Diffuse palmoplantar keratoderma

　　1. Etiology

　　It is autosomal dominant inheritance. It can occur in all races and has a roughly equal incidence in both genders, with a statistical incidence of 1 in 40,000 in Northern Ireland. It has a familial tendency.

　　2. Pathogenesis

　　The pathogenesis is not yet clear. It is autosomal dominant inheritance. It may be autosomal dominant inheritance. It usually starts from infancy.

　　Due to the skin ulceration, the integrity of the skin is destroyed, so skin bacterial or fungal infections can be induced by scratching, usually secondary to low body resistance, or long-term use of immunosuppressants, or patients with onychomycosis and other fungal infections. In case of concurrent bacterial infection, symptoms such as fever, skin swelling, ulceration, and purulent secretion may occur. Severe cases can lead to sepsis, so it should attract the attention of clinical doctors.

　　It usually starts from infancy, with mild cases only showing rough skin on the palms and soles. In severe cases, there are diffuse plaques on the palms and soles, with thickened keratin at the edges, appearing smooth and yellow, resembling calluses, or thickened like warts. Cracks often occur due to the loss of elasticity, causing pain and difficulty in hand and foot movement. The damage can be limited to the palms and soles, occasionally involving the back of the hand, foot, fingers, toes, elbows, knees, the extensor side of the forearm, the anterior tibia, and the ankle. It is symmetrically distributed, may be accompanied by excessive sweating, thickened and turbid nail plates, and some patients may have congenital ichthyosis or other congenital abnormalities. The lesions can last a lifetime.

　　This disease belongs to autosomal dominant inheritance. It can occur in all races and has a roughly equal incidence in both genders, with a statistical incidence of 1 in 40,000 in Northern Ireland. It has a familial tendency. Therefore, it is impossible to prevent the disease by its etiology. Chromosome testing can be performed before pregnancy, and marriage should be avoided for those with severe chromosomal abnormalities. At the same time, it is advisable to avoid marriage between close relatives, which can also reduce the incidence of the disease.

　　Clinical skin examination:The skin of the palm and sole is rough, and in severe cases, there are diffuse plaques on the palm and sole, with thickened keratin at the edges, smooth appearance, yellowish like callosities, or warty thickening, often due to the loss of elasticity, causing cracks, causing pain, and causing difficulty in hand and foot movement. The damage can be localized to the palm and sole, occasionally involving the back of the hand, the back of the foot, fingers, toes, elbows, knees, the extensor side of the forearm, the anterior tibia, and the ankle, with a symmetrical distribution.

　　Histopathology:Thickened stratum corneum, poor keratinization, thickened granular layer and stratum spinosum, slight inflammatory cell infiltration in the superficial dermis. The sweat glands and ducts occasionally atrophy.

　　1. High-Protein Diet:Supplementing a rich diet of high-protein foods can enhance the body's resistance and anti-inflammatory ability, and provide the necessary raw materials for tissue repair.

　　2. Adequate Vitamin Intake:Provide a variety of vitamins, especially B vitamins, vitamin C, and so on. B vitamins are helpful for digestion and can protect oral tissues; vitamin C can promote the healing of gingival hemorrhage.

　　3. Mineral Supplementation:Pay special attention to the intake of minerals, especially the intake and proportion of calcium, phosphorus, and zinc. Zinc can resist infection and enhance healing.

　　Reduce the intake of fried, fried, greasy, and spicy foods such as alcohol, seafood, garlic, chives, tobacco and alcohol, and increase the intake of foods rich in protein, such as soy products, eggs, milk, mung beans, oatmeal, rice, and fresh vegetables and fruits.

　　1. Treatment

　　This disease belongs to autosomal dominant inheritance. It can occur in all races, with a roughly equal incidence in both sexes. Statistics show that the incidence rate in Northern Ireland is 1:40,000. There is a family history, so there is no specific treatment for this disease. Vitamin A and vitamin A acid can be tried, and trauma should be avoided as much as possible. Topical keratolytic agents can be used locally. Local use of topical corticosteroid ointment can also be given.

　　2. Prognosis

　　The lesion can last a lifetime.