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Hyperkeratotic fissured hand and foot eczema

This eczema is characterised by hyperkeratosis on palms and/ or soles and painful fissures. It often runs a chronic course for years. The disease is most common among men between 30 and 60 years of age. Etiologic factors include atopy, contact allergy and constant irritation. An idiopathic form is also recognised.

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Clinical picture:

Yellowish hyperkeratoses and painful fissuring are characteristic for this disease.

Distribution:

Typically the palms and/ or soles are affected.

Diagnosis:

The diagnosis is based on the patient history and on the clinical picture. The possible etiologic factors mentioned above should be ruled out before settling on the diagnosis idiopathic hyperkeratotic fissured hand and foot eczema. Patch testing is used to exclude underlying contact allergies.

Differential diagnoses:

Palmoplantar psoriasis, diffuse types of palmoplantar keratoderma, Olmsted syndrome and palmoplantar keratoses in Sézary syndrome and other forms of advanced cutaneous lymphoma are possible differential diagnoses.



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