What are the other Names for this Condition? (Also known as/Synonyms)

• Acquired Palmoplantar Keratoderma
• Acquired PPK

What is Acquired Keratoderma? (Definition/Background Information)

• Acquired Keratoderma is a benign skin condition, wherein there is thickening of skin (keratoderma) of the palms and/or soles. The skin condition is considered to be a pattern of skin findings and not a condition in itself
• The skin thickening can be focal (localized keratoderma) or widespread (diffused keratoderma) and the manifestation is based on the underlying disorder or condition
• Acquired Keratoderma, as the name indicates, is acquired - meaning that it occurs due to various reasons either in childhood or adulthood, and is not congenital in nature (i.e., not present at birth)
• Acquired Keratoderma is classified according to its underlying cause. There are a host of factors that can cause the acquired form of keratoderma, some of which include:
  • Infections
  • Medications and drugs
  • Various skin disorders
• A diagnosis of Acquired Keratoderma can be made by clinical exam, skin exam, and various other diagnostic tools including dermoscopy and wood’s lamp examination. However, the diagnosis is often secondary to the underlying cause
• The treatment of Acquired Keratoderma is based on the underlying cause of the condition. However, the treatment of thickened skin may include the use of moisturizers, topical creams, and skin softeners
• The prognosis of Acquired Keratoderma depends upon the severity of the symptoms, the response to treatment, and most importantly upon the severity of the underlying condition 

Who gets Acquired Keratoderma? (Age and Sex Distribution)

• Acquired Keratoderma may be observed in a wide age range of individuals
• The condition affects both males and females
• It is seen worldwide and all racial and ethnic groups may be affected

What are the Risk Factors for Acquired Keratoderma? (Predisposing Factors)

• Acquired Keratoderma occur secondary to infections, medication use, chronic inflammatory conditions, circulatory disorders, and many other factors
• The risk factors are contingent upon the underlying cause of the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acquired Keratoderma? (Etiology)

Acquired Keratoderma is caused by several diseases, conditions, or medications that are listed below:

• Infections including scabies, viral warts, fungal infections caused by Tinea species, human papillomavirus (HPV), Reiter syndrome, AIDS, and syphilis
• Inflammatory skin conditions including systemic lupus erythematosus (SLE), psoriasis, pityriasis rubra pilaris, eczema, lichen planus, corns and calluses, etc.
• Drugs, medications, and toxins including cancer treatment drugs, dioxins, certain elements (such as iodine, lithium, and arsenic), polysaccharides, etc.
• Illnesses or conditions such as thyroid disease, certain cancers, malnutrition, lymphedema, keratoderma climacterum, etc.
• It may also occur secondary to certain genetic disorders such as ectodermal dysplasia, epidermolysis bullosa, and ichthyosis

What are the Signs and Symptoms of Acquired Keratoderma?

The signs and symptoms associated with Acquired Keratoderma may include:

• The presence of abnormally-thickened skin on the palms of the hands and soles of the feet
• The skin thickening may involve the entire palm and sole, or it may be localised to certain palmoplantar areas
• The hyperkeratosis affected areas can be small, just a few millimeters across, or broad
• Other skin signs and symptoms may be present
• The signs and symptoms of the underlying condition/infection, if any present, may be noted

How is Acquired Keratoderma Diagnosed?

The diagnosis of Acquired Keratoderma may involve:

• A complete evaluation of medical history along with a thorough examination of the skin lesions by a dermatologist
• The healthcare provider may also ask many questions related to the individual’s age, family medical history, current medications, cosmetics, body lotions used, other medical conditions, infections, etc.
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Tests and procedures to establish the underlying cause of keratoderma may have to be undertaken

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acquired Keratoderma?

Complications associated with Acquired Keratoderma include complications associated with the cause of the condition.

How is Acquired Keratoderma Treated?

The treatment of Acquired Keratoderma is based upon the underlying cause of the condition. However, the skin thickening may be addressed through skin softening treatment measures such as:

• Use of moisturizing creams and lotions; ointments containing vitamin D
• Use of topical and systemic retinoids
• Application of keratolytics (topical medications containing urea, lactic acid, or salicylic acid)

How can Acquired Keratoderma be Prevented?

• The prevention of Acquired Keratoderma depends upon the underlying cause of the skin condition. It may not be preventable in a majority of individuals
• In some cases, such as keratoderma caused by infections, certain illnesses, or is drug-induced, it may be possible to prevent it

What is the Prognosis of Acquired Keratoderma? (Outcomes/Resolutions)

• The prognosis of Acquired Keratoderma may depend on a set of several factors including:
  • Underlying disorder and the severity of the signs and symptoms
  • Response to therapy of the underlying cause of keratoderma
• Even though the skin condition (keratoderma) is benign, the overall prognosis is based on the underlying causative condition and can be established only on a case-by-case basis
• Regular follow up visits with the healthcare providers are important

Additional and Relevant Useful Information for Acquired Keratoderma:

Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition.