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Palmoplantar Hyperkeratotic Plaques
M. Hannah, MD;
W. K. Jacyk, MD
University of Pretoria, Pretoria, Republic of South Africa
Arch Dermatol. 1998;134:1019-1024.
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REPORT OF A CASE
A 72-year-old African man presented with tender, well-defined hyperkeratotic plaques on his soles and palms (Figure 1 and Figure 2). The rest of his skin was not affected. There was no lymphadenopathy and, except that the plantar lesions caused significant discomfort, he felt well. Results of laboratory investigations (a complete blood cell count, sequential 21-channel autoanalysis, chest radiography, and computed tomography of the liver and spleen) were within normal limits. A biopsy specimen was obtained from the plaque on the sole and stained with hematoxylin-eosin (Figure 3) and UCHL-1 (Figure 4).
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Figure 1.
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Figure 2.
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Figure 3.
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Figure 4.
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What is your diagnosis?
Diagnosis: Hyperkeratotic mycosis fungoides restricted to the palms and soles.
The biopsy specimen of the lesion on the sole revealed psoriasiform epidermal proliferation, a few Pautrier microabscesses, and a dense, predominantly T-cell infiltrate in the upper dermis. Some of the lymphocytes had large irregularly . . . [Full Text of this Article]
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