Diagnosis: Multiple minute digitate hyperkeratosis (MMDH).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Histologic analysis revealed a filiform projection of compact orthohyperkeratosis forming a thin, hornlike structure. The underlying epidermis was mildly acanthotic and devoid of dysplasia. Mild hypergranulosis was noted as was subtle perivascular lymphocytic infiltrate (Figure 2). The features were consistent with multiple minute digitate hyperkeratosis. The patient applied 12% ammonium lactate lotion twice a day to the affected areas resulting in significant flattening of the lesions.
Figure appears in full text version.
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DISCUSSION
In 1967, Goldstein1 described a disorder of keratinization in a patient with digitate papules on the chest and anterolateral aspects of the arms and legs. The lesions were 1 to 2 mm in length and one-third to 1 mm in diameter. Multiple biopsy specimens from that patient demonstrated acanthosis and hypergranulosis underlying a narrow hyperkeratotic horn. Goldstein called this entity multiple minute digitate hyperkeratosis.1
Similar cases have been reported under many names, including music spine dermatosis, conical keratosis, hyperkeratotic . . . [Full Text of this Article]
