Spiny Keratoderma

  • Autosomal dominant inheritance

  • Unknown

  • Multiple small, palmoplantar keratotic “spines” by age 10-30 years

Pathology: 

  • Epidermal depression, parakeratosis

Differential:

  • Acquired types of spiny palmoplantar keratoderma

  • Mechanical debridement, dermabrasion 
  • Keratolytics
  • Oral retinoids (transient benefit)
  • Topical 5-fluorouracil ointment (inconsistent results)