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A Case for Diagnosis (Keratoderma Palmaris? Mal de Meleda?). Presented by Dr. Robert Walton (by invitation).
A. I., a 26-yr.-old Japanese woman, first noticed thickening of the skin of her palm when she was 6 yr. old. She does not recall at what age her fingernails become dystrophic. Her palms perspire. A diagnosis of mal de Meleda was made by Dr. Niles and Dr. Clump in 1948. Biopsy findings were consistent with this diagnosis. There is no history that anyone else in the family had this condition.In addition, this patient has had hundreds of small flat warts covering her face and hands. This condition began seven years ago and has been refractory to numerous forms of therapy, such as x-ray, liquid nitrogen, smallpox vaccination, bismuth, electrolysis, and rat-wart toxin.
DISCUSSION
Dr. Rees B. Rees: This case does not resemble those cases of mal de Meleda I have seen, and