Multiple minute digitate hyperkeratosis

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Multiple minute digitate hyperkeratosis
Specialty Dermatology

Multiple minute digitate hyperkeratosis, also known as digitate keratoses, disseminated spiked hyperkeratosis, familial disseminated piliform hyperkeratosis, and minute aggregate keratosis is a rare cutaneous condition, with about half of cases being familial, inherited in an autosomal dominant fashion, while the other half are sporadic. [1]

Contents

Signs and symptoms

Multiple minute digitate hyperkeratosis is mostly a nonfollicular digitate keratosis that affects the limbs and trunk. There is no impact on the face or palmoplantar surfaces. The lesions consist of skin-colored, yellow, brown, or white spicules that range in length from 0.5 to 5.0 mm and diameter from 0.3 to 3.0 mm. Occasionally, flat-topped, dome-shaped, or crateriform papules are also present. [2]

Causes

Multiple minute digitate hyperkeratosis may be sporadic or familial. [2]

Diagnosis

Histopathology reveals a stratum granulosum with varying thickness and localized orthokeratotic hyperkeratosis originating from a tented epidermis. Rarely, there have also been reports of superficial cutaneous lymphoplasmocytic infiltrates, parakeratosis, and epidermal invagination. A recurring characteristic that unites all of the cases that have been documented is the absence of follicular involvement. [3]

Reduced keratohyaline granules with varying numbers of Odland bodies are seen under electron microscopy. [3]

Treatment

While improvements with various topical keratolytics and topical and oral retinoids have been reported, treatment is frequently ineffective or only temporary. [2]

See also

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References

  1. Odom, Richard B.; Davidsohn, Israel; James, William D.; Henry, John Bernard; Berger, Timothy G.; Clinical diagnosis by laboratory methods; Dirk M. Elston (2006). Andrews' diseases of the skin: clinical dermatology . Saunders Elsevier. p.  637. ISBN   0-7216-2921-0.
  2. 1 2 3 Caccetta, Tony Philip; Dessauvagie, Ben; McCallum, Dugald; Kumarasinghe, Sujith Prasad (2012). "Multiple minute digitate hyperkeratosis: A proposed algorithm for the digitate keratoses". Journal of the American Academy of Dermatology. 67 (1). Elsevier BV: e49–e55. doi:10.1016/j.jaad.2010.07.023. ISSN   0190-9622. PMID   21050621.
  3. 1 2 Coutinho, Inês; Gameiro, Ana Rita; Gouveia, Miguel Pinto; Cardoso, José Carlos; Figueiredo, Américo (2015). "Multiple minute digitate hyperkeratosis - a peculiar entity". Anais Brasileiros de Dermatologia. 90 (3 suppl 1). FapUNIFESP (SciELO): 153–155. doi:10.1590/abd1806-4841.20153440. ISSN   0365-0596.

Further reading