Puzzling palmar papules and pits

Treatment options: keratolytic agents may help temporarily

The mainstay of therapy is informing the patient of the benign nature of the diagnosis and avoiding unnecessary and unhelpful therapies and diagnostic modalities. Therapy with keratolytic agents or systemic retinoids may temporarily improve symptoms of KPPC.

However, lesions tend to recur when the medications are stopped or decreased.^5,7 Temporizing treatment of symptomatic keratoses, such as applying emollients and paring them, is all that is usually necessary. Systemic retinoids have far too many side effects to consider using in this completely benign condition.

Patient outcome

The patient was reassured by the explanation of the condition and chose to try a keratolytic/emollient agent, Lac-Hydrin, for symptomatic recurrences. At her last visit for another health issue, she has reported this to be helpful.

Acknowledgments

The authors would like to acknowledge the unfailingly cheerful cooperation and expert assistance of the St. Vincent Mercy Medical Center library staff.

Corresponding author
Gary N. Fox, MD, 2200 Jefferson Avenue, Toledo, OH 43624. E-mail: foxgary@yahoo.com.