Palmoplantar porokeratosis of Mantoux

Palmoplantar Porokeratosis of Mantoux is a rare skin disorder characterized by the development of keratotic lesions on the palms of the hands and soles of the feet. This condition is a variant of porokeratosis, a group of disorders that affect the skin's ability to perform normal keratinization, leading to the formation of keratotic lesions or plaques. Palmoplantar porokeratosis of Mantoux is distinguished by its specific location on the body and its unique clinical and histopathological features.

Etiology and Pathogenesis

The exact cause of Palmoplantar Porokeratosis of Mantoux remains unclear, but it is believed to involve a combination of genetic and environmental factors. The condition has been observed to run in families, suggesting a genetic predisposition. Mutations in certain genes involved in skin development and keratinization may play a role. Environmental factors, such as exposure to certain chemicals or physical trauma to the skin, may also contribute to the development of the disease.

Clinical Features

Patients with Palmoplantar Porokeratosis of Mantoux typically present with well-demarcated, hyperkeratotic lesions on the palms and soles. These lesions may vary in size and often have a central core or pit. The surrounding skin may appear erythematous or inflamed. The condition can be asymptomatic, but some patients may experience discomfort or pain, especially when walking or using their hands.

Diagnosis

Diagnosis of Palmoplantar Porokeratosis of Mantoux is primarily based on clinical examination and the characteristic appearance of the lesions. Dermoscopy can aid in the diagnosis by revealing specific features, such as the cornoid lamella, a pathognomonic sign of porokeratosis. Histopathological examination of a biopsy specimen can confirm the diagnosis, showing the typical features of porokeratosis, including the cornoid lamella.

Treatment

There is no cure for Palmoplantar Porokeratosis of Mantoux, and treatment is aimed at managing symptoms and preventing complications. Topical therapies, such as keratolytics and retinoids, may help to reduce hyperkeratosis and improve symptoms. In severe cases, systemic treatments, such as oral retinoids, may be considered. Physical therapies, including cryotherapy and laser therapy, have also been used with varying degrees of success.

Prognosis

The prognosis for individuals with Palmoplantar Porokeratosis of Mantoux varies. While the condition is chronic and may persist for life, symptoms can often be managed effectively with treatment. However, patients with porokeratosis are at an increased risk of developing skin cancer within the lesions, so regular monitoring and early treatment of suspicious changes are important.

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