Music box spine keratoderma

Tasleem Arif¹ , Mohammad Adil¹ , Suhailur Rehman²

¹ Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
² Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

Correspondence Address:
Tasleem Arif
New Colony Soura Srinagar Near Water Supply Control Room, Kashmir
India

A 60-year-old healthy female presented with gradually increasing, spiky projections on both palms for 5 years. On examination, multiple, discrete, firmly adherent, keratotic papules of the size 1–2 mm were noted over both the palms [Figure - 1]a and [Figure - 1]b. Rest of the cutaneous and systemic examination was unremarkable. Wet contact dermoscopy showed normal skin markings with brownish, keratotic, ovoid projections [Figure - 1]c. Complete hemogram, lipid profile, chest roentgenogram, and abdominal ultrasound were normal. Histopathology of the 3 mm punch skin biopsy showed a sharply defined column of parakeratotic cells with underlying hypogranulosis; other layers of the skin were unremarkable. A diagnosis of spiny keratoderma or “music box spine keratoderma” was made. She was treated with urea and salicylic acid formulation which led to slight improvement. Patient is under follow up to look for development of any systemic diseases or malignancy.

Figure 1a: Multiple, small 1-2 mm, discrete keratotic papules present over palmar surfaces of both hands

Figure 1b: Closer view of the lesions showing brownish colored spiky projections present over palmar surface of hand

Figure 1c: Dermoscopy showing brownish, shiny, translucent keratotic papules. Note the normal skin markings and sweat gland openings

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that name and initial will not be published and due efforts will be made to conceal patient identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.