Abstract:

Objective To investigate the relevant risk factors for, clinical manifestation and treatment responses of symmetric acral keratoderma in 9 patients. Methods Clinical data were collected from 9 outpatients with symmetric acral keratoderma. Skin lesions were photographed, tissue specimens were obtained from the lesions and subjected to fungal and histopathological examinations. The patients were given topical treatment. Results There were 8 males and 1 female in these patients with an average age of 28.2 years and age at onset of 24.6 years. The disease duration varied from 2 months to 16 years. The lesions were predominantly distributed on the dorsum of both hands and wrists symmetrically and circularly. Ankles were the third popular site involved. Generally, the lesions were aggravated in summer, spontaneously cured in winter. Most of the patients had a history of occupational contact with plastics or rubber. Some patients suffered from ichthyosis vulgaris. Microscopic examination for fungal element was negative. Histopathology revealed epidermal hyperkeratosis, acanthosis and mild papillomatosis. The urea and Vitamin E cream mixed with clobetasol propionate cream at a ratio of 1 ∶ 1 proved to be effective. Conclusions Ichthyosis vulgaris may be a risk factor for symmetric acral keratoderma. The whitening of lesions after short exposure to water may be a kind of physical phenomenon with the involvement of water and air. Topical steroids may serve as the first-line treatment choice for symmetric acral keratoderma.

Key words: keratoderma, acral, symmetric, pigmentation disorders