Diagnosis: Acrokeratoelastoidosis.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Hematoxylin-eosin staining of both biopsy specimens showed massive hyperkeratosis with mild papillomatosis and acanthosis and a shallow depression underlying the hyperkeratosis (Figure 3). Elastic stains (Verhoeff–van Gieson) revealed a decreased number and thinning and fragmentation of elastic fibers in the dermis. These findings are consistent with acrokeratoelastoidosis. Therapy was initiated with 12% lactic acid cream at the time of diagnosis. The patient has not required any further treatment, and the papules have remained asymptomatic.
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DISCUSSION
Acrokeratoelastoidosis is a rare cutaneous disorder that was originally described by Costa1 in 1953. A familial pattern has been well documented and appears to represent an autosomal dominant genodermatosis.2 A possible linkage to chromosome 2 has been suggested.3 The disease typically has its onset in early childhood, and no sex or race predominance has been reported.4 A similar condition, focal acral hyperkeratosis, demonstrates an increased predilection in African Americans and has clinically . . . [Full Text of this Article]
