Study of Clinico-Epidemiology & Dermatoscopic Patterns of Palmoplantar Keratodermas

Abstract

Introduction: Palmoplantar keratodermas (PPKs) are a heterogeneous group of disorders characterized by persistent hyperkeratosis of the palms and soles. Clinical overlap among hereditary and acquired forms can make diagnosis difficult, while dermoscopy offers a useful non-invasive method for identifying characteristic morphological patterns.

Aim & Objective: To evaluate the clinico-epidemiological profile of patients with palmoplantar keratodermas and to identify and document their dermatoscopic patterns.

Materials & Methods: This prospective cross-sectional observational study was conducted in our Dermatology outpatient Department, from January 2024 to December 2025. Ninety-three clinically diagnosed patients were included by convenient sampling. Detailed demographic and clinical evaluation was performed, followed by dermatoscopy using an IDS-1100™ dermatoscope in polarized and non-polarized modes.

Results: The mean age was 33.48 ± 14.71 years, with maximum cases in the 21–30-year group (29.03%). Males constituted 62.4% of patients, and 52.7% were urban residents. Acquired PPK was predominant (87.10%), while hereditary PPK accounted for 12.90%. Both palms and soles were involved in 62.37%, and lesion duration was commonly 6 months to 1 year (32.26%). Palmoplantar psoriasis (33.33%) was the commonest acquired cause, followed by eczema (27.96%). Dermoscopy most commonly showed a light red-yellow background (59.1%), diffuse white scales (55.9%), regular linear vessels (18.3%), patchy glomerular vessels (17.2%), white keratin plugs (15.1%), and yellow crusts (14.0%). Pits were characteristic of punctate PPK, while keratin plugs were prominent in Vorner’s syndrome.  

Conclusion: Acquired PPKs, particularly psoriasis and eczema, predominated in this cohort. Dermoscopy provided useful diagnostic clues and complemented clinical evaluation in differentiating acquired and hereditary PPKs.

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