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Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 12-14

Remarkable improvement of palmar hyperkeratosis to thyroxine replacement in a patient with severe undiagnosed severe hypothyroidism

1 Department of Family Medicine, Our Family Clinic, Idukki, Kerala, India
2 Department of Internal Medicine, CSI Holdsworth Memorial Hospital, Mangalore, Karnataka, India

Correspondence Address:
Dr. Akesh Thomas
Poovannal, Nedumkandam, Kumily, Idukki - 685 553, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jdep.jdep_6_18

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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.

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