Hyperkeratotic Plaques Research Articles

Pseudoepitheliomatous keratotic and micaceous balanitis treated with topical 5-fluorouracil and liquid nitrogen.

Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB) is an uncommon premalignant condition involving the glans penis. We report the case of an 86-year-old man who presented with phimosis and pain on retracting his foreskin. He had previously undergone circumcision, which revealed a hyperkeratotic plaque with thin mica-like scales involving his glans penis. Histology of the lesion showed hyperkeratosis, parakeratosis, epidermal acanthosis and papillomatosis with no evidence of dysplasia. Immunohistochemistry for human papillomavirus was negative. The patient was treated with topical 5-fluorouracil and liquid nitrogen with clinical improvement. He is now under long-term surveillance for verrucous carcinoma and squamous cell carcinoma.

Hyperkeratotic Plaque over the Ankle.

Hyperkeratotic Plaque over the Ankle.

A case of type 1 pachyonychia congenita with response to acitretin

An 8-year-old male born of nonconsanguineous marriage presented with multiple raised lesions all over the body, over palms and soles, and thickening of all nails of fingers and toes for 5 years. On examination, there were hyperkeratotic plaques over palms and soles with subungual hyperkeratosis of all finger and toe nails. Oral cavity revealed white hyperkeratotic plaque over buccal mucosa. There were hyperkeratotic papules distributed over dorsum of hands, feet, elbows, knees, trunk, and thighs. Biopsy taken from hyperkeratotic lesion over palms revealed findings suggestive of palmoplantar keratoderma. Considering the clinical features and histopathological examination, a diagnosis of Type 1 pachyonychia congenita was made. After hematological investigations, the patient was started on oral acitretin at a dose of 25 mg thrice a week. There was a marked improvement in the form of reduced hyperkeratosis over palms and soles and subsidence of hyperkeratotic papules and oral lesions, 2 months after treatment with acitretin.

Olmsted syndrome in three siblings

Olmsted syndrome (OS) is a rare congenital, sharply circumscribed transgredient palmoplantar keratoderma, first described by Olmsted in 1927, characterized by clinical features such as symmetrical involvement of keratoderma of the palms and soles and the symmetrical hyperkeratotic plaques around the body orifices. Other clinical findings include flexion deformities of the fingers, localized alopecia, leukokeratosis of the tongue, short stature, and laxity of the large joints. It starts in the neonatal period or in childhood. The disease has a slow but progressive and extremely disabling course. Treatment of OS is often based on topical therapy with retinoic acid, corticosteroid, emollients, and keratolytics. We present a case of OS in three siblings, two males and a female, born to nonconsanguineous parents with no family history. They were treated with topical corticosteroids and emollients and showed mild improvement in symptoms.

Placa hiperqueratósica en la planta del pie derecho

Placa hiperqueratósica en la planta del pie derecho

Hyperkeratotic plaques on the trunk and extremities

Hyperkeratotic plaques on the trunk and extremities

Tacrolimus for the management of psoriasis: clinical utility and place in therapy.

Psoriasis affects 1%–3% of the population in the United Kingdom and can convey significant detriment to the physical and mental health of sufferers. Plaques of psoriasis typically affect the extensor skin surfaces and scalp. Less frequently inverse psoriasis can affect more sensitive skin such as the face, genitals, and intertriginous areas. Psoriasis is incurable, but there are a range of treatment modalities that can be used to manage the condition. Treatment options include topical preparations, phototherapy, systemic therapy, and biological agents. Tacrolimus is a macrolide calcineurin inhibitor licensed for immunosuppression in transplant patients and topical administration in atopic dermatitis. Tacrolimus administered orally and in topical form has been shown to produce successful outcomes in patients with psoriasis. Topical tacrolimus is particularly effective for inverse psoriasis, which is likely to be due to the reduced level of induration seen in these psoriatic lesions, which allows greater skin penetrance, compared with hyperkeratotic plaques of psoriasis on the body. It is also notable that the areas affected by inverse psoriasis are more susceptible to adverse effects of topical corticosteroid therapy, and thus a topical preparation without the risk of skin atrophy, telangiectasia, and striae could be a valuable addition to current topical treatment options. Oral tacrolimus has shown efficacy in the treatment of severe, refractory psoriasis. Compared to ciclosporin, systemic tacrolimus may be more suited to a patient population with increased cardiovascular risk. This review will draw together the current literature on topical and oral tacrolimus for the treatment of psoriasis. Efficacy and safety have been evaluated by case reports and randomized controlled trials and comparisons have been made between tacrolimus therapy and standard treatment.

Reticulose Pagetóide de Woringer-Kolopp, uma Variante Rara de Micose Fungóide

Introdução: A reticulose pagetóide é uma variante rara de micose fungóide. Caracteriza-se por uma mancha ou placa, geralmente numa extremidade, assintomática, e hiperqueratósica. Foi descrita uma forma disseminada, mas a classificação recente reserva o termo apenas para a variante localizada (classicamente, “Woringer-Kolopp”).Caso clínico: Observámos uma doente, de 58 anos, por uma placa solitária, queratósica, acastanhada, 15mm x 18mm, na face plantar do hálux esquerdo. Tinha anos de evolução, recentemente com dor local. A histopatologia mostrou um infiltrado de pequenos linfócitos atípicos com extensa invasão pagetóide da epiderme. Na imunohistoquímica observou-se um predomínio de células T CD4+. Os achados confirmaram o diagnóstico de reticulose pagetóide. Aplicou-se, diariamente, propionato de clobetasol 0,05%, em pomada, com melhoria clinicamente significativa após dois meses.Conclusões: Embora seja classificada como uma variante da micose fungóide, a reticulose pagetóide tem características clínicas e histopatológicas próprias, relativamente uniformes, e um perfil imunofenotípico heterogéneo. Contrariamente à micose fungóide, não ocorre envolvimento extracutâneo.

Palmoplantar psoriasis

Palmoplantar psoriasis refers to a localized psoriasis variant. The disease can be associated with many clinical forms, including predominantly pustular lesions to thick scaly, hyperkeratotic plaques, or an overlapping of both of them. Palmoplantar psoriasis accounts for 3-4% of all psoriasis cases in most studies. Although it is localized only on the palms and the soles, the fissures, the hardening of the tissue, and hyperkeratosis affect daily routine activities. Taking the body surface area as a measure of severity can sometimes be misleading. In clinical practice, the level of functional impairment should be taken into account rather than relying on traditional instruments to evaluate the severity. Palmoplantar psoriasis is usually managed with topical therapy as a first step. Systemic therapy is needed when the topicals fail or when the disease becomes more severe. Sometimes, biologic agents are required for adequate maintenance of clinical response.

Outbreak of sheeppox in farmed sheep in Kyrgystan: Histological, eletron microscopical and molecular characterization.

On a farm in the Kyrgyz Republic, several dead sheep were found without any history of illness. The sheep showed several ulcerations on lips and bare-skinned areas. At necropsy the lungs showed multiple firm nodules, which were defined as pox nodules histologically. In the rumen hyperkeratotic plaques were visible. With electron microscopy pox viral particles were detected and confirmed with q PCR as Capripoxviruses. Although all members of the Capripoxvirus genus are eradicated in western countries, this study should remind us of the classical lesions observed in poxvirus infections.

Three rare cases of cutaneous phaeohyphomycosis

Phaeohyphomycosis is a chronic infectious condition caused by dematiaceous fungi which usually involve the skin and subcutaneous tissue. Subcutaneous phaeohyphomycosis is characterised by papulonodules, verrucous, hyperkeratotic or ulcerated plaques, cysts, abscesses, pyogranuloma, non-healing ulcers or sinuses. In India, commonly associated genera are Exophiala, Phialophora, Cladosporium, Curvularia, Fonsecaea and Alternaria. This condition involves the presence of brown-walled hyphal structures in the dermis and epidermis. Here, we are reporting a rare case series of three patients of phaeohyphomycosis with lesions on finger and dorsum of the hand.

Safety of ustekinumab for the treatment of psoriasis vulgaris with myotonic dystrophy

Psoriasis is a common inflammatory disorder characterized by well-demarcated hyperkeratotic erythema and plaques. Although biologic agents have dramatically changed the strategies of psoriasis treatment because of their great effectiveness, they should be used with care in order to avoid unexpected events, especially for patients with rare complications or comorbidities. The safety of biologic agents for psoriasis patients with muscular dystrophy is unknown. Herein we describe the first reported [...]

Erythrokeratodermia variabilis et progressiva.

Erythrokeratodermia variabilis et progressiva (EKVP) is a rare inherited skin disease characterized by fixed hyperkeratotic plaques and transient erythematous patches. EKVP is most often transmitted in an autosomal dominant manner. Causal mutations were found in the GJB3, GJB4 and GJA1 genes encoding connexins 31, 30.3 and 43, respectively. Approximately 50% of affected individuals develop palmoplantar keratoderma. Connexins are components of gap junctions, which are intercellular channels that are found in almost all tissues including the skin. Treatment of EKVP usually involves use of topical keratolytics and emollients resulting in some improvement in hyperkeratosis. Low-dose systemic retinoid may be beneficial. Novel therapies targeting connexin hemichannels and gap junctions may become available in the future.

Analysis of the clinical and genetic characteristics of a progressive symmetric erythrokeratoderma

Objective To investigate the clinical and genetic characteristics of a progressive symmetric erythrokeratoderma (PSEK). Methods The clinical and genetic characteristics of a PSEK were compared and analyzed with clinical collection and review of 17 PSEK families reported in China since 1980. Results PSEK was consistent with autosomal dominant inheritance. PSEK had the feature with incomplete penetrance and variable expression. The clinical features included hyperkeratotic plaques with distinct border and strikingly symmetric distribution pattern on the extremities. Part of patients was extended to other areas of the body. The onset of the disease commonly started in infancy or childhood. The general health condition was not affected. PSEK might be associated with other clinical symptoms. The diseased potential increased in the family of consanguineous marriage. Conclusions PSEK has genetic heterogeneity. Its causative genes have not been determined. Further studies are needed. Key words: Erythema/GE; Keratosis/GE

Papillon lefevre syndrome- An imperative role of periodontist

<p>Papillon Lefevre syndrome (PLS) is a rarely encountered disorder that shows autosomal recessive inheritance. Clinically, it exhibits hyperkeratotic plaques on palmar plantar surfaces, severe periodontal loss and precocious shedding of primary as well as permanent dentition. The reason for this exceptional clinical presentation is vague and speculative. We are reporting one such case of a 23year old female patient.</p>

Progressive symmetric erythrokeratoderma: A rare case report

Erythrokeratodermas are a rare group of genetic disorders presenting early in childhood as erythematous, hyperkeratotic plaques on the skin. There may be associated neurological involvement. A 12-year-old boy presented with symmetric keratotic plaques on the body since infancy. Psoriasis and pityriasis rubra pilaris were ruled out after histopathological examination of the skin. We are reporting a case of progressive symmetric erythrokeratoderma with classical lesions but can be missed due to unawareness.

Cellular dermatofibroma: A hyperkeratotic indurated plaque on the thigh.

Cellular dermatofibroma: A hyperkeratotic indurated plaque on the thigh.

Erythrokeratodermia variabilis and erythrokeratoderma en cocardes: Case series with review of literature

Erythrokeratodermia variabilis (EKV) are a rare heterogeneous group of inherited cornification disorders. They are characterized by two distinct morphological types of skin lesions: Fixed hyperkeratotic plaques and sharply marginated, pruritic, and migratory erythematous lesions. We report three cases of EKV along with a review of literature.

English

Epidermolytic hyperkeratosis is a rare autosomal dominant disorder of cornification with a prevalence of 1:100,000 to 1:300,000, which affect both sexes equally. We report the case of a 10-year-old girl who presented to the dermatology clinic with dirty brown, corrugated hyperkeratotic plaques involving joint flexures and the trunk. She had similar lesions arranged in a cobblestone pattern over the knees, elbows, and dorsal hands and feet, in addition to multiple superficial erosions. She had a history of generalized erythroderma and trauma-related blistering at the time of birth. All other family members were healthy, and had no such skin manifestations.

Oyster-shaped hyperkeratotic plaques on the penis.

Oyster-shaped hyperkeratotic plaques on the penis.