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Puzzling Palmar and Plantar Papules

Puzzling Palmar and Plantar Papules Abstract REPORT OF A CASE A 17-year-old white boy was referred to us from the neurology clinic for evaluation of congenital skin lesions of the right hand and the right foot. The patient was undergoing follow-up by the neurology clinic for a seizure disorder and left hemiparesis. The patient also had scoliosis.The dermatologic examination revealed a linear arrangement of multiple 1- to 3-mm firm papules with a central keratotic plug located along the lateral portions of the right palm and the right foot. The lesions were also scattered along the thenar eminence of the right palm. All lesions were asymptomatic and could not be dislodged with a comedone extractor.Figures 1 and 2 are clinical photographs of the patient's right hand and foot, respectively. Figures 3 and 4 are photomicrographs of a 4-mm punch biopsy specimen taken from a lesion on the patient's right palm.What is your diagnosis? DIAGNOSIS: Porokeratotic eccrine ostial and dermal duct nevus. HISTOPATHOLOGIC FINDINGS Histopathologic examination revealed multiple depressions and comedolike invaginations of the epidermis filled with parakeratotic columns. References 1. Solomon LM, Fietzin DF, DeWald RL. The epidermal nevus syndrome . Arch Dermatol. 1968;97:273-285.Crossref 2. Wood MG, Thew MA. Nevus comedonicus . Arch Dermatol. 1968;98:111-116.Crossref 3. Lever WF, Schaumburg-Lever G. Histopathology of the Skin . 6th ed. Philadelphia, Pa: JB Lippincott; 1983:474. 4. Scribner MD. Congenital linear porokeratosis . Arch Dermatol. 1977;113:1623. 5. Eyre WG, Carson WE. Linear porokeratosis of Mibelli . Arch Dermatol. 1972;105:426-429.Crossref 6. Himmelstein R, Lynfield YL. Punctate porokeratosis . Arch Dermatol. 1984;120:263-264.Crossref 7. Abell E, Read SI. Porokeratotic eccrine ostial and dermal duct naevus . Br J Dermatol. 1980;103:435-441.Crossref 8. Aloi FG, Pippione M. Porokeratotic eccrine ostial and dermal duct nevus . Arch Dermatol. 1986;122:892-895.Crossref 9. Moreno A, Pujol RM, Salvetella N, et al. Porokeratotic eccrine ostial and dermal duct nevus . J Cutan Pathol. 1988;15:43-48.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Puzzling Palmar and Plantar Papules

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References (11)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680070123021
Publisher site
See Article on Publisher Site

Abstract

Abstract REPORT OF A CASE A 17-year-old white boy was referred to us from the neurology clinic for evaluation of congenital skin lesions of the right hand and the right foot. The patient was undergoing follow-up by the neurology clinic for a seizure disorder and left hemiparesis. The patient also had scoliosis.The dermatologic examination revealed a linear arrangement of multiple 1- to 3-mm firm papules with a central keratotic plug located along the lateral portions of the right palm and the right foot. The lesions were also scattered along the thenar eminence of the right palm. All lesions were asymptomatic and could not be dislodged with a comedone extractor.Figures 1 and 2 are clinical photographs of the patient's right hand and foot, respectively. Figures 3 and 4 are photomicrographs of a 4-mm punch biopsy specimen taken from a lesion on the patient's right palm.What is your diagnosis? DIAGNOSIS: Porokeratotic eccrine ostial and dermal duct nevus. HISTOPATHOLOGIC FINDINGS Histopathologic examination revealed multiple depressions and comedolike invaginations of the epidermis filled with parakeratotic columns. References 1. Solomon LM, Fietzin DF, DeWald RL. The epidermal nevus syndrome . Arch Dermatol. 1968;97:273-285.Crossref 2. Wood MG, Thew MA. Nevus comedonicus . Arch Dermatol. 1968;98:111-116.Crossref 3. Lever WF, Schaumburg-Lever G. Histopathology of the Skin . 6th ed. Philadelphia, Pa: JB Lippincott; 1983:474. 4. Scribner MD. Congenital linear porokeratosis . Arch Dermatol. 1977;113:1623. 5. Eyre WG, Carson WE. Linear porokeratosis of Mibelli . Arch Dermatol. 1972;105:426-429.Crossref 6. Himmelstein R, Lynfield YL. Punctate porokeratosis . Arch Dermatol. 1984;120:263-264.Crossref 7. Abell E, Read SI. Porokeratotic eccrine ostial and dermal duct naevus . Br J Dermatol. 1980;103:435-441.Crossref 8. Aloi FG, Pippione M. Porokeratotic eccrine ostial and dermal duct nevus . Arch Dermatol. 1986;122:892-895.Crossref 9. Moreno A, Pujol RM, Salvetella N, et al. Porokeratotic eccrine ostial and dermal duct nevus . J Cutan Pathol. 1988;15:43-48.Crossref

Journal

Archives of Dermatology – American Medical Association

Published: Aug 1, 1991

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