Keratosis punctata palmaris et plantaris (KPPP) is a simple punctuate palmoplantar keratoderma that displays autosomal dominant inheritance with variable penetrance. Lesions typically begin between early adolescence and age 30 years as 2- to 20-mm hyperkeratotic papules along the lateral margins of the digits. With time and trauma, they enlarge and distribute over the whole palmoplantar surface, often coalescing into diffuse plaques over pressure points on the plantar surface. The KPPP papules can be asymptomatic, painful, or pruritic. We report the successful treatment of KPPP with topical fluorouracil.
Yancovitz M, Pasternack FR, Ward KM, Grossman ME. Keratosis Punctata Palmaris et Plantaris Treated With Topical Fluorouracil. Arch Dermatol. 2006;142(8):1065-1086. doi:10.1001/archderm.142.8.1074