Ishiko A, Dekio I, Fujimoto A, Kameyama K, Sakamoto M, Benno Y, Amagai M, Nishikawa T. Abnormal keratin expression in circumscribed palmar hypokeratosis.
J Am Acad Dermatol 2007;
57:285-91. [PMID:
17553594 DOI:
10.1016/j.jaad.2007.02.035]
[Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2006] [Revised: 01/20/2007] [Accepted: 02/18/2007] [Indexed: 11/23/2022]
Abstract
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.
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