Overview
Diffuse palmoplantar keratoderma (also called diffuse PPK) is a skin condition in which the skin on the palms of the hands and the soles of the feet becomes abnormally thick, hard, and sometimes yellowish. The word "diffuse" means the thickening covers most or all of the palm and sole surfaces evenly, rather than appearing in patches or spots. This thickening happens because the outer layer of skin (the epidermis) produces too much of a tough protein called keratin. The condition usually begins in early childhood, often within the first few years of life. The thickened skin can crack and become painful, making it difficult to walk comfortably or use the hands for fine tasks. Some people also develop excessive sweating (hyperhidrosis) on the affected areas, which can lead to an unpleasant odor or increase the risk of fungal or bacterial infections. In some forms, the thickened skin may extend slightly beyond the palms and soles onto the tops of the hands, feet, or wrists — this is called a "transgrediens" pattern. Diffuse palmoplantar keratoderma can be inherited (genetic) or, less commonly, acquired later in life. The inherited forms are caused by mutations in genes that are important for skin structure and barrier function. Treatment is mainly focused on managing symptoms, as there is currently no cure. Regular use of moisturizers, keratolytic creams (which help soften and remove thickened skin), and careful foot care are the mainstays of management. In more severe cases, oral retinoids may be prescribed to help reduce skin thickening.
Key symptoms:
Thick, hard skin on the palms of the handsThick, hard skin on the soles of the feetYellowish discoloration of palms and solesPainful cracking or fissuring of thickened skinDifficulty walking due to painful solesExcessive sweating on hands and feetUnpleasant odor from affected skinSkin infections in the thickened areasRedness around the edges of the thickened skinDifficulty gripping objects or performing fine hand tasksCallus-like appearance of palms and solesPossible thickening extending to the backs of hands or feet
Variable
Can be inherited in different ways depending on the underlying gene
Childhood
Begins in childhood, roughly ages 1 to 12
Treatments
No FDA-approved treatments are currently listed for Diffuse palmoplantar keratoderma.
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Treatment Centers
8 centersBaylor College of Medicine Rare Disease Center ↗
Baylor College of Medicine
📍 Houston, TX
🏥 NORDStanford Medicine Rare Disease Center ↗
Stanford Medicine
📍 Stanford, CA
🔬 UDNNIH Clinical Center Undiagnosed Diseases Program ↗
National Institutes of Health
📍 Bethesda, MD
🔬 UDNUCLA UDN Clinical Site ↗
UCLA Health
📍 Los Angeles, CA
🔬 UDNBaylor College of Medicine UDN Clinical Site ↗
Baylor College of Medicine
📍 Houston, TX
🔬 UDNHarvard/MGH UDN Clinical Site ↗
Massachusetts General Hospital
📍 Boston, MA
🏥 NORDMayo Clinic Center for Individualized Medicine ↗
Mayo Clinic
📍 Rochester, MN
👤 Mayo Clinic Center for Individualized Medicine
🏥 NORDUCLA Rare Disease Day Program ↗
UCLA Health
📍 Los Angeles, CA
Travel Grants
No travel grants are currently matched to Diffuse palmoplantar keratoderma.
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Caregiver Resources
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Social Security Disability
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Questions for your doctor
Bring these to your next appointment
- Q1.What specific type of palmoplantar keratoderma do I or my child have, and is genetic testing recommended?,What is the best daily skin care routine to manage the thickened skin?,Are oral retinoids appropriate in my case, and what are the risks and benefits?,Should I see a podiatrist regularly for foot care?,Is this condition likely to be passed on to my children, and should we consider genetic counseling?,Are there any clinical trials or new treatments being studied for this condition?,What should I do if the skin becomes infected or the cracks get worse?
Common questions about Diffuse palmoplantar keratoderma
What is Diffuse palmoplantar keratoderma?
Diffuse palmoplantar keratoderma (also called diffuse PPK) is a skin condition in which the skin on the palms of the hands and the soles of the feet becomes abnormally thick, hard, and sometimes yellowish. The word "diffuse" means the thickening covers most or all of the palm and sole surfaces evenly, rather than appearing in patches or spots. This thickening happens because the outer layer of skin (the epidermis) produces too much of a tough protein called keratin. The condition usually begins in early childhood, often within the first few years of life. The thickened skin can crack and beco
At what age does Diffuse palmoplantar keratoderma typically begin?
Typical onset of Diffuse palmoplantar keratoderma is childhood. Age of onset can vary across affected individuals.
Which specialists treat Diffuse palmoplantar keratoderma?
5 specialists and care centers treating Diffuse palmoplantar keratoderma are listed on UniteRare, sourced from ClinicalTrials.gov principal investigators, published research, and the NPPES NPI registry.