What Is Keratosis Palmoplantar Nummular

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Rx Dermatology (A-Z)

Keratosis palmoplantar nummular, often referred to as palmoplantar keratoderma or simply PPPKN, is a skin condition that affects the palms of the hands and soles of the feet. This article aims to provide a simple and accessible explanation of this condition, covering its types, causes, symptoms, diagnostic tests, treatments, and drugs involved.

Types of Keratosis Palmoplantar Nummular:

Keratosis palmoplantar nummular can manifest in various forms, but the two primary types are:

a. Hereditary Keratosis Palmoplantar Nummular: This type is passed down through families due to genetic mutations.

b. Acquired Keratosis Palmoplantar Nummular: This form is not inherited and may develop due to external factors.

Causes of Keratosis Palmoplantar Nummular:

Understanding what triggers this condition is crucial. Here are 20 common causes:

  1. Genetics: Family history can increase the risk.
  2. Aging: It often occurs in adulthood.
  3. Environmental factors: Exposure to harsh chemicals or excessive moisture.
  4. Friction and pressure: Frequent hand or foot use.
  5. Allergies: Reactions to certain substances.
  6. Autoimmune disorders: Conditions like psoriasis.
  7. Hormonal changes: Such as during pregnancy.
  8. Infections: Fungal or bacterial infections.
  9. Diabetes: Linked to some cases.
  10. Nutritional deficiencies: Lack of essential nutrients.
  11. Medications: Some drugs can trigger PPPKN.
  12. Thyroid disorders: Hormonal imbalances.
  13. Excessive sweating: Especially in the palms and soles.
  14. Smoking: Can exacerbate the condition.
  15. Alcohol use: Especially in excess.
  16. Obesity: Excess weight can contribute.
  17. Stress: Emotional factors may play a role.
  18. Immune system disorders: Like HIV.
  19. Occupational factors: Certain jobs with constant hand use.
  20. Poor-fitting footwear: Shoes that don’t provide proper support.

Symptoms of Keratosis Palmoplantar Nummular:

Recognizing the symptoms can help in early diagnosis and treatment. Here are 20 common symptoms:

  1. Thickened skin: Palms and soles become excessively thick.
  2. Dryness: Skin becomes dry and rough.
  3. Scaling: Formation of scales or patches.
  4. Cracking: Skin may develop painful cracks.
  5. Redness: Affected areas may appear red.
  6. Itching: Persistent itching can be uncomfortable.
  7. Pain: Some individuals experience pain.
  8. Discomfort: General discomfort while walking or using hands.
  9. Blistering: Blisters may form in severe cases.
  10. Fissures: Deep cracks in the skin.
  11. Peeling: Skin may peel off in layers.
  12. Burning sensation: Affected areas may feel hot or burn.
  13. Yellowish tint: Skin can take on a yellow hue.
  14. Nail changes: Thickened, pitted, or discolored nails.
  15. Warts: Occasional development of warts.
  16. Malodor: Unpleasant smell due to infection.
  17. Bleeding: Skin may bleed if cracks are severe.
  18. Swelling: Swelling of affected areas.
  19. Restricted movement: Limited joint movement.
  20. Emotional distress: Impact on self-esteem and confidence.

Diagnostic Tests for Keratosis Palmoplantar Nummular:

Getting a proper diagnosis is essential. Here are 20 diagnostic tests and procedures that may be used:

  1. Visual examination: A doctor will assess the affected areas.
  2. Medical history: Discussing family and personal history.
  3. Skin biopsy: Removing a small sample for analysis.
  4. Blood tests: To check for underlying conditions.
  5. Allergy tests: Identifying allergens if relevant.
  6. Patch testing: Determining allergic reactions.
  7. Dermoscopy: Examining skin with a special device.
  8. X-rays: To rule out bone-related issues.
  9. Cultures: Identifying infections.
  10. Skin scrapings: Examining skin under a microscope.
  11. Nail clippings: For nail-related symptoms.
  12. Thyroid function tests: Assessing hormonal balance.
  13. Skin prick tests: Checking for allergies.
  14. Ultrasonography: Imaging affected areas.
  15. MRI: Magnetic resonance imaging for detailed pictures.
  16. Immunological tests: For autoimmune disorders.
  17. Sweat tests: Measuring sweat production.
  18. Electrocardiogram (ECG): Evaluating heart health.
  19. Skin culture: Growing bacteria from skin samples.
  20. Psychological assessment: To address emotional impact.

Treatment Options for Keratosis Palmoplantar Nummular:

Treating keratosis palmoplantar nummular involves managing symptoms and addressing underlying causes. Here are 30 treatment options:

  1. Topical moisturizers: Keeping the skin hydrated.
  2. Emollients: Softening thickened skin.
  3. Steroid creams: Reducing inflammation.
  4. Salicylic acid: Promoting skin shedding.
  5. Urea creams: Moisturizing and exfoliating.
  6. Topical retinoids: Improving skin texture.
  7. Antibiotics: Treating secondary infections.
  8. Antifungal medications: For fungal infections.
  9. Immunosuppressants: Managing autoimmune factors.
  10. Phototherapy: Using UV light for treatment.
  11. Oral retinoids: Severe cases may require oral medication.
  12. Cryotherapy: Freezing off warts or lesions.
  13. Laser therapy: Removing thickened skin.
  14. Physical therapy: Maintaining joint mobility.
  15. Footwear changes: Wearing comfortable shoes.
  16. Foot soaks: Soaking feet to soften skin.
  17. Pumice stone: Gently removing dead skin.
  18. Moisturizing gloves/socks: Enhancing absorption.
  19. Keratolytic agents: Breaking down keratin.
  20. Anti-itch creams: Relieving itching.
  21. Anti-inflammatory drugs: Reducing swelling.
  22. Weight management: Addressing obesity.
  23. Stress management: Reducing emotional triggers.
  24. Orthopedic inserts: Improving foot support.
  25. Psychological counseling: Coping with emotional distress.
  26. Splints: For joint support.
  27. Tumor necrosis factor (TNF) inhibitors: Managing inflammation. 28. Cyclosporine: Suppressing the immune system.
  28. Medication adjustments: Addressing drug-induced cases.
  29. Surgery: In severe cases, surgical removal may be necessary.

Drugs Used in Treating Keratosis Palmoplantar Nummular:

Medications can play a significant role in managing this condition. Here are 20 common drugs:

  1. Clobetasol (Clobex)
  2. Tazarotene (Tazorac)
  3. Salicylic acid ointment
  4. Urea-based creams (Carmol, Keralac)
  5. Methotrexate
  6. Acitretin (Soriatane)
  7. Etanercept (Enbrel)
  8. Infliximab (Remicade)
  9. Adalimumab (Humira)
  10. Coal tar preparations (Psoriasin)
  11. Calcipotriene (Dovonex)
  12. Topical tacrolimus (Protopic)
  13. Oral antibiotics (Cephalexin, Doxycycline)
  14. Itraconazole (Sporanox)
  15. Ketoconazole (Nizoral)
  16. Ciclopirox (Penlac)
  17. Hydroxyurea (Hydrea)
  18. Colchicine
  19. Tumor necrosis factor inhibitors (Humira, Enbrel)
  20. Cyclosporine (Neoral)

Conclusion:

Keratosis palmoplantar nummular is a complex skin condition that can be caused by various factors. Recognizing the symptoms, getting a proper diagnosis, and exploring treatment options are crucial steps in managing this condition. With the right approach, individuals can improve their quality of life and alleviate the discomfort associated with PPPKN. It’s essential to consult with a healthcare professional for personalized guidance and treatment recommendations.

 

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.

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References

 

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