The biopsy specimen revealed large cystic spaces within the dermis. Two cell layers of the cystic wall were evident: outer cuboidal cells and inner columnar cells with decapitation secretion. These findings were consistent with multiple apocrine hidrocystomas. A diagnosis of Schopf-Schulz-Passarge syndrome was made. For skin cancer prophylaxis and possible treatment of both hyperkeratosis and apocrine hidrocystomas, acitretin therapy (25 mg/d) was initiated. There was minimal improvement of the hyperkertosis, and the acitretin therapy was discontinued.