No Fruits or Vegetables Directly Cause Hyperkeratosis
The provided medical evidence does not identify any fruits or vegetables that cause or exacerbate hyperkeratosis. Hyperkeratosis is not caused by dietary intake of specific fruits or vegetables, but rather results from genetic conditions, nutritional deficiencies (particularly malnutrition), mechanical pressure/friction, or medication side effects.
Understanding Hyperkeratosis Causes
Primary Etiologies
Genetic disorders such as epidermolytic hyperkeratosis result from mutations in keratin genes (keratin 1 and 10), affecting approximately 1 in 200,000 infants 1
Mechanical stress from pressure points on palms, soles, and weight-bearing surfaces leads to acquired hyperkeratosis through repeated friction 2
Medication-induced hyperkeratosis occurs with chemotherapy agents (capecitabine, 5-fluorouracil, doxorubicin) and targeted therapies (BRAF inhibitors, MEK inhibitors, VEGFR inhibitors), causing palmar-plantar erythrodysesthesia syndrome 3
Nutritional Deficiency Connection
Phrynoderma (follicular hyperkeratosis) is associated with severe malnutrition rather than specific vitamin deficiencies, despite historical attribution to vitamin A deficiency 4
General malnutrition appears to be the strongest association with follicular hyperkeratosis, not the absence of specific fruits or vegetables 4
Multiple nutritional deficiencies (vitamins E, B, A, and essential fatty acids) may contribute, but no specific fruits or vegetables are implicated as causative agents 4
Clinical Implications
The absence of fruits and vegetables (leading to malnutrition) may contribute to hyperkeratosis, but no specific produce items cause the condition. Treatment focuses on:
Mechanical debridement with professional blade or scalpel removal by podiatrists for non-fragile lesions 2, 5
Topical keratolytics including urea 10-40% or salicylic acid 5-10% 5, 6
Pressure redistribution and cushioning to prevent recurrence 2, 5
Nutritional rehabilitation in cases of malnutrition-associated phrynoderma 4
Important Caveat
Avoid aggressive blade debridement in epidermolytic hyperkeratosis as it can cause severe complications; use conservative debridement with emery boards only after soaking in warm saline water 2, 5.