# A case report of palmoplantar keratoderma in a 3-year-old girl: A structured approach in primary care settings

## TL;DR

A 3-year-old girl with thickened palms and soles was found to have hereditary, not acquired, palmoplantar keratoderma, highlighting the need for better diagnosis in primary care.

## Contribution

The case emphasizes the importance of a structured approach in primary care to distinguish hereditary from acquired PPK.

## Key findings

- The girl's condition was linked to a family history, indicating a hereditary cause.
- A structured diagnostic approach in primary care can improve patient outcomes and reduce healthcare costs.
- Hereditary PPK remains underexplored in medical literature.

## Abstract

Palmoplantar keratoderma (PPK) is a dermatological disorder characterised by excessive thickening of the palms and soles, encompassing more than 20 conditions. The disease is often misdiagnosed in primary care settings, leading to unnecessary treatments and delays. We present the case of a 3-year-old girl with skin thickening on both her palms and soles persisting for 2 years, initially believed to be an acquired condition. Subsequent evaluation revealed a family history of similar skin lesions. This case report highlights the crucial role of family physicians in differentiating hereditary from acquired PPK, especially in settings where advanced testing is unavailable. Implementing a structured diagnostic approach at the primary care level can significantly improve patient management and reduce morbidities and healthcare costs. This case contributes to the existing knowledge in this field, where hereditary PPK remains underexplored.