本文综述了有关掌足底角化症的文献,这个过程在10年前才被首次确认,讨论了我们的理解现状,可用的治疗选择,以及关于病因学的争论。发现了44份报告69例病例的出版物。手掌或足底角化减退主要发生在女性(76.8%),首次就诊时的年龄为42至84岁。大多数病例出现在51至70岁之间。大多数患者有孤立性病变,通常位于右手掌,特别是在鱼际区域(在44/79个病变中[55.7%])或鱼际隆起(在11/79个病变中[13.9%])。仅在8例中,该部位有既往创伤史。在大多数情况下,使用聚合酶链反应技术鉴定人乳头瘤病毒参与的研究均为阴性。这些低角化病变是由角质层突然变薄形成的局部表皮凹陷,提供独特的组织病理学特征。该病症目前可被认为是影响其中存在厚角质层的区域的局部角质化病症。沉淀原因尚不清楚,最终的治疗方法仍有待发现。机制将是角质形成细胞克隆在向正常掌fl底角质化过度分化过程中的局部失败。
This review of the literature on palmoplantar
hypokeratosis, a process that was first indentified only 10 years ago, discusses the current state of our understanding, the therapeutic options available, and the debate about etiology. Forty-four publications reporting 69 cases were found. Palmar or plantar
hypokeratosis occurs mainly in women (76.8%) and age at the time of a first visit to a physician ranges from 42 to 84 years. Most cases present between the ages of 51 and 70 years. The majority of patients have had solitary lesions usually located on the right palm, particularly in the regions of the thenar (in 44/79 lesions [55.7%]) or hypothenar eminences (in 11/79 lesions [13.9%]). In only 8 cases was there a history of prior trauma at the site. Studies using polymerase chain reaction techniques to identify human papillomavirus involvement were negative in most cases. These hypokeratotic lesions are localized epidermal depressions formed by an abrupt thinning of the stratum corneum, providing a singular histopathologic feature. This condition can currently be considered a localized keratinization disorder affecting zones where there is a thick stratum corneum. The precipitating cause is unknown and a definitive treatment remains to be found. The mechanism would be the localized failure of a clone of keratinocytes during differentiation toward normal palmoplantar hyperkeratinization.