Gentamicin improves symptoms in paediatric Nagashima-type palmoplantar keratosis

A randomised-controlled trial evaluating a topical gentamicin ointment as a therapy for children with Nagashima-type palmoplantar keratosis (NPPK) showed that the agent was well tolerated. Moreover, the efficacy data were promising, indicating that this may be an interesting therapeutic option for this patient population.

“Topical vitamin D3, topical keratolytic agents, and topical retinoids are usually unsatisfactory symptomatic therapies for patients with NPPK,” explained Dr Shan Wang (National Center for Children’s Health, China). The current trial assessed a topical gentamicin ointment as therapy for NPPK [1]. “NPPK is often caused by a nonsense mutation of SERPINB7, and this agent has displayed to suppress the founder nonsense mutation of SERPINB7 in vitro,” clarified Dr Wang [1,2]. The study included 10 children with NPPK and the experimental therapy was applied to one hand, whereas the other hand was treated with an emollient.

After 3 months of therapy, the hand that was treated with gentamicin showed significant improvements in terms of hyperkeratosis, erythema, maceration, and desquamation compared with the hand that was treated with an emollient (P<0.05). Dr Wang pointed out that these effects were already present after 1 month of therapy. In contrast, no significant differences were found regarding hyperhidrosis and odour between the 2 treatment conditions. Finally, no adverse events were reported.

The efficacy and safety of a topical gentamicin ointment in children with NPPK were encouraging in the current study. “This agent is a promising therapeutic choice in children with NPPK,” concluded Dr Wang.

1. Wang S, et al. The application of topical gentamicin ointment in treatment of Nagashima-type palmoplantar keratosis in children with nonsense mutation. Late-breaker Session 5, WCD 2023, 3–8 July, Singapore, Singapore.
2. Ohguchi Y, et al. J Invest Dermatol. 2018;138(4):836–843.