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April 2011

Thickened Plaques on the Hands—Quiz Case

Author Affiliations

Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Dermatol. 2011;147(4):499-504. doi:10.1001/archdermatol.2011.65-a

A 71-year-old woman presented with a 20-year history of bilateral symmetric thickening and fissuring of the skin along the sides of her hands. The lesions were asymptomatic, other than tenderness from splitting of the skin and a slight reduction in range of motion of her fingers. Physical examination revealed indurated, linear, erythematous plaques along the dorsoventral juncture of her hands. The lesions extended onto the lateral aspect of her thumbs, along the web space, and onto the medial aspect of her index fingers (Figure 1). A punch biopsy was performed (Figure 2 and Figure 3).