Case for Diagnosis
Filiform Palmoplantar Papules
Pápulas filiformes palmoplantares
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Hiraldo-Gamero, J. Gordillo Chaves" "autores" => array:2 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Hiraldo-Gamero" "email" => array:2 [ 0 => "alihiraldo@hotmail.com" 1 => "alhiga82@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Gordillo Chaves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital de Mérida, Badajoz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital de Mérida, Badajoz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápulas filiformes palmoplantares" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 708 "Ancho" => 788 "Tamanyo" => 90335 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 78-year-old woman presented lesions on the palms and soles that caused discomfort because they were exposed to constant friction. The lesions had first appeared several years earlier. The patient had a history of osteoarthritis, systemic hypertension, dyslipidemia, and atrial fibrillation. She was on treatment with acenocoumarol, carvedilol, atorvastatin, metamizol, paracetamol, and omeprazole.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed multiple brownish, filiform hyperkeratotic papules measuring only a few millimeters. The lesions were distributed across the entire surface of the palms (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and less densely on the soles.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 2<span class="elsevierStyleHsp" style=""></span>mm punch biopsy that included a complete lesion was taken from one of the patient's palms. Histology revealed a column of parakeratosis in the stratum corneum with underlying focal hypogranulosis and a depressed epidermis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Spiny keratoderma or filiform hyperkeratosis of the palms and soles.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course and Treatment</span><p id="par0030" class="elsevierStylePara elsevierViewall">Blood tests with tumor markers, chest radiograph, and abdominal ultrasound were requested. The only relevant findings were hepatic steatosis and the presence of renal cysts. Treatment with 0.1% tretinoin and 40% urea cream obtained a poor results. On further interrogation, the patient reported that several of her relatives had similar problems of “spines” on the hands.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Spiny keratoderma is a rare condition; only around 30 cases have been reported in the literature. Most cases are acquired but there are also familial cases,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> like that of our patient. This skin condition is characterized by the appearance of small, filiform hyperkeratotic lesions distributed across the surface of the palms and/or soles.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The lesions resemble the spines of an old-fashioned music box cylinder.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Although they are usually asymptomatic, the lesions can make manual labor difficult and cause pain on pressure or walking. The condition is chronic and spontaneous remissions are rare.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Spiny keratoderma can be hereditary, with an autosomal dominant inheritance pattern and onset in the second or third decades of life, or sporadic, with onset at a later age. In either case, it is more common in men.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Histologically, spiny keratoderma is characterized by a compact, cornoid lamella–like column of parakeratosis that is clearly separated from the normal stratum corneum and the underlying granular layer is thin or absent.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Like porokeratotic eccrine ostial and dermal duct nevi, the lesions are occasionally associated with hair follicles and acrosyringia.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Spiny keratoderma has been found in association with various diseases, including polycystic kidney and liver disease, Darier disease, tuberculosis, epidermodysplasia verruciformis, and neoplasms. It was originally considered to be a paraneoplastic syndrome, but today, the most widely accepted opinion is that there is no clear association between spiny keratoderma and other diseases. Clinically and histologically, it is considered to be a distinct entity that should not be mistakenly identified as a variant of either punctate keratoderma or porokeratosis, which have respectively been associated with internal and cutaneous malignancies.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The pathogenesis of spiny keratoderma is poorly understood. It has been suggested, on the basis of the keratin patterns found in the column of parakeratosis, that it may be caused by anomalous ectopic hair formation.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Spiny keratoderma has been treated with numerous agents, including topical and oral retinoids, emollients containing salicylic acid, urea, ammonium lactate, propylene glycol, and 5-fluorouracil<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>; the results have been variable.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical Course and Treatment" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Comment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of Interest" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hiraldo-Gamero A, Gordillo Chaves J. Pápulas filiformes palmoplantares. Actas Dermosifiliogr. 2013;104:819–820.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 708 "Ancho" => 788 "Tamanyo" => 90335 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 564 "Ancho" => 751 "Tamanyo" => 171533 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Hematoxylin-eosin, original magnification × 4. B, Hematoxylin-eosin, original magnification × 10.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Queratodermia espinosa palmar: a propósito de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Guhl" 1 => "R. Goiriza" 2 => "E. Vargasa" 3 => "J. Fraga" 4 => "A. García-Díeza" 5 => "J. Fernández-Herrera" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "392" "paginaFinal" => "394" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476261" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Queratodermia espinulosa ortoqueratósica palmoplantar tipo <span class="elsevierStyleSmallCaps">ii</span>a" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. Rodríguez-Castellanos" 1 => "J.E. Campos-Arceo" 2 => "M.G. Zárate-Torres" 3 => "M. Hernández-Torres" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatología Rev Mex" "fecha" => "2011" "volumen" => "55" "paginaInicial" => "381" "paginaFinal" => "384" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lesiones queratósicas palmoplantares" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.J. Ferrando Roca" 1 => "A. Mateu Puchades" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Piel" "fecha" => "2004" "volumen" => "19" "paginaInicial" => "215" "paginaFinal" => "216" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spiky keratotic projections on the palms and fingers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Grillo" 1 => "B. Pérez-García" 2 => "C. González-García" 3 => "S. Vano-Galván" 4 => "P. Jaén-Olasolo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2012" "volumen" => "15" "paginaInicial" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20040258" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hiperqueratosis filiforme paraqueratósica palmar sin malignidad subyacente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Pérez-Pérez" 1 => "C. Peteiro" 2 => "J. Sánchez-Aguilar Toribio" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2007" "volumen" => "98" "paginaInicial" => "420" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17663932" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010400000009/v1_201310240051/S1578219013002138/v1_201310240051/en/main.assets" "Apartado" => array:4 [ "identificador" => "6154" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010400000009/v1_201310240051/S1578219013002138/v1_201310240051/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013002138?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 20 | 13 | 33 |
| 2024 Octubre | 98 | 48 | 146 |
| 2024 Septiembre | 105 | 33 | 138 |
| 2024 Agosto | 115 | 65 | 180 |
| 2024 Julio | 73 | 47 | 120 |
| 2024 Junio | 103 | 41 | 144 |
| 2024 Mayo | 75 | 44 | 119 |
| 2024 Abril | 76 | 19 | 95 |
| 2024 Marzo | 86 | 28 | 114 |
| 2024 Febrero | 82 | 38 | 120 |
| 2024 Enero | 45 | 31 | 76 |
| 2023 Diciembre | 56 | 20 | 76 |
| 2023 Noviembre | 72 | 24 | 96 |
| 2023 Octubre | 53 | 35 | 88 |
| 2023 Septiembre | 84 | 32 | 116 |
| 2023 Agosto | 53 | 25 | 78 |
| 2023 Julio | 55 | 38 | 93 |
| 2023 Junio | 72 | 26 | 98 |
| 2023 Mayo | 68 | 26 | 94 |
| 2023 Abril | 63 | 18 | 81 |
| 2023 Marzo | 57 | 31 | 88 |
| 2023 Febrero | 41 | 23 | 64 |
| 2023 Enero | 48 | 27 | 75 |
| 2022 Diciembre | 55 | 39 | 94 |
| 2022 Noviembre | 25 | 33 | 58 |
| 2022 Octubre | 31 | 27 | 58 |
| 2022 Septiembre | 34 | 45 | 79 |
| 2022 Agosto | 33 | 49 | 82 |
| 2022 Julio | 37 | 42 | 79 |
| 2022 Junio | 22 | 40 | 62 |
| 2022 Mayo | 47 | 44 | 91 |
| 2022 Abril | 50 | 37 | 87 |
| 2022 Marzo | 45 | 51 | 96 |
| 2022 Febrero | 40 | 31 | 71 |
| 2022 Enero | 36 | 30 | 66 |
| 2021 Diciembre | 53 | 43 | 96 |
| 2021 Noviembre | 68 | 33 | 101 |
| 2021 Octubre | 47 | 46 | 93 |
| 2021 Septiembre | 49 | 49 | 98 |
| 2021 Agosto | 45 | 27 | 72 |
| 2021 Julio | 54 | 31 | 85 |
| 2021 Junio | 57 | 34 | 91 |
| 2021 Mayo | 53 | 35 | 88 |
| 2021 Abril | 79 | 61 | 140 |
| 2021 Marzo | 71 | 27 | 98 |
| 2021 Febrero | 73 | 35 | 108 |
| 2021 Enero | 37 | 22 | 59 |
| 2020 Diciembre | 34 | 19 | 53 |
| 2020 Noviembre | 37 | 12 | 49 |
| 2020 Octubre | 22 | 13 | 35 |
| 2020 Septiembre | 36 | 15 | 51 |
| 2020 Agosto | 28 | 16 | 44 |
| 2020 Julio | 24 | 14 | 38 |
| 2020 Junio | 29 | 23 | 52 |
| 2020 Mayo | 22 | 31 | 53 |
| 2020 Abril | 35 | 19 | 54 |
| 2020 Marzo | 33 | 18 | 51 |
| 2020 Febrero | 3 | 6 | 9 |
| 2020 Enero | 0 | 1 | 1 |
| 2019 Diciembre | 0 | 2 | 2 |
| 2019 Noviembre | 0 | 1 | 1 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 0 | 6 | 6 |
| 2019 Agosto | 0 | 7 | 7 |
| 2019 Julio | 0 | 22 | 22 |
| 2019 Junio | 0 | 15 | 15 |
| 2019 Mayo | 2 | 17 | 19 |
| 2019 Abril | 0 | 15 | 15 |
| 2019 Marzo | 0 | 7 | 7 |
| 2019 Febrero | 0 | 5 | 5 |
| 2019 Enero | 0 | 3 | 3 |
| 2018 Diciembre | 2 | 6 | 8 |
| 2018 Noviembre | 1 | 2 | 3 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 4 | 0 | 4 |
| 2018 Mayo | 0 | 2 | 2 |
| 2018 Marzo | 3 | 8 | 11 |
| 2018 Febrero | 42 | 2 | 44 |
| 2018 Enero | 44 | 5 | 49 |
| 2017 Diciembre | 47 | 6 | 53 |
| 2017 Noviembre | 35 | 2 | 37 |
| 2017 Octubre | 46 | 18 | 64 |
| 2017 Septiembre | 46 | 13 | 59 |
| 2017 Agosto | 78 | 12 | 90 |
| 2017 Julio | 52 | 11 | 63 |
| 2017 Junio | 100 | 28 | 128 |
| 2017 Mayo | 77 | 19 | 96 |
| 2017 Abril | 64 | 8 | 72 |
| 2017 Marzo | 72 | 9 | 81 |
| 2017 Febrero | 34 | 28 | 62 |
| 2017 Enero | 36 | 32 | 68 |
| 2016 Diciembre | 53 | 6 | 59 |
| 2016 Noviembre | 61 | 19 | 80 |
| 2016 Octubre | 125 | 24 | 149 |
| 2016 Septiembre | 189 | 6 | 195 |
| 2016 Agosto | 159 | 13 | 172 |
| 2016 Julio | 80 | 10 | 90 |
| 2016 Junio | 7 | 10 | 17 |
| 2016 Mayo | 5 | 10 | 15 |
| 2016 Abril | 6 | 23 | 29 |
| 2016 Marzo | 8 | 19 | 27 |
| 2016 Febrero | 13 | 26 | 39 |
| 2016 Enero | 14 | 18 | 32 |
| 2015 Diciembre | 6 | 18 | 24 |
| 2015 Noviembre | 7 | 18 | 25 |
| 2015 Octubre | 2 | 16 | 18 |
| 2015 Septiembre | 4 | 9 | 13 |
| 2015 Agosto | 4 | 4 | 8 |
| 2015 Julio | 92 | 4 | 96 |
| 2015 Junio | 57 | 5 | 62 |
| 2015 Mayo | 57 | 0 | 57 |
| 2015 Abril | 54 | 3 | 57 |
| 2015 Marzo | 37 | 2 | 39 |
| 2015 Febrero | 45 | 4 | 49 |
| 2015 Enero | 39 | 1 | 40 |
| 2014 Diciembre | 45 | 4 | 49 |
| 2014 Noviembre | 28 | 1 | 29 |
| 2014 Octubre | 42 | 5 | 47 |
| 2014 Septiembre | 30 | 2 | 32 |
| 2014 Agosto | 21 | 3 | 24 |
| 2014 Julio | 28 | 4 | 32 |
| 2014 Junio | 44 | 1 | 45 |
| 2014 Mayo | 44 | 7 | 51 |
| 2014 Abril | 30 | 2 | 32 |
| 2014 Marzo | 49 | 4 | 53 |
| 2014 Febrero | 24 | 5 | 29 |
| 2014 Enero | 24 | 2 | 26 |
| 2013 Diciembre | 27 | 4 | 31 |
| 2013 Noviembre | 14 | 2 | 16 |
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