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May 16, 2011

Unilateral Prickly Palmar Papules—Diagnosis

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Arch Dermatol. 2011;147(5):609-614. doi:10.1001/archdermatol.2011.88-b

Histopathologic examination of the skin biopsy specimen from the left palm (Figure 2) demonstrated thin vertical columns of stacked parakeratosis above a diminished granular layer, bearing resemblance to a cornoid lamella. Keratinocyte dyskeratosis and vacuolar change were notably absent.

In 1971, Brown1 described the first case of punctuate keratotic projections on the palms and soles as “punctate keratoderma.” Since that time, this unique clinical entity has been classified under a variety of terms, including spiny keratoderma of the palms and soles, minute digitate hyperkeratosis, filiform hyperkeratosis, palmoplantar keratosis acuminata, punctuate porokeratosis, porokeratosis punctata palmaris et plantaris, and PPK.24

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