Since being diagnosed with Ledderhose and Dupuytren’s, I have developed numerous tiny papules on my palms and in my palm and finger creases. They often dry up and leave tiny pits in the palm and its creases. I believe it is keratosis punctata of the palmar creases (KPPC) and keratosis punctata palmaris et plantaris (KPPP). I am working to secure an appointment with a dermatologist, but the wheels of medicine turn at a glacial pace here in Canada. My GP is baffled.

Literature seems to suggest these conditions are associated with Dupuytren’s (references below); however, after examining 100s of palm photos from the various LD and DD support group sites, I haven’t seen a single palm that looks like mine.

I’m wondering if the ROs on the site might weigh in and tell me if this is something they’ve seen in their practice over the years? Have patients elected to proceed with treatment in spite of the conditions?

I’ve had first round of radiation on my right foot and am scheduled for a first round on my left foot in a week. (We’re doing a wait and see on my hands.) I have just noticed a papule on my right sole and am anxious that radiation may exacerbate the condition (ala the Koebner Phenomenon). I showed my hands to my RO at the masking session, and he suggested moisturizing, so no answers there. I lost my mobility rapidly with Ledderhose and see radiation as my only hope to comfortably walk again, so having this possibly throw a wrench in the plan is unnerving.

Thanks for weighing in. Have tried to attached several photos to illustrate, but can’t figure out how the process works.

1. Kladney & Johnson, Keratosis Punctata of the Palmar Creases, J Gen Intern Med., 2018 Jul 2;33(9):1582
2. Hyun Jin Mo et al., A Case of Keratosis Punctata of the Palmar Creases, Ann Dermatol, 2002, 14(2) 114-116
3. De D et al, Asymptomatic Palmar Pits: Clinical Evaluation of Six Cases and Review of the Literature. Journal of Cutaneous Medicine and Surgery. 2008;12(4):198-202).

Edited 03/10/2025 02:44

Thanks for your reply. I’d love to include photos, but can’t figure out how to do so. I’ve converted to jpeg so they’re smaller and have clicked on “choose file” button. It seems like I can only add one photo but not more because I can’t choose multiple to attach and when I try to add another it erases the first. Then, when I publish my post, the photo doesn’t show. Working on an iPad so maybe it’s a compatibility thing?


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spanishbuddha:

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Hi SAB,

I've not previously heard of this condition, so no knowledge of an association with Dupuytrens. In very bright sunlight I see numerous tiny small white 'spots' below the surface of the skin on my palms, which I do associate with my own DD condition, but these spots are not just along the palmar creases, do not come and go, cannot be felt and don't bother me at all. I might try to catch them in a photo if the sun ever returns this year!

If you have a moment maybe you can explain what does or doesn't happen, when you try to upload a photo via the attachment button? Note the restrictions on file formats and size.

Thanks SB