Pathogenetic aspects underlying palmoplantar keratodermas. Current therapies

Abstract

Palmoplantar keratodermas are a heterogeneous group of diseases of the hereditary or acquired nature whose clinical picture includes diffuse or focal thickening of the horny layer of the epidermis, mainly in the palms and soles and sometimes in combination with keratoses in other areas. They are characterized by ectodermal dysplasia and inflammation. This article presents general information on the epidemiology, etiology, and pathogenesis of this disease, provides a classification of hereditary keratodermas, and shows the relationship between genetic mutations and manifestations of basic syndromes. The clinical manifestations of keratodermas of both acquired and hereditary nature are described. The authors point out at the fact that therapeutic procedures for keratodermas are usually aimed at treating symptoms. Application of retinoids is recommended for general treatment of all forms of keratoderma. Hormone replacement therapy is also used. Topical treatment of keratodermas includes balneotherapy and the use of keratolytic and moiorsturizing topical agents. Physiotherapy techniques are successfully used in combination with topical treatment. Given that keratodermas in some cases can manifest themselves as symptoms of paraneoplastic processes and other diseases, it is necessary to continue the diagnostic search for and differentiated approach to therapeutic interventions.