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January 1991

Callused Feet, Thick Nails, and White Tongue

Author Affiliations

The Cleveland (Ohio) Clinic

Arch Dermatol. 1991;127(1):115-116. doi:10.1001/archderm.1991.01680010125022

REPORT OF A CASE  A 39-year-old white man presented for examination of recurrent, painful blisters on his plantar surfaces, which he believed to be present since birth. Historically, the blisters usually appeared during the warm summer months and, in recent years, plantar calluses on pressure points have also developed. He offered no complaints of vision or voice.Family history revealed no consanguinity in his parents. He has three sisters, and all have nail problems and recurrent blisters on their feet. His paternal grandfather, father, uncle, and aunt are all similarly affected. He has no children.Physical examination revealed symmetrical, progressive thickening of all fingernails and toenails (Fig 1). The plantar surfaces of both feet revealed hyperkeratotic plaques over the pressure points (Fig 2). No bullae were noted. Several small blisters were observed on the palms. Scattered areas of white striae were noted on the buccal mucosa. The patient's tongue appeared

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