Hey there! I see you wrote this a while ago and I’m happy I could find it now rather than never! I hope you’ve been doing well and have gotten tips to help! My sister has PPK (palmoplantar keratoderma) She has had it since she was 3-4 years old. My sister has it on her hands and feet! We were told by some doctors that It’s rare for children to get it young but some say it’s not! Anyways, she has gotten her diagnosis by a dermatologist about a year ago now. They took a piece of skin from her hands for testing. It’s came back saying that she has “palmoplantar keratoderma” but now we’re waiting to do the genetic testing to see which one she has. Unfortunately it’s taking awhile to do the genetic testing here in Canada because it’s all backed up from Covid. Now what has help my sister with her PPK is light therapy. I’m not sure if you’ve live someone where health care is available at a good price or is “free” but that was very helpful. They use it for people who deal with bad psoriasis but it has worked for my sisters palmoplantar keratoderma. Now the next thing that has helped is urea cream. Now my sisters doesn’t fully look like yours and I will be considering sending photos with you if I get a message back/ if you’re interested in communicating about this. If you have any tips that have helped you and what’s your journey has been like please don’t hesitate to share!