Palmoplantar keratoderma is a heterogeneous group of diseases, both hereditary and acquired, affecting, as a rule, the skin of the palms and soles in the form of focal or diffuse hyperkeratotic layers. Hereditary forms are characterized by a defect in the genes encoding certain structural components of keratinocytes, which leads to the corresponding clinical manifestations. The actual method of genomic sequencing has made it possible to identify the localization of defects in certain genes for specific types of hereditary palmoplantar keratoderma, however, despite the big step in diagnosis, therapy still remains complex and can only reduce the manifestations of the disease and improve the quality of life, and not cure it completely. The authors demonstrate a clinical case of UnnaToast keratoderma in a young patient with a long history of treatment of the disease, who showed a pronounced positive dynamics from the skin process against the background of the use of local agents, as well as the use of such a physiotherapeutic method as local PUVA therapy. In addition, the article provides a clinical case of hereditary keratoderma BuschkeFischerBrauer as an example of an accidentally diagnosed disease at a dermatologists appointment.