de Azevedo Thales Pereira, Sodré Celso Tavares, Santangelo Christiana de Lima, Quintella Danielle Carvalho, Cuzzi Tullia, Ramos-E-Silva Marcia
Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
J Cosmet Dermatol. 2020 Aug;19(8):2006-2010. doi: 10.1111/jocd.13248. Epub 2019 Dec 20.
Spiny keratoderma shows "music box spine" keratotic papules limited to the palms and soles and these lesions do not cause any trouble besides the cosmetic impairment and the sensation of roughness of hands and soles.
To present cases and review the literature on spiny keratoderma.
PATIENTS/METHODS, RESULTS: Three cases of spiny keratoderma are presented. The first case is a 52-year-old man with protein S deficiency presented with multiple spiny keratotic papules on palms and soles for more than 30 years, referring to remove them with a razor blade. The second case is an 84-year-old man who was hospitalized due to a rectal adenocarcinoma diagnosed 2 months before and presented multiples papules on palms and soles that were present for more than 50 years, with worsening after being bedridden. The third case is a 59-year-old woman who had since birth together with relatives the same type of spiny keratotic papules on palms and soles.
The authors discuss the epidemiologic data and differential diagnosis of spiny keratoderma, as well as the related literature. Associations with systemic disease or malignancy occur in some acquired cases. It is important to distinguish from other palmoplantar keratodermas as some of that can be linked to cutaneous and internal malignancies. To date, no cases of spiny keratoderma in patients with protein S deficiency and only one case of association with rectal carcinoma have been reported.
棘状角化病表现为局限于手掌和足底的“音乐盒样棘状”角化性丘疹，除了造成美观损害以及手部和足底粗糙感外，这些损害不会引起任何不适。
介绍棘状角化病的病例并复习相关文献。
患者/方法、结果：介绍了3例棘状角化病病例。第1例为一名52岁男性，患有蛋白S缺乏症，手掌和足底出现多个棘状角化性丘疹30多年，自述用剃须刀片去除过这些丘疹。第2例为一名84岁男性，因2个月前诊断出的直肠腺癌住院，手掌和足底出现多个丘疹已有50多年，卧床后病情加重。第3例为一名59岁女性，自出生起手掌和足底就与亲属有相同类型的棘状角化性丘疹。
作者讨论了棘状角化病的流行病学数据、鉴别诊断以及相关文献。在一些后天性病例中存在与系统性疾病或恶性肿瘤的关联。将其与其他掌跖角化病相鉴别很重要，因为其中一些可能与皮肤和内部恶性肿瘤有关。迄今为止，仅报道过1例蛋白S缺乏症患者患棘状角化病的病例，以及1例与直肠癌相关的病例。
