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April 1994

Persistent Flat-Topped Papules on the Extremities

Author Affiliations

Hahnemann University Hospital, Philadelphia, Pa

Arch Dermatol. 1994;130(4):511-512. doi:10.1001/archderm.1994.01690040117020

REPORT OF A CASE  A 35-year-old black woman presented with a 30-year history of numerous asymptomatic lesions on her hands. For at least 15 years, she noticed similar lesions on her knees, legs, and feet that were increasing in number. Treatment with tretinoin cream had been ineffective. Her medical history was not significant. She has no children. One of six siblings has similar lesions on the hands and feet since childhood. This sister has two sons who are similarly affected.Cutaneous examination showed numerous 2- to 3-mm flat-topped brownish papules on the dorsal aspects of the hands, arms, knees, legs, and feet (Figure 1 and Figure 2). A biopsy specimen was taken from a papule on the dorsal aspect of the hand (Figure 3).What is your diagnosis?Figure 1.Figure 2.Figure 3.Persistent Flat-Topped Papules on the Extremities

DIAGNOSIS:  Acrokeratosis verruciformis (AKV) of Hopf.

DISCUSSION  Hopf1 first

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