ICD-10: L85.1

Acquired keratosis palmaris et plantaris, classified under ICD-10 code L85.1, is a dermatological condition characterized by thickened skin on the palms of the hands and the soles of the feet. This condition can manifest in various ways, and understanding its clinical presentation, signs, symptoms, and patient characteristics is essential for accurate diagnosis and management.

Clinical Presentation

Acquired keratosis palmaris et plantaris typically presents as localized or diffuse thickening of the skin on the palms and soles. The condition may be asymptomatic or associated with discomfort, particularly when pressure is applied, such as during walking or gripping objects. The skin may appear dry, scaly, and may have a yellowish or brownish hue.

Signs

1. Hyperkeratosis: The most prominent sign is the thickening of the stratum corneum, which can be observed as rough, raised patches on the palms and soles.
2. Fissuring: In more severe cases, the thickened skin may develop fissures or cracks, leading to potential pain and secondary infections.
3. Color Changes: The affected areas may exhibit changes in pigmentation, often appearing darker than the surrounding skin.
4. Distribution: The keratosis is typically bilateral and symmetrical, affecting both palms and soles equally.

Symptoms

Patients with acquired keratosis palmaris et plantaris may experience a range of symptoms, including:

• Pain or Discomfort: Thickened skin can lead to pain, especially during activities that involve pressure on the hands or feet.
• Itching or Burning Sensation: Some patients report itching or a burning sensation in the affected areas.
• Sensitivity: Increased sensitivity in the thickened areas may occur, particularly if fissures are present.

Patient Characteristics

Acquired keratosis palmaris et plantaris can affect individuals of various ages and backgrounds, but certain characteristics may be more prevalent:

1. Age: This condition is often seen in adults, particularly those over the age of 30, although it can occur in younger individuals as well.
2. Occupation: Individuals with occupations that involve repetitive hand or foot use, such as manual laborers or athletes, may be more susceptible due to increased friction and pressure on the skin.
3. Skin Type: Patients with thicker skin or a history of skin conditions may be at higher risk for developing keratosis.
4. Genetic Factors: A family history of similar skin conditions may predispose individuals to acquired keratosis.

Conclusion

Acquired keratosis palmaris et plantaris (ICD-10 code L85.1) is characterized by thickened, often painful skin on the palms and soles. Recognizing the clinical signs and symptoms, along with understanding patient characteristics, is crucial for effective diagnosis and treatment. Management may involve topical treatments, lifestyle modifications, and in some cases, procedural interventions to alleviate symptoms and improve skin appearance. If you suspect you or someone you know may have this condition, consulting a dermatologist for a thorough evaluation and personalized treatment plan is advisable.

Acquired keratosis, specifically referred to in the ICD-10 coding system as L85.1, encompasses a range of conditions characterized by thickened skin on the palms and soles. This condition is also known as keratoderma palmaris et plantaris. Below are alternative names and related terms associated with this diagnosis.

Alternative Names

1. Palmoplantar Keratoderma: This term is often used interchangeably with acquired keratosis palmaris et plantaris and refers to the thickening of the skin on the palms and soles.
2. Acquired Palmoplantar Keratoderma: This is a more specific term that emphasizes the acquired nature of the condition, distinguishing it from hereditary forms.
3. Keratoderma: A broader term that refers to any thickening of the skin, which can occur in various forms and locations on the body.

Related Terms

1. Epidermal Thickening: This term describes the general condition of thickened skin, which can be a symptom of various dermatological issues, including keratoderma.
2. Hyperkeratosis: This term refers to an increase in the thickness of the outer layer of the skin (the stratum corneum) and can be a feature of keratoderma.
3. Callus Formation: While not synonymous, calluses can occur on the palms and soles and represent localized thickening of the skin due to friction or pressure, similar to keratoderma.
4. Ichthyosis: A group of skin disorders characterized by dry, scaly skin, which can sometimes be confused with keratoderma but has different underlying causes.

Clinical Context

Acquired keratosis palmaris et plantaris (L85.1) can arise from various factors, including environmental influences, friction, or underlying systemic conditions. Understanding the terminology surrounding this condition is crucial for accurate diagnosis and treatment.

In summary, L85.1 is associated with several alternative names and related terms that reflect its clinical presentation and underlying pathology. Recognizing these terms can aid healthcare professionals in communication and documentation regarding this skin condition.

Acquired keratosis, specifically referred to as keratoderma palmaris et plantaris, is a dermatological condition characterized by thickening of the skin on the palms of the hands and the soles of the feet. This condition is classified under the ICD-10 code L85.1, which is part of the broader category of acquired keratoses.

Clinical Description

Definition

Acquired keratosis palmaris et plantaris is a condition that results in the development of thick, often rough patches of skin on the palms and soles. This thickening is due to an increase in the keratin layer of the epidermis, which can be a response to various environmental factors, friction, or pressure.

Symptoms

Patients with this condition may experience:
- Thickened skin: The most prominent feature is the thickening of the skin, which can appear yellowish or grayish.
- Rough texture: The affected areas may feel rough to the touch.
- Cracking or fissuring: In severe cases, the thickened skin can crack, leading to pain or discomfort.
- Itching or irritation: Some individuals may experience itching or irritation in the affected areas.

Etiology

The exact cause of acquired keratosis palmaris et plantaris can vary, but it is often associated with:
- Genetic predisposition: Some individuals may have a hereditary tendency to develop keratoderma.
- Environmental factors: Repeated friction or pressure on the palms and soles, such as from manual labor or certain sports, can contribute to the development of this condition.
- Underlying health conditions: Certain systemic diseases, such as psoriasis or eczema, may also lead to keratoderma.

Diagnosis

Diagnosis of L85.1 typically involves a clinical examination by a healthcare provider, who will assess the appearance of the skin and may inquire about the patient's medical history and any potential environmental exposures. In some cases, a skin biopsy may be performed to rule out other conditions.

Treatment

Treatment options for acquired keratosis palmaris et plantaris may include:
- Topical therapies: Keratolytic agents, such as salicylic acid or urea, can help to soften and remove the thickened skin.
- Moisturizers: Regular use of emollients can help to keep the skin hydrated and reduce cracking.
- Avoidance of irritants: Identifying and avoiding activities that exacerbate the condition can be beneficial.
- In severe cases: More aggressive treatments, such as laser therapy or surgical intervention, may be considered.

Conclusion

Acquired keratosis palmaris et plantaris (ICD-10 code L85.1) is a condition marked by thickened skin on the palms and soles, often resulting from environmental factors or genetic predisposition. While it can be uncomfortable, various treatment options are available to manage symptoms and improve skin appearance. Regular consultation with a healthcare provider is essential for effective management and to rule out any underlying conditions that may contribute to the keratosis.

Acquired keratosis, specifically keratoderma palmaris et plantaris, is classified under the ICD-10 code L85.1. This condition is characterized by thickening of the skin on the palms of the hands and the soles of the feet. The diagnosis of this condition typically involves several criteria, which can be categorized into clinical evaluation, patient history, and sometimes histopathological examination.

Clinical Evaluation

1. Physical Examination: A thorough examination of the skin on the palms and soles is essential. Clinicians look for:
   - Hyperkeratosis: Thickened skin that may appear dry, scaly, or cracked.
   - Distribution: The keratosis is usually localized to the palms and soles, distinguishing it from other forms of keratosis that may affect different areas of the body.

2. Symptoms: Patients may report symptoms such as:
   - Pain or Discomfort: Thickened skin can lead to discomfort, especially when walking or using the hands.
   - Itching or Burning Sensation: Some patients may experience these sensations, which can indicate inflammation.

Patient History

1. Medical History: A detailed medical history is crucial. Clinicians will inquire about:
   - Duration of Symptoms: How long the patient has been experiencing symptoms can help determine the chronicity of the condition.
   - Previous Skin Conditions: A history of other dermatological issues may provide context for the current diagnosis.

2. Family History: Genetic predisposition can play a role in keratoderma, so understanding family history of similar skin conditions is important.

3. Environmental Factors: Exposure to irritants or allergens, occupational hazards, or lifestyle factors (such as frequent hand washing or use of certain chemicals) may contribute to the development of keratosis.

Histopathological Examination

In some cases, a biopsy may be performed to confirm the diagnosis. The histopathological examination can reveal:
- Acanthosis: Thickening of the stratum corneum (the outermost layer of the skin).
- Hyperkeratosis: An increase in keratin production, which is a hallmark of keratoderma.

Differential Diagnosis

It is also important to differentiate acquired keratosis from other skin conditions that may present similarly, such as:
- Psoriasis: Characterized by red, scaly patches that may also affect the palms and soles.
- Eczema: Can cause thickened skin but usually presents with inflammation and itching.

Conclusion

The diagnosis of acquired keratosis (ICD-10 code L85.1) involves a comprehensive approach that includes clinical evaluation, patient history, and, if necessary, histopathological examination. By carefully assessing these criteria, healthcare providers can accurately diagnose and manage this condition, ensuring appropriate treatment and care for affected individuals.

Acquired keratosis, specifically palmaris et plantaris keratoderma, is a condition characterized by thickened skin on the palms of the hands and the soles of the feet. This condition is classified under the ICD-10 code L85.1. Treatment approaches for this condition can vary based on the severity of the keratosis and the individual patient's needs. Below, we explore standard treatment options and management strategies.

Understanding Acquired Keratosis

Acquired keratosis, particularly palmaris et plantaris keratoderma, can manifest as localized or diffuse thickening of the skin. It may be associated with various underlying conditions, including genetic factors, environmental influences, or systemic diseases. The primary goal of treatment is to alleviate symptoms, improve skin appearance, and prevent complications such as pain or secondary infections.

Standard Treatment Approaches

1. Topical Treatments

Topical therapies are often the first line of treatment for acquired keratosis. These may include:

• Keratolytics: Agents such as salicylic acid or urea are commonly used to soften and remove the thickened skin. Salicylic acid helps to exfoliate the outer layer of skin, while urea hydrates and breaks down the keratin in the skin[1].

• Retinoids: Topical retinoids, such as tretinoin, can promote cell turnover and help reduce the thickness of the skin. They may also improve the overall texture and appearance of the affected areas[2].

• Moisturizers: Regular use of emollients can help maintain skin hydration and prevent further thickening. Products containing ingredients like glycerin or lanolin are beneficial[3].

2. Physical Treatments

In more severe cases, physical treatments may be necessary:

• Cryotherapy: This involves freezing the keratotic lesions with liquid nitrogen, which can effectively reduce the thickness of the skin[4].

• Laser Therapy: Certain laser treatments can target thickened skin and promote smoother skin texture. This method is particularly useful for patients who do not respond to topical treatments[5].

• Electrosurgery: This technique uses electrical currents to remove thickened skin and can be effective for localized lesions[6].

3. Systemic Treatments

For patients with extensive keratoderma or those associated with systemic conditions, systemic treatments may be considered:

• Oral Retinoids: In cases where topical treatments are ineffective, oral retinoids like acitretin may be prescribed. These medications can significantly reduce keratin production and improve skin condition[7].

• Immunosuppressants: In certain cases, particularly when keratoderma is associated with autoimmune conditions, immunosuppressive therapy may be indicated[8].

4. Lifestyle and Home Care

In addition to medical treatments, lifestyle modifications can play a crucial role in managing symptoms:

• Footwear Choices: Wearing well-fitting shoes and using protective pads can help reduce pressure on the feet, alleviating discomfort associated with keratoderma[9].

• Regular Skin Care: Establishing a daily skin care routine that includes gentle cleansing and moisturizing can help manage symptoms and prevent flare-ups[10].

Conclusion

The management of acquired keratosis, particularly palmaris et plantaris keratoderma, involves a combination of topical, physical, and systemic treatments tailored to the individual patient's needs. Regular follow-up with a healthcare provider is essential to monitor the condition and adjust treatment as necessary. Patients are encouraged to adopt a comprehensive skin care regimen and make lifestyle adjustments to enhance treatment outcomes. If symptoms persist or worsen, further evaluation may be warranted to rule out underlying conditions or complications.

For those seeking more information or personalized treatment options, consulting a dermatologist is recommended.