Palmoplantar keratodermas are a heterogeneous group of disorders characterized by abnormal thickening of the stratum corneum of the palms and soles. It comprises a group of disorders characterised by hyperkeratosis of palms and soles. It may be associated with several diseases and syndromes including icthyosiform dermatoses, or may not be associated with any other abnormalities. When hyperkeratosis is diffuse and involves only the entire surface of palms and soles, it is called diffuse palmo- plantar keratoderma or tylosis. It is transmitted by autosomal dominant gene and may be associated with painful fissures and hyperhidrosis. The thickening of palms and soles persists throughout the life with accentuation by trauma. When diffuse palmo-plantar keratoderma extend to the dorsum of hands and feet and is associated with variable degree of erythema, it is called Mal-de-Meleda. It is transmitted by an autosomal recessive gene and may be associated with poor physical development, koilonychia and subungual keratosis. When the hyperkeratosis is localised to multiple small punctate areas, it is called, punctate keratoderma. When keratoderma is just localised to certain areas it is called localised keratoderma.
It consists of removal of thick masses of keratoderma and keeping the area soft and supple. The drugs used in these include Alum., Ant-c., Ars., Calc., Calc-f., Graph., Lyc., Petr., Sars., Sil., Syco-co., Thyr., and X-ray.