hyperkeratotic

Hyperkeratotic is a dermatological term describing thickening of the stratum corneum, the outermost layer of the epidermis, due to increased keratin production or abnormal keratinization. The resulting skin findings are called hyperkeratosis and can occur in response to friction, inflammation, infection, or genetic factors.

Clinically it presents as rough, dry plaques that may be yellowish or gray and adherent to surrounding skin. Common sites include weight-bearing areas such as the soles and palms, though hyperkeratosis can occur on any part of the body.

Causes and associations include mechanical factors such as chronic pressure and friction (callus and plantar keratoderma); inflammatory or genetic skin disorders such as psoriasis and palmoplantar keratodermas; infections with human papillomavirus causing warts; and, less commonly, systemic diseases or medications.

Diagnosis is usually clinical, supported by history and examination. A skin biopsy may be performed to confirm hyperkeratosis or to exclude other conditions; histology shows thickened stratum corneum with variable accompanying changes such as acanthosis or parakeratosis.

Management aims to reduce thickness and address the cause. Treatments include regular emollients and keratolytics such as salicylic acid or urea, mechanical debridement, and protection from further friction. Warts may require cryotherapy or topical antivirals; extensive keratodermas may need systemic therapy.