A 33-year-old white man presented with a 15-year history of persistent asymptomatic verrucous lesions on the dorsum of his hands and on the extensor aspect of his forearms. There was no involvement of his nails or palms. He reported that one of his siblings had milder involvement on the dorsum of the hands. Before presentation, he had tried topical salicylic acid and 16.7% lactic acid paint, and subsequently 5% imiquimod, with no improvement. His general health was otherwise good.