Palmoplantar keratodermas are a heterogeneous group of skin disorders characterized by abnormal thickening (scleroderma) of the stratum corneum of the palms and soles.Autosomal recessive, dominant, X-linked, and acquired forms have all been described in medical literature.[1]: 505 [2]: 211 [3] Clinically, three distinct patterns of palmoplantar keratoderma may be identified: diffuse, focal, and punctate.[1]: 505 Restated, diffuse palmoplantar keratoderma is an autosomal dominant disorder in which hyperkeratosis is confined to the palms and soles.[4] The two major types can have a similar clinical appearance:[4] Focal palmoplantar keratoderma, a type of palmoplantar keratoderma in which large, compact masses of keratin develop at sites of recurrent friction, principally on the feet, although also on the palms and other sites, a pattern of calluses that may be discoid (nummular) or linear.