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Multiple minute digitate hyperkeratosis, also known as digitate keratoses, disseminated spiked hyperkeratosis, familial disseminated piliform hyperkeratosis, and minute aggregate keratosis is a rare cutaneous condition, with about half of cases being familial, inherited in an autosomal dominant fashion, while the other half are sporadic.[1]
| Multiple minute digitate hyperkeratosis | |
|---|---|
| Specialty | Dermatology |
Multiple minute digitate hyperkeratosis is mostly a nonfollicular digitate keratosis that affects the limbs and trunk. There is no impact on the face or palmoplantar surfaces. The lesions consist of skin-colored, yellow, brown, or white spicules that range in length from 0.5 to 5.0 mm and diameter from 0.3 to 3.0 mm. Occasionally, flat-topped, dome-shaped, or crateriform papules are also present.[2]
Multiple minute digitate hyperkeratosis may be sporadic or familial.[2]
Histopathology reveals a stratum granulosum with varying thickness and localized orthokeratotic hyperkeratosis originating from a tented epidermis. Rarely, there have also been reports of superficial cutaneous lymphoplasmocytic infiltrates, parakeratosis, and epidermal invagination. A recurring characteristic that unites all of the cases that have been documented is the absence of follicular involvement.[3]
Reduced keratohyaline granules with varying numbers of Odland bodies are seen under electron microscopy.[3]
While improvements with various topical keratolytics and topical and oral retinoids have been reported, treatment is frequently ineffective or only temporary.[2]
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