title: Ulcerating plantar keratoderma in association with systemic lupus erythematosus.
abstract: This report highlights the finding of ulcerative plantar keratoderma in two patients with systemic lupus erythematosus (SLE). Both patients suffered from painful plantar ulcerations and fissures; in one patient there was diffuse desquamation over the entire plantar surface, while the other patient's lesions were focal and accentuated over weight-bearing surfaces. Other etiologies for keratoderma including papulosquamoua disease, contact dermatitis, tinea and primary keratodermas were excluded. Both patients were resistant to multiple topical therapies including super-potent topical corticosteroids, vitamin D analogues and retinoids, but did report moderate relief with hydrocolloid dressings applied over super-potent topical corticosteroids and pressure off-loading measures. Lupus-associated keratoderma can be recurrent and recalcitrant to treatment, often necessitating aggressive therapy and particular attention to advanced wound care methodologies. While not a specific cutaneous sign of lupus, it should be recognized as a cause for considerable morbidity.
authors.affiliation: Department of Dermatology, Henry Ford Health System, Detroit, Michigan 48202-2608, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Grossberg
authors.forename: L
authors.initials: L
authors.lastname: Scherschun
authors.forename: D P
authors.initials: DP
authors.lastname: Fivenson
mesh_terms: D000368:Aged; D005260:Female; D016523:Foot Ulcer / Q000150:complications*; D006801:Humans; D007645:Keratoderma, Palmoplantar / Q000150:complications*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged