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October 1989

Punctate Porokeratotic Keratoderma

Author Affiliations

Department of Medicine Division of Dermatology UCLA Los Angeles, CA 90024-1736

2100 N Mesa St El Paso, TX 79902

Department of Dermatology Mayo Clinic Rochester, MN 55905

Arch Dermatol. 1989;125(10):1432. doi:10.1001/archderm.1989.01670220130026

To the Editor. —  The nosologic designation of numerous fine, acuminate, firm, keratotic palmoplantar papules resembling the spines of old-fashioned music box cylinders with histologic findings of a compact parakeratotic vertical column (cornoid lamella) arising from a mildly thinned stratum malpighii with little or no granular or lucid layer includes punctate keratoderma, punctate porokeratotic kera-toderma, porokeratosis punctata palmaris et plantaris, and palmoplantar keratosis acuminata.1In their article, Lestringant and Berge2 described a family in whom many members demonstrated clinical and histologic findings characteristic of these lesions, and used the term porokeratosis punctata palmaris et plantaris. Since their patients lacked annular or centrifugally expanding lesions and there was no histologic evidence of dyskeratosis, this would argue against porokeratosis. Although a cornoid lamella was present in their patients' histologic specimens, it is not specific for porokeratosis.3 They propagate the misconception that these lesions are porokeratosis and admit they

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