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Prados-Carmona A, Prados-Carmona JJ, Ruiz-Villaverde R, Navarro-Triviño FJ. Multiple minute digitate hyperkeratosis: 10 years from Caccetta's algorithm. A case report and narrative review. J Dtsch Dermatol Ges 2023; 21:1447-1454. [PMID: 37840359 DOI: 10.1111/ddg.15186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/18/2023] [Indexed: 10/17/2023]
Abstract
To date, the clinical appearance and histological features of multiple minute digitate hyperkeratosis have been well characterized. However, there is no consensus on its treatment. After a comprehensive search of the databases MEDLINE, EMBASE, Web of Science, and the Cochrane Library and Database of Systematic Reviews, we have summarized the available clinical evidence regarding the therapeutic approaches already reported for this entity since its first description in 1967. Additional publications were identified within the references of retrieved papers. Sixty-five articles have been revised, resulting in a total of 73 compatible cases. The histopathological features and different classifications used through history have also been considered, updating and completing the available knowledge. Ultimately, we propose topical treatment with 5 % 5-fluorouracil formulated with 10 % salicylic acid as a potential treatment that has been used successfully in a 51-year-old woman at our facility. Further research in form of prospective or comparative studies is encouraged for a better conceptualization of the therapeutics of this disease.
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Affiliation(s)
| | | | | | - Francisco José Navarro-Triviño
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
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Prados-Carmona A, Prados-Carmona JJ, Ruiz-Villaverde R, Navarro-Triviño FJ. Multiple Minute Digitate Hyperkeratosis: 10 Jahre nach Caccettas Algorithmus. Fallbericht und narrative Übersicht. J Dtsch Dermatol Ges 2023; 21:1447-1455. [PMID: 38082527 DOI: 10.1111/ddg.15186_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/18/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungDas klinische Erscheinungsbild und die histologischen Merkmale der Multiple Minute Digitate Hyperkeratosis sind bereits gut charakterisiert. Es besteht jedoch kein Konsens über die Behandlung dieser Erkrankung. Nach einer umfassenden Recherche in den Datenbanken MEDLINE, EMBASE, Web of Science und der Cochrane Library and Database of Systematic Reviews haben wir die vorliegenden klinischen Daten zu den therapeutischen Ansätzen zusammengefasst, die für diese Entität seit ihrer Erstbeschreibung im Jahr 1967 publiziert wurden. Zusätzliche Veröffentlichungen wurden in den Referenzen der gefundenen Artikel identifiziert. Fünfundsechzig Artikel wurden durchgesehen, sodass sich insgesamt 73 kompatible Fälle ergaben. Die histopathologischen Merkmale und die verschiedenen Klassifizierungen, die im Laufe der Zeit verwendet wurden, wurden ebenfalls berücksichtigt. Letztendlich schlagen wir die topische Behandlung mit 5% 5‐Fluorouracil in Kombination mit 10% Salicylsäure als eine mögliche Behandlung vor, die bei einer 51‐jährigen Frau in unserer Einrichtung erfolgreich angewendet wurde. Weitere Forschung in Form von prospektiven oder vergleichenden Studien werden empfohlen, um ein besseres Konzept für die Therapie dieser Krankheit zu entwickeln.
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Affiliation(s)
| | | | | | - Francisco José Navarro-Triviño
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
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Caccetta TP, Dessauvagie B, McCallum D, Kumarasinghe SP. Multiple minute digitate hyperkeratosis: A proposed algorithm for the digitate keratoses. J Am Acad Dermatol 2012; 67:e49-55. [DOI: 10.1016/j.jaad.2010.07.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/02/2010] [Accepted: 07/20/2010] [Indexed: 02/06/2023]
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Mevorah B, Gat A, Golan H, Brenner S. Unilateral Spiny Hyperkeratosis. Dermatology 2008; 217:181-6. [DOI: 10.1159/000140678] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Accepted: 12/11/2007] [Indexed: 11/19/2022] Open
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Cuerda Galindo E, Aparicio Fernández S, Sánchez-Yus E. Hiperqueratosis digitada diminuta múltiple. ACTAS DERMO-SIFILIOGRAFICAS 2002. [DOI: 10.1016/s0001-7310(02)76649-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pujol RM, Perez–Losada E, Matias–Guiu X, Fuentes J, Alonso CM, Alomar A, Craven–Bartle J. Postirradiation Multiple Minute Digitate Porokeratosis. J Cutan Med Surg 2001. [DOI: 10.1177/120347540100500205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Development of multiple minute digitate hyperkeratoses (MMDH) after irradiation has been reported previously. The keratotic lesions in these cases were confined within the irradiation field, and histopathological examination disclosed a focal column of parakeratosis (cornoid lamella) arising from an epidermis devoid of granular layer. Objective: We describe a 78-year-old woman who developed multiple, discrete, tiny, filiform, keratotic papules on the anterior aspect of the right chest wall, 13 months after postmastectomy cobalt irradiation therapy for mammary infiltrating ductal carcinoma. Conclusion: Postirradiation MMDH represents a peculiar radiation-induced disorder that we believe should be distinguished from other cases of MMDH and included within the spectrum of porokeratosis.
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Affiliation(s)
- Ramon M. Pujol
- Department of Dermatology, Hospital del Mar, IMAS, Barcelona, Spain
| | - Eugenia Perez–Losada
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Xavier Matias–Guiu
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Josefina Fuentes
- Department of Radiotherapy, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carmen M. Alonso
- Department of Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Agustin Alomar
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jordi Craven–Bartle
- Department of Radiotherapy, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Pujol RM, Perez-Losada E, Matias-Guiu X, Fuentes J, Alonso MC, Alomar A, Craven-Bartle J. Postirradiation multiple minute digitate porokeratosis. J Cutan Med Surg 2001; 5:126-30. [PMID: 11443484 DOI: 10.1007/bf02737866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Development of multiple minute digitate hyperkeratoses (MMDH) after irradiation has been reported previously. The keratotic lesions in these cases were confined within the irradiation field, and histopathological examination disclosed a focal column of parakeratosis (cornoid lamella) arising from an epidermis devoid of granular layer. OBJECTIVE We describe a 78-year-old woman who developed multiple, discrete, tiny, filiform, keratotic papules on the anterior aspect of the right chest wall, 13 months after postmastectomy cobalt irradiation therapy for mammary infiltrating ductal carcinoma. CONCLUSION Postirradiation MMDH represents a peculiar radiation-induced disorder that we believe should be distinguished from other cases of MMDH and included within the spectrum of porokeratosis.
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Affiliation(s)
- R M Pujol
- Department of Dermatology, Hospital del Mar, IMAS, Barcelona, Spain.
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Abstract
A familial case of multiple minute digitate hyperkeratoses is reported. Hundreds of tiny, spiked, keratotic papules were scattered on the trunk and limbs. Microscopically, the lesions showed digitiform orthohyperkeratosis with tenting of the epidermis. Neither atypical epidermal cells nor a dermal infiltrate were observed. This disease has three types: familial, sporadic and postinflammatory. We have analysed the histopathological features of all the cases reported to date. While the familial and sporadic types are similar, the lesions in the postinflammatory type are composed of parakeratotic columns with an invaginated epidermis. Although morphological analysis may not provide any clues to pathogenetic differences, it seems reasonable to assume that the postinflammatory type is an entity different from the other two forms.
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Affiliation(s)
- S Takagawa
- Department of Dermatology, School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku Tokyo, 113-8519, Japan.
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Abstract
We report a new case of multiple minute digitate hyperkeratoses after postmastectomy irradiation therapy for mammary cancer. This is the first case of multiple minute digitate hyperkeratoses in an Asian country as well as the third report of the disorder after irradiation. The characteristic eruption, the consistent trigger of irradiation and its occurrence in patients of different racial groups indicate that multiple minute digitate hyperkeratoses are a distinct clinical entity.
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Affiliation(s)
- K Mizuno
- Department of Dermatology, Faculty of Medicine, Kyoto University, Japan
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Gimenez-Arnau A, Camarasa JG. Palmar filiform or spiny hyperkeratosis associated with pulmonary tuberculosis. J Eur Acad Dermatol Venereol 1994. [DOI: 10.1111/j.1468-3083.1994.tb00385.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- L E Judd
- Valley Diagnostic Laboratory, Lower Hutt, New Zealand
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Abstract
A case of non-familial multiple digitate hyperkeratosis is reported. Digitate hyperkeratosis is a new, non-follicular disorder of keratinization and three different types have been distinguished in the literature: the familial type, with an autosomal dominant trait; the sporadic type; and the post-inflammatory type.
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Affiliation(s)
- D Benoldi
- Istituto di Clinica Dermosifilopatica, Università di Parma, Italy
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Abstract
Digitate hyperkeratoses are rare lesions of unknown cause. We wish to add a new variant of this entity to the few reports in the literature. Our patient is a 79-year-old woman with palmar pits and digitate hyperkeratoses limited to her palms and soles.
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Affiliation(s)
- E H Knobler
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, Columbia-Presbyterian Medical Center, New York 10032
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Abstract
We report details of two patients who had digitate keratoses as a transient phenomenon following inflammatory skin disorders. In one patient, keratoses arose from the epidermal surface, from invaginated pits in the epidermis, and from follicles. Apart from the short duration of the lesions, the clinical and histological features were similar to previously reported cases of digitate keratoses.
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