Palmoplantar keratoderma with growth hormone deficiency

Palmoplantar keratoderma (PPK) is a diverse group of disorders, characterized by thickening of the palms and soles, which are subdivided into focal or diffuse; it can be acquired or hereditary. Syndromic association of PPK is described in literature with all patterns of inheritance. Skin and nail changes, predisposition to malignancy, skeletal deformities, dwarfism and enamel abnormalities are rarely associated with PPK. In this case report, we present monozygotic twin sisters with palmoplantar keratoderma and growth hormone deficiency. We speculate a common mutation leading to these two apparently unrelated entities.