Circumscribed acral hypokeratosis: A benign localized lesion in the palm
Circumscribed acral hypokeratosis is a benign entity, usually presenting in middle-aged women, over the thenar or hypothenar eminences (less frequently in the soles) as an asymptomatic depressed pink plaque with well-defined borders [Figure 1].1 Dermoscopy shows regularly distributed white dots (which we have described as rosettes) which appear to correspond to the acrosyringium [Figure 2].2 Histologic examination shows an abrupt stair-like thinning of the horny layer. Although no clear etiology has been determined for circumscribed acral hypokeratosis, it has been proposed to be a localized acquired genodermatosis of keratinocytes secondary to repeated trauma or other noxious exposition.3,4 Even though it is usually benign in its course, there are a few reports of premalignant transformation in the elderly.5 Treatment options in such cases include cryotherapy, topical fluorouracil or calcipotriol, ablative laser or surgery, with variable results.3,4 Circumscribed acral hypokeratosis is an underdiagnosed dermatosis and it should be included in the differential diagnosis of well-defined erosive lesions of the palms and the soles.
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Conflicts of interestThere are no conflicts of interest.
- Cutis. 2014;93:97-101.Circumscribed acralhypokeratosis: A report of 2 cases and a brief review of the literature.
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