Pain mechanisms in hereditary palmoplantar keratodermas

R. L. Weinberg, P. A. Coulombe, Michael J Polydefkis, Michael Caterina

Research output: Contribution to journalReview article

Abstract

Background: Palmoplantar keratodermas (PPKs) are a heterogeneous group of skin disorders characterized by thickening of the epidermis on the palms of the hands and soles of the feet. Individuals with PPKs report varying degrees of palmoplantar pain that can severely affect quality of life. Objectives: To provide an overview of the scope of pain in hereditary PPKs and highlight candidate mechanisms underlying this pain. Methods: In this review, we discuss several forms of hereditary PPKs, with a focus on the incidence, nature, candidate underlying mechanisms and treatment of pain in these conditions. We also synthesize this information with current understanding of the mechanisms contributing to pathological pain in other conditions. Results: Pain is a major problem for many, but not all individuals with hereditary PPK. This pain remains poorly understood, inconsistently reported and inadequately treated. The heterogeneity of pain prevalence and presentations across the many forms of PPK suggests that there may exist corresponding heterogeneity in the cellular and molecular mechanisms that drive and shape PPK-associated pain. Some candidate mechanisms include structural (e.g. fissures and blisters), infectious and immune/inflammatory processes. However, a growing body of evidence also supports the occurrence of localized neuropathic alterations in the affected skin of individuals with PPK, which might contribute to their pain. Conclusions: Greater understanding of these diverse mechanisms may provide a rational basis for the development of improved and targeted approaches to prevention and treatment of pain in individuals with PPK.

Original languageEnglish (US)
JournalBritish Journal of Dermatology
DOIs
StatePublished - Jan 1 2019

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Palmoplantar Keratoderma
Pain
Skin
Blister
Epidermis
Foot

ASJC Scopus subject areas

  • Dermatology

Cite this

Pain mechanisms in hereditary palmoplantar keratodermas. / Weinberg, R. L.; Coulombe, P. A.; Polydefkis, Michael J; Caterina, Michael.

In: British Journal of Dermatology, 01.01.2019.

Research output: Contribution to journalReview article

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