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June 2010

Severe Palmoplantar Keratoderma—Quiz Case

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Arch Dermatol. 2010;146(6):667-672. doi:10.1001/archdermatol.2010.116-a

A 23-year-old native Algerian man presented with severe palmoplantar keratoderma that had been present since childhood. Keratotic plaques had slowly enlarged to the point that painful fissuring compromised his hand function. His medical history was remarkable for chronic asthmatiform bronchitis. There was no family history of a keratinizing disorder. Physical examination revealed confluent vegetating hyperkeratotic masses on the palms and soles, most prominently on the right hand (Figure 1). The entire cutaneous surface was covered with hypopigmented, scaling patches (Figure 2). A skin biopsy specimen was obtained from a flat lesion on the trunk (Figure 3).

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