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Dermatology
Painful thickening of the soles: importance of keeping a wide differential
  1. G Ege Eskibozkurt1,2 and
  2. Allen Shih1,2
  1. 1Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to G Ege Eskibozkurt; geskibozkurt{at}hms.harvard.edu

Abstract

Acquired plantar keratoderma refers to the hyperkeratotic plaques on the soles of the feet, which can result from a variety of underlying conditions. Psoriasis, allergic or irritant contact dermatitis and eczema are several causes of acquired plantar psoriasis. This case report describes a female patient in her 50s with plantar keratoderma, initially attributed to psoriasis that was recalcitrant to systemic treatments. Subsequent evaluation suggested the possibility of contact dermatitis triggered by footwear. Allergen avoidance and supportive management led to clinical improvement. This case highlights the critical importance of considering environmental irritants and allergens in the evaluation and management of refractory acquired keratoderma.

  • Dermatology
  • Psoriasis

https://doi.org/10.1136/bcr-2025-264861

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, and critical revision for important intellectual content: GEE and AS. The following authors gave final approval of the manuscript: GEE and AS. Guarantor: GEE.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.