Abnormal keratin expression in circumscribed palmar hypokeratosis

Background Circumscribed palmar or plantar hypokeratosis (CPH) is a rare skin disorder only recently described. Objective To determine the diagnostic features and to provide insight into the pathogenesis of CPH, with analysis of two new Japanese cases. Methods Dermoscopy, immunohistochemistry, elect...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2007-08, Vol.57 (2), p.285-291
Main Authors: Ishiko, Akira, MD, PhD, Dekio, Itaru, MD, PhD, Fujimoto, Atsushi, MD, Kameyama, Kaori, MD, PhD, Sakamoto, Mitsuo, PhD, Benno, Yoshimi, DVM, PhD, Amagai, Masayuki, MD, PhD, Nishikawa, Takeji, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Bacteria - genetics
Biological and medical sciences
Dermatology
DNA, Viral - analysis
Dyskeratosis
Female
Hand Dermatoses - metabolism
Hand Dermatoses - microbiology
Hand Dermatoses - pathology
Humans
Immunohistochemistry - methods
Keratin-2 - metabolism
Keratins - metabolism
Keratosis - metabolism
Keratosis - microbiology
Keratosis - pathology
Medical sciences
Microscopy, Electron
Middle Aged
Papillomaviridae - genetics
Polymorphism, Restriction Fragment Length
RNA, Ribosomal, 16S - analysis
Staining and Labeling
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Summary:Background Circumscribed palmar or plantar hypokeratosis (CPH) is a rare skin disorder only recently described. Objective To determine the diagnostic features and to provide insight into the pathogenesis of CPH, with analysis of two new Japanese cases. Methods Dermoscopy, immunohistochemistry, electron microscopy, polymerase chain reaction amplification for human papillomavirus (HPV) DNA and 16S microbial rRNA gene profiling were conducted. Results Dermoscopy showed characteristic features using both dry and jelly immersion observation; step-like desquamation and a homogeneous erythema with regularly distributed whitish spots. Immunohistochemistry revealed strong staining with anti-pankeratin antibody (AE1+AE3) and anti-keratin 16 antibody, and decreased expression of keratin 2e. EM revealed a breakage of the corneocytes within their cytoplasm, but structures for cell attachment were intact. HPV and lesion-specific bacteria were not detected. Limitations The number of cases analyzed was two. Conclusion Hyperproliferative epidermal state along with enhanced corneocyte fragility may account for the unique features in CPH.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2007.02.035