Multiple minute digitate hyperkeratosis explained
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]
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.
See also
Further reading
- Pimentel . CL . Puig . L . García‐Muret . MP . Fernandez‐Figueras . MT . Alomar . A . Multiple minute digitate hyperkeratosis . Journal of the European Academy of Dermatology and Venereology . Wiley . 16 . 4 . 2002 . 0926-9959 . 10.1046/j.1468-3083.2002.00570_9.x . 422–424 . none.
- Rubegni . P. . De Aloe . G. . Pianigiani . E. . Cherubini-Di Simplicio . F. . Fimiani . M. . Two sporadic cases of idiopathic multiple minute digitate hyperkeratosis . Clinical and Experimental Dermatology . Oxford University Press (OUP) . 26 . 1 . 2001 . 0307-6938 . 10.1046/j.1365-2230.2001.00762.x . 53–55 . none.
Notes and References
- Book: Odom, Richard B. . Davidsohn, Israel . James, William D. . Henry, John Bernard . Berger, Timothy G. . Clinical diagnosis by laboratory methods . Dirk M. Elston . Andrews' diseases of the skin: clinical dermatology . limited . Saunders Elsevier . 2006 . 637 . 0-7216-2921-0.
- Caccetta . Tony Philip . Dessauvagie . Ben . McCallum . Dugald . Kumarasinghe . Sujith Prasad . Multiple minute digitate hyperkeratosis: A proposed algorithm for the digitate keratoses . Journal of the American Academy of Dermatology . Elsevier BV . 67 . 1 . 2012 . 0190-9622 . 10.1016/j.jaad.2010.07.023 . e49–e55. 21050621 .
- Coutinho . Inês . Gameiro . Ana Rita . Gouveia . Miguel Pinto . Cardoso . José Carlos . Figueiredo . Américo . Multiple minute digitate hyperkeratosis - a peculiar entity . Anais Brasileiros de Dermatologia . FapUNIFESP (SciELO) . 90 . 3 suppl 1 . 2015 . 0365-0596 . 10.1590/abd1806-4841.20153440 . 153–155.