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Off-Center Fold
January 2006

Asymptomatic Lesions on the Hands—Quiz Case

Author Affiliations


Arch Dermatol. 2006;142(1):101-106. doi:10.1001/archderm.142.1.101-g

A 62-year-old woman presented with a 20-year history of progressively enlarging asymptomatic lesions that had been progressing in a linear fashion across the lateral aspect of her palms, between the thumb and the index finger. Her medical history was significant only for mild eczema, which was controlled with topical steroid therapy. She was otherwise healthy and was not taking any medications. She worked as an elementary school teacher and played tennis recreationally.

Physical examination revealed linear, symmetrical plaques on the lateral aspect of both hands (Figure 1). These plaques exhibited mild erythema, scale, and some atrophy. The distribution was limited to the medial surface of the thumb and the lateral surface of the index finger at the juncture of the palm and dorsal skin. A skin biopsy specimen was obtained from an involved area on the left index finger, near the web space of the index finger and thumb, and stained with hematoxylin-eosin (Figure 2) and the Verhoeff–van Gieson method (Figure 3).