A Case of Diffuse Palmoplantar Keratoderma in a Middle-aged Male

Abstract

Introduction: Palmoplantar keratoderma (PPK) represents a heterogeneous group of disorders characterized by abnormal thickening and hyperkeratosis of the palms and soles. The hereditary diffuse type often begins in childhood with progressive thickening and may be associated with nail dystrophy.

Place and Duration of Study: This study was conducted at the Dermatology and Venereology Department, Faculty of Medicine Universitas Sumatera Utara, Universitas Sumatera Utara Hospital, Medan, Indonesia from 06 May 2025 to 16 May, 2025.

Case Presentation: A 43-year-old male who presented with progressive thickening, fissuring, and painful hyperkeratotic plaques on both palms and soles since childhood. Family history revealed similar conditions in multiple relatives, suggesting a hereditary pattern.

Findings: Clinical examination showed diffuse hyperkeratotic plaques with fissures, nail dystrophy, and extension to dorsal surfaces. Histopathology demonstrated hyperkeratosis and acanthosis without malignancy.

Management: The patient was treated with topical desoximethasone combined with salicylic acid, urea cream, and oral cetirizine, with gradual improvement within 10 days.

Conclusion: This case highlights the chronic and disabling nature of PPK, its hereditary pattern, and the importance of early recognition and symptomatic treatment to improve quality of life.