REPORT OF A CASE
A 39-year-old black woman requested a dermatology consultation while hospitalized at Parkland Memorial Hospital, Dallas, with idiopathic cardiomyopathy. She was concerned about the asymptomatic "bumps" along the edges of her hands and feet that had been present since early childhood. She could not recall seeing similar lesions on the skin of family members. This patient was an intravenous drug abuser, but had been taking no prescription medications. Her VDRL result was negative.Physical examination revealed numerous round to polyglonal papules distributed along the medial and lateral aspects of the hands and feet (Figs 1 and 2). The papules were discrete, firm, and flesh-colored. In addition, there were hyperpigmented papules on the dorsal aspect of her finger joints (Fig 3). The palms and soles appeared normal.A punch biopsy specimen was obtained from the radial edge of one hand, and a hematoxylin-eosin-stained section revealed a focal area
Blum SL, Cruz PD, Siegel DM, Tigelaar RE. Hyperkeratotic Papules on the Hands and Feet. Arch Dermatol. 1987;123(9):1225–1226. doi:10.1001/archderm.1987.01660330136027
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