Overview
Punctate palmoplantar keratoderma (also known as keratosis punctata palmaris et plantaris, Buschke-Fischer-Brauer disease, or punctate keratoderma) is a rare inherited skin condition that affects the palms of the hands and the soles of the feet. In this condition, many small, hard, round bumps or pits develop on the skin of the palms and soles. These tiny thickened spots of skin, often described as looking like small thorns or seeds pressed into the skin, are caused by an overgrowth of the outer layer of skin (the keratin layer) at specific points. Symptoms usually begin in late adolescence or early adulthood, though they can appear at different ages. The bumps may be skin-colored, yellowish, or slightly translucent and can range from 2 to 8 millimeters in size. They may cause discomfort when walking or gripping objects, especially if they become numerous. The condition tends to be lifelong, though the severity can vary over time and may worsen with manual labor or friction. There is currently no cure for punctate palmoplantar keratoderma. Treatment focuses on managing symptoms and improving comfort. Options include regular use of moisturizers, keratolytic creams (which help soften and remove thickened skin), careful trimming or paring of the bumps, and in some cases retinoid medications. The condition does not typically affect overall health or lifespan, but it can cause significant discomfort and cosmetic concern for those affected.
Key symptoms:
Small hard bumps on the palms of the handsSmall hard bumps on the soles of the feetTiny pits or depressions in palm and sole skinThickened skin spots that look like seeds or thornsPain or tenderness when walkingDiscomfort when gripping objectsYellowish or translucent hard spots on palms and solesRough or gritty texture on palms and solesWorsening of bumps with manual work or frictionCosmetic changes to the skin of hands and feet
Autosomal dominant
Passed on from just one parent; each child has about a 50% chance of inheriting it
Adult
Begins in adulthood (age 18 or older)
Treatments
No FDA-approved treatments are currently listed for Punctate palmoplantar keratoderma.
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Specialists
View all specialists →No specialists are currently listed for Punctate palmoplantar keratoderma.
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 Punctate palmoplantar keratoderma.
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Caregiver Resources
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Mental Health Support
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Family & Caregiver Grants
Financial assistance programs specifically for caregivers of rare disease patients.
Social Security Disability
Learn how rare disease patients may qualify for SSDI/SSI benefits.
Questions for your doctor
Bring these to your next appointment
- Q1.What type of punctate palmoplantar keratoderma do I have, and is genetic testing recommended?,What are the best creams or treatments to reduce the bumps and discomfort?,Should I be screened for any associated health conditions?,Is oral retinoid therapy appropriate for my case, and what are the risks?,Should my family members be examined or tested for this condition?,How often should I have follow-up appointments?,Are there any clinical trials or new treatments being studied for this condition?
Common questions about Punctate palmoplantar keratoderma
What is Punctate palmoplantar keratoderma?
Punctate palmoplantar keratoderma (also known as keratosis punctata palmaris et plantaris, Buschke-Fischer-Brauer disease, or punctate keratoderma) is a rare inherited skin condition that affects the palms of the hands and the soles of the feet. In this condition, many small, hard, round bumps or pits develop on the skin of the palms and soles. These tiny thickened spots of skin, often described as looking like small thorns or seeds pressed into the skin, are caused by an overgrowth of the outer layer of skin (the keratin layer) at specific points. Symptoms usually begin in late adolescence o
How is Punctate palmoplantar keratoderma inherited?
Punctate palmoplantar keratoderma follows a autosomal dominant inheritance pattern. Genetic counseling can help families understand recurrence risk and testing options.
At what age does Punctate palmoplantar keratoderma typically begin?
Typical onset of Punctate palmoplantar keratoderma is adult. Age of onset can vary across affected individuals.