From the Guidelines
Hyperlinear palms are a characteristic feature of certain skin conditions, including psoriasis, and are associated with an increased number and prominence of skin creases or lines on the palmar surface of the hands. This condition is often debilitating, painful, and interferes with simple functions, having a significant impact on quality of life, as noted in the guidelines of care for the management of psoriasis and psoriatic arthritis 1. Some key points to consider about hyperlinear palms include:
- They are frequently associated with palm and sole psoriasis, which affects a small percent of the total cutaneous surface but has a significant impact on quality of life 1
- The condition can be managed with intensive topical therapy under occlusion or photochemotherapy, but in some cases, oral or biologic medications may be necessary to achieve adequate improvement and long-term control 1
- Treatment options for hyperlinear palms associated with psoriasis include oral retinoids, methotrexate, and cyclosporine, although caution is needed due to potential side effects such as hepatotoxicity, bone-marrow toxicity, and nephrotoxicity 1
- Other treatment options, such as targeted phototherapy or PUVA, may also be effective in managing hyperlinear palms associated with psoriasis 1
From the Research
Definition of Hyperlinear Palms
- Hyperlinear palms refer to a condition where the palms of the hands have an increased number of lines or creases, which can be a feature of certain skin disorders.
- According to a study published in 2021 2, palmar hyperlinearity is a feature of ichthyosis vulgaris, a monogenic skin disorder caused by FLG loss-of-function mutations.
Association with Skin Disorders
- Hyperlinear palms have been associated with atopic dermatitis, with some studies suggesting that they may be a manifestation of concomitant ichthyosis vulgaris 3, 4, 5.
- However, other studies have found that hyperlinear palms are not a reliable sign of ichthyosis vulgaris, and that they can occur in patients with atopic dermatitis without concomitant ichthyosis vulgaris 3, 4, 5.
- A study published in 2020 6 discussed the clinical recognition of Ehlers-Danlos syndromes, which are a group of heritable connective tissue disorders, but did not specifically mention hyperlinear palms as a feature of these disorders.
Diagnostic Accuracy
- The study published in 2021 2 investigated the diagnostic accuracy of hyperlinear palms in detecting FLG genotype in children, and found that the presence of hyperlinear palms was not a reliable sign of FLG mutations, but that the absence of hyperlinear palms could exclude FLG null genotype with a reasonable degree of certainty.