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Filiform Horny Projections on the Palms of a 69-Year-Old Man—Diagnosis
Arch Dermatol. 2006;142:235-240.
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Diagnosis: Filiform hyperkeratosis (minute digitate hyperkeratosis) of the palms.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
A skin biopsy specimen revealed that each horny projection was composed of a single, well-defined, compact, parakeratotic column without evidence of dyskeratosis, acantholysis, cytologic atypia, or vacuolation of keratinocytes in the underlying epidermis. The parakeratotic column arose directly from the granular layer, which appeared thinned at this area. Neither continuity of the keratotic lesions with the acrosyringium nor an underlying dermal eccrine duct was present. The dermis was unremarkable. Based on the clinical and histopathologic findings, a diagnosis of filiform hyperkeratosis of the palms was made, and keratolytic creams were prescribed, with little improvement of the lesions.
DISCUSSION
Filiform hyperkeratosis is a rare disorder of keratinization of unclear etiology. Clinically, it is characterized by the presence of multiple keratotic projections that affect the palms and usually the soles as well.1-6 Histopathologically, columns of parakeratosis or orthokeratosis have been reported in cases of filiform hyperkeratosis.1-2,5-6 Whether cases with orthokeratosis and cases with . . . [Full Text of this Article]
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Arch Dermatol. 2006;142(2):235-240.
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