Keratodermia

The article covers information about keratodermia, a heterogeneous group of conditions characterized by abnormal thickening of the skin of the palms and soles. Traditionally, acquired and hereditary forms are distinguished. In clinical practice, the most common hyperkeratosis of the palms and soles, as one of the manifestations of psoriasis, eczema, dermatomycosis and many other diseases. Mechanical and toxic factors (including taking medications), intake of toxic substances with food that lead to changes in the intestinal mucosa can also lead to the development of hyperkeratosis of the palms and soles, modern fashion and beauty requirements can contribute to the development of multiple vitamin deficiencies. Much less common are hereditary forms of keratoderma, which are independent diseases. Early onset, the presence of a positive family history suggest a genetic nature. The distinctive features of hereditary forms are the nature of inheritance, the degree of damage to the epidermis, the presence/absence of the spread of foci beyond the skin of the palms and soles, and concomitant pathology. The development of hereditary forms is based on mutations of various genes encoding proteins (for example, keratin, desmosomes, loricrin, cathepsin C, gap junction proteins), which are involved in the process of keratinization. Hereditary palmoplantar keratoderma has a large genetic and phenotypic heterogeneity, as a result of which making an accurate diagnosis based on clinical manifestations alone, when it is not possible to perform molecular genetic research, is a very difficult task. Thanks to the next-generation sequencing, significant progress has been made in deciphering the genetic basis of keratoderms. This review examines the pathogenetic, clinical, and diagnostic features of diffuse forms of keratoderma, and options for symptomatic therapy, taking into account the torpidity and resistance of the pathological process.

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