Spiny keratoderma (SpK) is a rare skin condition characterized by spine-like papules on the palms and soles. The condition is identified under several names such as "music box spine keratosis" and "palmoplantar filiform hyperkeratosis," creating ambiguity in the diagnostic and histopathologic features of the disease. In this study, we reviewed 84 cases of SpK to examine patient demographics, medical history, clinical and histopathological descriptions, and sporadic versus hereditary onset. Notably, the most used histopathological terms were "parakeratosis" and "hypogranulosis," and the most used clinical terms were "spine" and "hyperpigmented." The average age at presentation was 60.1 years with the majority of cases in males. Only 29.8% of cases were associated with a family history of SpK and underlying malignancies were present in 28.6% of cases. This review investigates the frequency of histopathologic and clinical terms used to describe SpK to provide insight into the clinical and histopathological characteristics of this rarely reported condition.

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http://dx.doi.org/10.1111/cup.14392DOI Listing

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Article Synopsis
  • * Histological analysis shows these lesions are made up of distinct columns of abnormal keratin on a thin outer skin layer, and sporadic cases may be linked to chronic illnesses or cancers.
  • * A case study describes an elderly man with liver cirrhosis and cancer who experienced a remission of skin lesions two months after a liver transplant, suggesting the condition may relate to his cancer diagnosis.
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Article Synopsis
  • - Spiny keratoderma is a rare skin condition characterized by small, spiny growths on the palms and soles, which can be inherited or acquired.
  • - The acquired form may be linked to other health issues but not necessarily to cancer, and it can be confused with similar skin conditions like arsenical keratosis.
  • - This article discusses three cases of acquired spiny keratoderma in patients with different systemic diseases, highlighting that none had underlying malignancies.
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Spiny keratoderma is a rare skin condition that presents on the palmar and plantar surfaces of the hands and/or feet. This condition is difficult to appreciate under ambient lighting but can be both physically and emotionally distressing to patients. Furthermore, because of the association with various neoplasms and systemic diseases, timely diagnosis and appropriate follow-up is of importance.

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