Progressive symmetrical erythrokeratoderma - response to topical calcipotriol

Progressive symmetrical erythrokeratoderma is characterized by well-demarcated, symmetrically distributed, erythtematous and hyperkeratotic plaques. Treatment options are topical retinoids, emollients, keratolytics and topical corticosteroids with limited or no success. Oral retinoids have been shown to be successful in some cases, but recurrence is to be expected on cessation of therapy. Topical calcipotriol is an established mode of treatment for psoriasis and also reported to be effective in many hyperkeratotic skin diseases. A 20-year-old female patient presented with reddish-brown lesions in her axillae, groins, submammary regions and on the eyelids. Clinical and histological findings were consistent with the diagnosis of progressive symmetrical erythrokeratoderma. She had noted that her lesions did not improve with topically applied steroids and emollients. We recommended our patient to use topical calcipotriol and observed a remarkable improvement within two weeks. When compared with the other treatment modalities, topical calcipotriol is a safe and effective drug with minimal side effects and it would be a good alternative.