BACKGROUND: Circumscribed palmar or plantar hypokeratosis (CPH) is a rare skin disorder only recently described. OBJECTIVE: To determine the diagnostic features and to provide insight into the pathogenesis of CPH, with analysis of two new Japanese cases. METHODS: Dermoscopy, immunohistochemistry, electron microscopy, polymerase chain reaction amplification for human papillomavirus (HPV) DNA and 16S microbial rRNA gene profiling were conducted. RESULTS: Dermoscopy showed characteristic features using both dry and jelly immersion observation; step-like desquamation and a homogeneous erythema with regularly distributed whitish spots. Immunohistochemistry revealed strong staining with anti-pankeratin antibody (AE1+AE3) and anti-keratin 16 antibody, and decreased expression of keratin 2e. EM revealed a breakage of the corneocytes within their cytoplasm, but structures for cell attachment were intact. HPV and lesion-specific bacteria were not detected. LIMITATIONS: The number of cases analyzed was two. CONCLUSION: Hyperproliferative epidermal state along with enhanced corneocyte fragility may account for the unique features in CPH.
BACKGROUND: Circumscribed palmar or plantar hypokeratosis (CPH) is a rare skin disorder only recently described. OBJECTIVE: To determine the diagnostic features and to provide insight into the pathogenesis of CPH, with analysis of two new Japanese cases. METHODS: Dermoscopy, immunohistochemistry, electron microscopy, polymerase chain reaction amplification for human papillomavirus (HPV) DNA and 16S microbial rRNA gene profiling were conducted. RESULTS: Dermoscopy showed characteristic features using both dry and jelly immersion observation; step-like desquamation and a homogeneous erythema with regularly distributed whitish spots. Immunohistochemistry revealed strong staining with anti-pankeratin antibody (AE1+AE3) and anti-keratin 16 antibody, and decreased expression of keratin 2e. EM revealed a breakage of the corneocytes within their cytoplasm, but structures for cell attachment were intact. HPV and lesion-specific bacteria were not detected. LIMITATIONS: The number of cases analyzed was two. CONCLUSION: Hyperproliferative epidermal state along with enhanced corneocyte fragility may account for the unique features in CPH.
Authors: Adriana Polańska; Monika Bowszyc-Dmochowska; Ryszard Żaba; Zygmunt Adamski; Jakub Pazdrowski; Aleksandra Dańczak-Pazdrowska Journal: Arch Med Sci Date: 2016-10-24 Impact factor: 3.318