A girl in her teens presented for evaluation of asymptomatic, punctate, keratotic papules localized to the right palm and right third proximal finger that had been present since age 2 years. Prior treatments included cryotherapy, pulsed dye laser, and 40% salicylic acid, with partial improvement reported but never complete clearance. Medical history and family history were unremarkable. Physical examination revealed grouped and circumscribed, firm, skin-colored, 1- to 3-mm papules with a central punctate dark core (Figure, A and B). A 4-mm punch biopsy from a papule on the palm was performed (Figure, C and D).
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Vissing MB, Tolaymat L, Sluzevich J. Punctate Keratotic Papules on the Palm. JAMA Dermatol. 2019;155(11):1310–1311. doi:10.1001/jamadermatol.2019.2956
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