Hypothyroidism can present with a wide range of nonspecific symptoms, some of which
are cutaneous. However, hypothyroidism presenting as isolated palmar hyperkeratosis
is rarely described in the literature. Here, we describe a 30-year-old male who presented
with hyperkeratosis and painful fissures of both palms for 1½ years' duration. He
had minimal relief with keratolytic agents. On physical examination, he was found
to have bradycardia and when investigated he was found to have severe hypothyroidism.
A diagnosis of autoimmune hypothyroidism was made after further laboratory studies.
He was treated with thyroxine, and a gradual improvement of hyperkeratosis was noted
over a period of 3 months. Although extremely rare, clinicians should consider hypothyroidism
as a cause of hyperkeratosis, especially when it is refractory to treatment and/or
there are other possible symptoms of hypothyroidism.
Keywords
Hypothyroidism - palmar hyperkeratosis - secondary palmoplantar hyperkeratosis
