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Therapeutic Approach

Palmoplantar keratoderma (PPK) refers to a clinically and genetically heterogeneous group of disorders of cornification, characterized by abnormal thickening of the skin of the palms and soles. PPKs can be inherited or acquired as in psoriasis. Inherited PPKs are usually classified according to their morphology (diffuse, focal, punctate), mode of inheritance, and the presence or absence of extracutaneous features. This chapter discusses therapeutic options for hereditary PPKs, for which, unfortunately, no curative therapy is currently available. In the authors’ experience, initial therapy should include lifestyle adjustments as well as topical emollients and keratolytic agents, with first-line systemic therapy often being retinoids. Other treatment options should be based on the PPK subtype as well as clinical severity and medical history. See Table 34-1.

Table 34-1Hereditary Palmoplantar Keratodermas Treatment Table

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