Climacteric keratoderma: causes, symptoms, diagnosis, treatment

Climacteric keratoderma (synonyms: Haxthausen's disease, hypoestrogenic keratodermatitis of the palms and soles, postmenopausal keratoderma).

Haxthausen was the first to provide a detailed clinical description of skin changes during menopause in women in 1934 and proposed the name “Kеratodermia climacterium”.

Causes and pathogenesis. Currently, many dermatologists consider keratoderma climacteric as part of the climacteric syndrome. The occurrence of the disease is associated with hypofunction of the ovaries (fading of the function of the sex glands) and the thyroid gland. This dermatosis affects 15-20% of women.

Symptoms of climacteric keratoderma. Climacteric keratoderma occurs mainly in women. The disease is observed in women at approximately the age of 45-55, often before or during menopause, in men - between 50-60 years. The dermatosis begins with symmetrical reddening and thickening of the horny layer of the palms and soles, peeling. Furrows become accentuated, focal or diffuse keratoderma develops. In this case, the skin looks dry, painful cracks appear, and an increase in horny layers is observed along the edge of the palms and soles. Many patients experience itching, which increases at night. The clinical picture sometimes resembles horny eczema. However, the characteristic signs of eczema (the appearance of blisters, oozing, crusting, etc.) are absent. Often, climacteric keratoderma is accompanied by pathology of internal organs. The disease is cyclical - exacerbations alternate with periods of remission. In many patients, after the end of the climacteric period, the manifestations of the disease disappear.

Histopathology. Marked hyperkeratosis and slight parakeratosis are observed; acanthosis microabscesses are not observed. In the dermis, there is a varying degree of infiltrate consisting of lymphoid cells, dilated capillaries, and degeneration of elastic collagen fibers.

Differential diagnosis. Climacteric keratoderma must be distinguished from palmoplantar psoriasis, rubromycosis of the palms and soles, keratotic (horny) eczema, and palmoplantar syphilid.

Treatment of climacteric keratoderma is aimed at correcting endocrine disorders. For this purpose, estrogens and thyroid medications are used. It is recommended to take vitamin A and E (aevit) orally, take warm soda baths for hands and feet, ointments with 5-10% salicylic acid, pastes and ointments with naphthalone, tar, and corticosteroids.

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