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JAMA Dermatology Clinicopathological Challenge
September 2014

Chronic Translucent Papules of the Palms and Soles

Author Affiliations
  • 1Department of Dermatology, University of Michigan Health System, Ann Arbor
  • 2Department of Dermatopathology, University of Michigan Health System, Ann Arbor
JAMA Dermatol. 2014;150(9):1001-1002. doi:10.1001/jamadermatol.2014.208

A woman in her 50s with a medical history of asthma and seasonal allergies presented with numerous asymptomatic flesh-colored to translucent papules on her palms and palmar and lateral aspects of her fingers (Figure, A and B). Many of the papules were depressed centrally. There was no extension onto the dorsal aspect of the hands. There were similar translucent papules over the margins of her feet, particularly her great toes, and hyperkeratotic yellow plaques with scattered pits over her bilateral soles, concentrated in areas of pressure. The lesions on her hands first developed in her 40s and were exacerbated by alcohol-based hand sanitizer at work. They became more prominent with exposure to water but remained asymptomatic. Occasional application of urea cream to her feet did not lead to significant improvement. She also had fine-textured hair, present since childhood with thinning noted in the past 7 years. She had no history of eczema. At the time, she denied a family history of similar skin findings but recently reported similar hand and foot findings in her mother. Two punch biopsies were performed from the left thenar eminence (Figure, C).

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