REPORT OF A CASE
A 19-year-old man presented with a ten-year history of skin lesions. The lesions involved his face, the upper part of his torso, his nails, and his palms.On physical examination, there were lightly crusted erythematous perifollicular papules over the back, the upper part of the trunk, and the sides of the face (Figs 1 and 2). Some lesions had a waxy scale. Longitudinal red-and-white ridging of the nails was seen, as well as palmar pitting. Small flesh-colored papules resembling flat warts were evident on the hands and feet. The skin eruption is exacerbated by heat and by sun exposure, which cause the lesions to become more vesicular, pruritic, and prone to superinfection.A complete blood cell count, fasting lipid levels, and results of serial liver function tests were all normal.The patient has been intermittently treated with antibiotics and topical/oral vitamin A preparations. Since 1983,