A 72-year-old African man presented with tender, well-defined hyperkeratotic plaques on his soles and palms (Figure 1 and Figure 2). The rest of his skin was not affected. There was no lymphadenopathy and, except that the plantar lesions caused significant discomfort, he felt well. Results of laboratory investigations (a complete blood cell count, sequential 21-channel autoanalysis, chest radiography, and computed tomography of the liver and spleen) were within normal limits. A biopsy specimen was obtained from the plaque on the sole and stained with hematoxylin-eosin (Figure 3) and UCHL-1 (Figure 4).
Hannah M, Jacyk WK. Palmoplantar Hyperkeratotic Plaques. Arch Dermatol. 1998;134(8):1019-1024. doi: