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Mal de Meleda
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Mal de Meleda

Mal de Meleda is a rare, inherited skin disorder characterized by the thickening and hardening of the skin on the palms of the hands and soles of the feet.

Overview

Mal de Meleda is a form of palmoplantar keratoderma that begins in early infancy. The condition causes the skin on the palms and soles to become thick, hard, and callused. This thickening often extends to the back of the hands and feet, as well as the wrists and ankles.

Symptoms

  • Skin thickening: Rough, thick pads may appear on the joints of fingers and toes, as well as on elbows and knees.
  • Infections: Recurrent fungal infections in the thickened skin are common and can cause a strong odor.
  • Other features: Potential symptoms include short fingers and toes (brachydactyly), nail abnormalities, red skin around the mouth, and excessive sweating (hyperhidrosis).

Causes

The disorder is caused by mutations in the SLURP1 gene. This gene provides instructions for making the SLURP-1 protein, which acts as an epidermal neuromodulator. The protein binds to nicotinic acetylcholine receptors (nAChRs) in the skin to help control the growth, maturation, and survival of skin cells. A lack of this protein is thought to alter gene activity, leading to the overgrowth of skin cells and subsequent skin thickening.

Inheritance

Mal de Meleda is inherited in an autosomal recessive pattern. This means that an affected individual must have two mutated copies of the gene—one inherited from each parent. Parents of an affected individual typically carry one mutated copy but do not show symptoms of the condition.

Frequently Asked Questions

Yes—sequencing of the SLURP1 gene confirms the diagnosis and allows carrier testing for siblings and future children. Autosomal recessive inheritance means both parents carry one mutated copy without symptoms; each pregnancy has a 25 % chance of an affected child, a 50 % chance of a carrier, and a 25 % chance of an unaffected non‑carrier.
Keep the affected skin as dry as possible—wash with a gentle, fragrance‑free cleanser, pat dry, and apply antifungal powder or spray after bathing. Use breathable, moisture‑wicking socks and shoes, rotate footwear daily, and consider a prophylactic topical antifungal (e.g., clotrimazole 1% cream) applied to high‑risk areas.
First‑line options include daily keratolytic creams containing urea (10–20%) or salicylic acid, which help break down excess keratin. For more severe cases, oral retinoids such as acitretin can reduce keratinocyte proliferation, but they require monitoring of liver function and lipids. Physical debridement by a dermatologist combined with moisturizers can also improve texture.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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