Unna-Thost keratosis of the feet and hands is the most common variant. It is inherited autosomal dominantly.
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The condition is related to a defect in keratin 9, which is only found in the feet and hands. The lesions are clearly demarcated from healthy skin. Keratosis is accompanied by increased sweating. The lesions are symmetrical and usually appear in the 1st-2nd year of chewing.
Symptoms
Symptoms are a thickening of the stratum corneum. The epidermis is hard, preceded by furrows, and may be smooth or rough with a yellowish waxy colour. The condition also involves the nails. The nail plates are thickened and raised. The hair remains unchanged. In the disseminated variety with autosomal recessive inheritance, there are hyperkeratotic, round foci on the hands and feet. The lesions resemble flat or common warts or corns.
Thefirst symptoms can be seen at over 20 years of age. The condition usually affects multiple family members. A variant of keratosis with autosomal inheritance manifests itself in the first months of life. Associated conditions include excessive sweating, nail changes and developmental disorders. Knees and elbows may also be affected.
Greither's variant
Is inherited autosomal recessively or dominantly. It occurs in early childhood and progresses until the age of 6. It affects other areas besides the palms and soles, but tends to regress and stabilise spontaneously.
Papillon-Lefevre variant
It is inherited autosomal recessively. It occurs in children between 2 and 4 years of age. Associated conditions are parodontosis and tooth loss. Lesions also involve other areas besides the palms and soles.
Vohwinkel syndrome
Is inherited in an autosomal dominant fashion. It is likely that the condition is associated with an involucrin mutation. It occurs in the early years of life and causes spontaneous amputation of the phalanges of the hands. Hearing impairment is often a comorbid condition. Congenital nail thickening is inherited autosomal dominantly.
Psoriasis, photo: panthermedia
The main symptom is thickening of the nail plates along with subungual hyperkeratosis and the soles. The condition is often accompanied by excessive sweating. Typically, lesions are already visible in newborns. Oral mucosal lesions, hair thinning, dental and corneal lesions may also be present.
