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Multiple Minute Digitate Hyperkeratoses Clinical Presentation

  • Author: Annie Wester, MS; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Oct 30, 2015
 

History

Patients with minute digitate hyperkeratosis (spiny hyperkeratosis) report multiple tiny spiky hyperkeratotic projections. Sometimes, small domed papules can be seen. Patients rarely report any other symptomatology.

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Physical

Lesions of minute digitate hyperkeratosis (spiny hyperkeratosis) are white, yellow, brown, or flesh colored nonfollicular spicules. They are occasionally flat-topped, dome shaped, or crateriform papules. They generally measure 0.5-5 mm long and 0.3-3 mm in diameter. Most reported cases note presence on the trunk and limbs, with sparing of the face and palmoplantar surfaces. However, no evidence-based review has been performed on the location of multiple minute digitate hyperkeratosis.

Multiple minute digitate hyperkeratosis. PublishedMultiple minute digitate hyperkeratosis. Published with permission granted from and with copyright retained by the American Medical Association. Clark JL, Davis G, Bennett DD. Arch Dermatol. 2008 Aug;144(8):1051-6.
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Causes

No one cause of minute digitate hyperkeratosis (spiny hyperkeratosis) is known. Some current theories and thoughts on the etiology are discussed in Pathophysiology.

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Contributor Information and Disclosures
Author

Annie Wester, MS Loyola University, Chicago Stritch School of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Rashid M Rashid, MD, PhD Director, Mosaic Clinic Hair Transplant Center of Houston

Rashid M Rashid, MD, PhD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Texas Dermatological Society, International Society of Hair Restoration Surgery, Council for Nail Disorders, Houston Dermatological Society

Disclosure: Nothing to disclose.

James W Swan, MD Associate Professor of Medicine, Division of Dermatology, Loyola University Stritch School of Medicine; Attending Physician, Loyola University Medical Center; Attending Physician, Section of Dermatology, Hines Veterans Affairs Medical Center

James W Swan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Contact Dermatitis Society, Chicago Dermatological Society

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Timothy McCalmont, MD Director, UCSF Dermatopathology Service, Professor of Clinical Pathology and Dermatology, Departments of Pathology and Dermatology, University of California at San Francisco; Editor-in-Chief, Journal of Cutaneous Pathology

Timothy McCalmont, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society of Dermatopathology, California Medical Association, College of American Pathologists, United States and Canadian Academy of Pathology

Disclosure: Received consulting fee from Apsara for independent contractor.

References
  1. Caccetta TP, Dessauvagie B, McCallum D, Kumarasinghe SP. Multiple minute digitate hyperkeratosis: a proposed algorithm for the digitate keratoses. J Am Acad Dermatol. 2012 Jul. 67 (1):e49-55. [Medline].

  2. Weibel L, Berger M, Regenass S, Kamarashev J, Hafner J, French LE. Follicular spicules of the nose and ears--quiz case. Arch Dermatol. 2009 Apr. 145(4):479-84. [Medline].

  3. Benoldi D, Zucchi A, Allegra F. Multiple minute digitate hyperkeratoses. Clin Exp Dermatol. 1993 May. 18(3):261-2. [Medline].

  4. Mueller KK, Yeager JK. Clinical considerations in digitate dermatosis. Int J Dermatol. 1997 Oct. 36(10):767-8. [Medline].

  5. Miller A, Aires D, Fraga G. Multiple minute digitate hyperkeratoses: a case report. Dermatol Online J. 2011. 17(5):1. [Medline].

  6. Ramselaar C, Toonstra J. Multiple minute digitate hyperkeratoses report of two cases with an updated review and proposal for a new classification. Eur J Dermatol. 1999 Sep. 9(6):460-5. [Medline].

  7. Holzer AM, Hughey LC. Trichodysplasia of immunosuppression treated with oral valganciclovir. J Am Acad Dermatol. 2009 Jan. 60(1):169-72. [Medline].

  8. Caccetta TP, Dessauvagie B, McCallum D, Kumarasinghe SP. Multiple minute digitate hyperkeratosis: A proposed algorithm for the digitate keratoses. J Am Acad Dermatol. 2010 Nov 1. [Medline].

  9. Bordel-Gomez M. Palmoplantar spiny keratoderma associated with chronic lymphoid leukaemia. J Eur Acad Dermatol Venereol. 2008 Dec. 22(12):1507-8. [Medline].

  10. Takagawa S, Satoh T, Yokozeki H, Nishioka K. Multiple minute digitate hyperkeratoses. Br J Dermatol. 2000 May. 142(5):1044-6. [Medline].

  11. Zarour H, Grob JJ, Andrac L, Bonerandi JJ. Palmoplantar orthokeratotic filiform hyperkeratosis in a patient with associated Darier's disease. Classification of filiform hyperkeratosis. Dermatology. 1992. 185(3):205-9. [Medline].

  12. Torres G, Behshad R, Han A, Castrovinci AJ, Gilliam AC. "I forgot to shave my hands": A case of spiny keratoderma. J Am Acad Dermatol. 2008 Feb. 58(2):344-8. [Medline]. [Full Text].

  13. Sriprakash K, Yong-Gee S. Multiple minute digitate hyperkeratoses associated with paraproteinaemia. Australas J Dermatol. 2008 Nov. 49(4):233-6. [Medline].

  14. Balus L, Donati P, Amantea A, Breathnach AS. Multiple minute digitate hyperkeratosis. J Am Acad Dermatol. 1988 Feb. 18(2 Pt 2):431-6. [Medline].

  15. Cox NH, Ince P. Transient post-inflammatory digitate keratoses. Clin Exp Dermatol. 1989 Mar. 14 (2):170-2. [Medline].

  16. Rubegni P, De Aloe G, Pianigiani E, Cherubini-Di Simplicio F, Fimiani M. Two sporadic cases of idiopathic multiple minute digitate hyperkeratosis. Clin Exp Dermatol. 2001 Jan. 26(1):53-5. [Medline].

  17. Goldstein N. Multiple minute digitate hyperkeratoses. Arch Dermatol. 1967 Dec. 96(6):692-3. [Medline].

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Multiple minute digitate hyperkeratosis. Published with permission granted from and with copyright retained by the American Medical Association. Clark JL, Davis G, Bennett DD. Arch Dermatol. 2008 Aug;144(8):1051-6.
Multiple minute digitate hyperkeratosis. Published with permission granted from and with copyright retained by the American Medical Association. Clark JL, Davis G, Bennett DD. Arch Dermatol. 2008 Aug;144(8):1051-6.
 
 
 
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