Fracture Reveals a Case of Spiny Keratoderma!

Spiny keratoderma is a rare and likely underreported condition characterised by asymptomatic multiple pinpoint, keratotic projections over palms and soles. We report a case of a 50-year-old female with hereditary spiny keratoderma without any associated disease. Interestingly, the patient consulted us after a fracture of her right middle finger splinted, due to which she was unable to use her hand and wash it as usual and the consequent absence of exfoliation caused by hand usage and washing made the spines prominent. The characteristic clinical presentation with histopathologic and dermoscopic findings helped us to diagnose this case. The differential diagnosis of palmoplantar hyperkeratosis can be extensive. Therefore, it is important to distinguish spiny keratoderma from other palmoplantar hyperkeratosis.