The biopsy specimen of the lesion on the sole revealed psoriasiform epidermal proliferation, a few Pautrier microabscesses, and a dense, predominantly T-cell infiltrate in the upper dermis. Some of the lymphocytes had large irregularly shaped hyperchromatic nuclei.
The patient failed to return for scheduled follow-up until 3 months later, by which time there was not much change in the clinical appearance of the acral lesions. However, 2 slightly raised and scaly plaques had developed on his trunk. A biopsy specimen of 1 of the lesions revealed features consistent with incipient mycosis fungoides. Since then, the patient has been unavailable for follow-up.
Palmoplantar Hyperkeratotic Plaques. Arch Dermatol. 1998;134(8):1019-1024. doi: