4. https://www.cdc.gov/niosh/topics/skin/default.html
  5. https://www.skincancer.org/
  6. https://illnesshacker.com/
  7. https://endinglines.com/
  8. https://www.jaad.org/
  9. https://www.psoriasis.org/about-psoriasis/
  10. https://books.google.com/books?
  11. https://www.niams.nih.gov/health-topics/skin-diseases
  12. https://cms.centerwatch.com/directories/1067-fda-approved-drugs/topic/292-skin-infections-disorders
  13. https://www.fda.gov/files/drugs/published/Acute-Bacterial-Skin-and-Skin-Structure-Infections—Developing-Drugs-for-Treatment.pdf
  14. https://dermnetnz.org/topics
  15. https://www.aaaai.org/conditions-treatments/allergies/skin-allergy
  16. https://www.sciencedirect.com/topics/medicine-and-dentistry/occupational-skin-disease
  17. https://aafa.org/allergies/allergy-symptoms/skin-allergies/
  18. https://www.nibib.nih.gov/
  19. https://rxharun.com/rxharun/rxharun/article-types/skin-care-beauty/skin-diseases-types-symptoms-treatment/
  20. https://www.nei.nih.gov/
  21. https://en.wikipedia.org/wiki/List_of_skin_conditions
  22. https://en.wikipedia.org/?title=List_of_skin_diseases&redirect=no
  23. https://en.wikipedia.org/wiki/Skin_condition
  24. https://oxfordtreatment.com/
  25. https://www.nidcd.nih.gov/health/
  26. https://consumer.ftc.gov/articles/w
  27. https://www.nccih.nih.gov/health
  28. https://catalog.ninds.nih.gov/
  29. https://www.aarda.org/diseaselist/
  30. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets
  31. https://www.nibib.nih.gov/
  32. https://www.nia.nih.gov/health/topics
  33. https://www.nichd.nih.gov/
  34. https://www.nimh.nih.gov/health/topics
  35. https://www.nichd.nih.gov/
  36. https://www.niehs.nih.gov
  37. https://www.nimhd.nih.gov/
  38. https://www.nhlbi.nih.gov/health-topics
  39. https://obssr.od.nih.gov/
  40. https://www.nichd.nih.gov/health/topics
  41. https://rarediseases.info.nih.gov/diseases
  42. https://beta.rarediseases.info.nih.gov/diseases
  43. https://orwh.od.nih.gov/

References