A Child With Unusual Palms and Soles

REPORT OF A CASE

A 10-month-old boy was brought to our clinic by his parents for evaluation of a palmoplantar alteration that they had noticed since he was 10 weeks old. The family history was negative for similar disorders. At general physical examination, the baby was normal and healthy. Cutaneous examination (Figure 1andFigure 2) showed a yellowish keratoderma of the palms and soles. The keratoderma was surrounded by an erythematous rim that sharply demarcated the lesions from normal-appearing skin. No other cutaneous lesions were found, and the mucous membranes, nails, and teeth were all normal. A cutaneous biopsy specimen was obtained (Figure 3). What is your diagnosis? A Child With Unusual Palms and Soles

DIAGNOSIS:

Epidermolytic palmoplantar keratoderma (PPK) of Vörner.

HISTOPATHOLOGIC FINDINGS

Microscopic examination showed epidermal acanthosis with an intense orthokeratotic hyperkeratosis. The granular cell layer was markedly thickened with numerous keratohyaline granules, and there was a pronounced vacuolization of the keratinocytes in the granular and spinous