Manjulata Dash, Manish Kumar Sahu, Tanmay Padh

BACKGROUND Acquired hyperkeratotic disorders of the palms and soles constitute a large majority of outdoor visits in Dermatology practice. Even though they can easily be identified from their morphological appearance, treating them properly needs accurate clinical diagnosis corroborated by histopathological examination. The objectives of the present study were to find out the clinical features of patients presenting with acquired hyperkeratosis over palms and soles and to correlate the findings with that of histopathological examination. MATERIALS AND METHODS It was a hospital based study where 100 patients presenting with acquired hyperkeratosis over palms and soles were included. Clinical examination was done followed by biopsy in all cases. RESULTS Male agricultural workers in their 4th and 5th decade were the most common group of patients. Eczema comprised the maximum number of cases (45%), followed by psoriasis (37%). Hyperkeratosis, parakeratosis, and acanthosis were present in all cases of psoriasis while Munro’s microabscess, pustule of Kogoj and suprapapillary thinning were found specific in 13%, 13% and 64.8% case of psoriasis respectively. Hyperkeratosis and acanthosis were seen in all cases of eczema whereas elongation of rete ridges and spongiosis were seen in 93.3% and 84.4% of cases respectively. The clinical findings matched with the histopathological findings in 75.6 % cases of psoriasis and 73.6% cases of eczema whereas the concordance was 100% in warts and callosity. CONCLUSION Hyperkeratotic lesions of palm and sole often present with typical clinical features and in cases in which they are absent, skin biopsy and special tests has to be done to aid diagnosis.