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To the Editor.—
I appreciate Dr. Arnold's thoughtfulness in sending a copy of his Letter to the Editor in reply to our paper, "Hyperkeratosis Penetrans," which appeared in the September Archives. Through exchanges of frantic correspondence, I was well aware of Dr. Arnold's revised views. An addendum, which was subsequently submitted, arrived too late for publication. Since Dr. Arnold tended to agree with his kindly Italian critic in 1947, it is not the authors' wish to add another possible atypical case of Kyrle's disease to the medical literature. As was intimated in our paper, I personally would concur with his revised opinion that both cases probably represent mere variants of keratosis punctata palmaris. With this admission goes a feeling somewhat akin to Noah, standing on the shore, watching his ark sail away. However, the differential list of patients with "palmar pits" continues to lengthen in the literature. We all must
Skipworth GB. HYPERKERATOSIS PENETRANS. Arch Dermatol. 1968;98(6):684. doi:10.1001/archderm.1968.01610180127030