Acquired Palmoplantar Keratoderma Revealing Primary Biliary Cholangitis: Therapeutic Response to Ursodeoxycholic Acid.
- 1Dermatology Department, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, University Hospital Mohammed VI, Tangier, MAR.
Abstract
Acquired palmoplantar keratoderma (PPK) may be associated with drug exposure, inflammatory or infectious dermatoses, malignancies, and systemic disorders. Although several systemic associations have been described, its occurrence in primary biliary cholangitis (PBC) appears to be exceptionally rare. We report the case of a 36-year-old woman with no significant medical history who presented with a three-month history of diffuse, non-pruritic palmoplantar keratoderma refractory to topical therapies. Clinical examination revealed erythema with multiple punctate yellowish hyperkeratotic lesions, some coalescing into plaques, involving the palms and soles. Dermoscopy showed a pinkish background with multiple yellowish, occasionally confluent, plaque-like scales and no visible vascular pattern. Hematologic, renal, thyroid, and infectious investigations were unremarkable. Liver biochemical tests, however, revealed a cholestatic pattern, and anti-mitochondrial antibodies were positive. PBC was diagnosed based on the combination of cholestatic liver biochemistry and anti-mitochondrial antibody positivity. Treatment with oral ursodeoxycholic acid was followed by progressive improvement of the palmoplantar lesions, with marked clearing and normalization of liver biochemical tests after three months. This observation adds to the very limited literature linking acquired PPK with PBC and highlights the importance of investigating an underlying systemic disorder in otherwise unexplained or treatment-refractory acquired keratoderma.
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BibTeX
@article{dahmani2026acquired,
title = {{Acquired Palmoplantar Keratoderma Revealing Primary Biliary Cholangitis: Therapeutic Response to Ursodeoxycholic Acid.}},
author = {Hajar Dahmani and Ouiame El Jouari and Sabrina Oujdi and Salim Gallouj},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117007},
url = {https://europepmc.org/article/MED/42948682},
note = {CC BY},
}
RIS
TY - JOUR
TI - Acquired Palmoplantar Keratoderma Revealing Primary Biliary Cholangitis: Therapeutic Response to Ursodeoxycholic Acid.
AU - Hajar Dahmani
AU - Ouiame El Jouari
AU - Sabrina Oujdi
AU - Salim Gallouj
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.117007
UR - https://europepmc.org/article/MED/42948682
AB - Acquired palmoplantar keratoderma (PPK) may be associated with drug exposure, inflammatory or infectious dermatoses, malignancies, and systemic disorders. Although several systemic associations have been described, its occurrence in primary biliary cholangitis (PBC) appears to be exceptionally rare. We report the case of a 36-year-old woman with no significant medical history who presented with a three-month history of diffuse, non-pruritic palmoplantar keratoderma refractory to topical therapies. Clinical examination revealed erythema with multiple punctate yellowish hyperkeratotic lesions, some coalescing into plaques, involving the palms and soles. Dermoscopy showed a pinkish background with multiple yellowish, occasionally confluent, plaque-like scales and no visible vascular pattern. Hematologic, renal, thyroid, and infectious investigations were unremarkable. Liver biochemical tests, however, revealed a cholestatic pattern, and anti-mitochondrial antibodies were positive. PBC was diagnosed based on the combination of cholestatic liver biochemistry and anti-mitochondrial antibody positivity. Treatment with oral ursodeoxycholic acid was followed by progressive improvement of the palmoplantar lesions, with marked clearing and normalization of liver biochemical tests after three months. This observation adds to the very limited literature linking acquired PPK with PBC and highlights the importance of investigating an underlying systemic disorder in otherwise unexplained or treatment-refractory acquired keratoderma.
SN - 2168-8184
ER -