A rare skin condition characterized by thickening of the soles in middle-aged women, often around menopause
What is Keratoderma Climactericum?
Keratoderma Climactericum, also known as Climacteric Keratoderma, is a localized form of keratoderma that mainly affects the soles of the feet and, less commonly, the palms of the hands. It typically occurs in middle-aged women, particularly around the time of menopause (the climacteric period).
This condition is not inherited and is considered an acquired disorder, often linked to hormonal changes, mechanical stress, or other underlying health conditions. It results in painful thickening, cracking, and hardening of the skin, particularly on the weight-bearing areas of the feet.
What causes Keratoderma Climactericum?
The exact cause is not fully understood, but several contributing factors have been identified:
- Hormonal changes during menopause
- Repeated pressure or mechanical stress on the feet (e.g., from walking or standing for long periods)
- Obesity, which increases mechanical pressure
- Poor circulation or peripheral vascular disease
- Underlying metabolic conditions, such as thyroid disorders or diabetes
- Nutritional deficiencies (like vitamin A or zinc)
It is considered a non-genetic, acquired form of palmoplantar keratoderma.
Who is at risk?
- Women aged 40–60, especially around menopause
- Individuals who are overweight or obese
- People who spend a lot of time on their feet or wear tight footwear
- Patients with diabetes, thyroid dysfunction, or vascular disease
- Those living in hot, dry climates or with a history of chronic foot irritation
What are the symptoms of Keratoderma Climactericum?
- Thickened, dry, and hardened skin on the soles (especially heels and balls of feet)
- Cracking (fissures), which may be deep and painful
- Redness, inflammation, and tenderness
- Occasionally, similar thickening may occur on the palms
- Pain may increase with walking or standing
- Secondary infections can develop in cracked skin if not treated
How is Keratoderma Climactericum diagnosed?
Diagnosis is mainly clinical, based on appearance and history. Investigations may include:
- Physical examination of affected areas
- Patient history, especially menopausal status and lifestyle
- Skin biopsy – rarely needed but may confirm the diagnosis
- Blood tests – to rule out associated metabolic or hormonal disorders (e.g., thyroid panel, blood glucose)
How is Keratoderma Climactericum treated?
Treatment focuses on symptom relief and improving skin condition. Common approaches include:
Topical treatments:
- Keratolytics – salicylic acid, urea, or lactic acid to soften thick skin
- Topical corticosteroids – to reduce inflammation and pain
- Moisturizers and emollients – used regularly to keep skin soft and hydrated
- Antibiotics or antiseptics – if cracks become infected
Lifestyle and supportive measures:
- Weight management to reduce pressure on feet
- Wearing cushioned, well-fitting footwear
- Foot soaks and gentle debridement (by a healthcare provider)
- Avoiding harsh soaps or walking barefoot on hard surfaces
Medical treatment:
- Treat any underlying condition (e.g., thyroid disorder or diabetes)
- In severe cases, oral retinoids (like acitretin) may be prescribed under specialist care
What is the prognosis for Keratoderma Climactericum?
- With consistent skin care and appropriate treatment, symptoms often improve
- It may become a chronic condition, especially if mechanical or metabolic factors persist
- If untreated, painful fissures and recurrent infections can occur
- Managing weight, hormonal balance, and skin care can significantly improve quality of life
Can Keratoderma Climactericum be prevented?
While it may not be entirely preventable, especially during hormonal changes, risk can be reduced by:
- Maintaining a healthy weight
- Wearing supportive footwear
- Using regular moisturizers to prevent skin dryness
- Managing metabolic conditions (like diabetes or thyroid disease)
- Avoiding prolonged standing or foot trauma