PMC5726709_01
Hands and feet of the patient 1. A Bilateral symmetrical
diffuse planter waxy yellowish hyperkeratosis of the feet, more severe
in pressure sites, less severe in the plantar arch, and associated with
deep fissures and cracks all over the sole. B
Asymmetrically striate and focal hyperkeratosis in both palmar surfaces
without significant nail changes
abd-92-05-s1-0154-g01.jpg
PMC5726709_01_abd-92-05-s1-0154-g01.jpg
f1
On examination, the female patient (case 1) showed bilateral symmetrical diffuse plantar waxy yellowish hyperkeratosis, associated with deep fissures and cracks all over the sole (Figure 1). The hyperkeratosis was asymmetrically striate and focal in both palmer surfaces (Figure 1).
Hands and feet of the patient 2. A - Bilateral symmetrical
diffuse waxy yellowish hyperkeratosis with cracks in both plantar
aspects of the soles. B - Warty papules on the knuckles of
the dorsal aspect of the big toes. Note the dystrophic nail changes in
the form of onychographosis (hyperkeratotic and grossly thickened nail
plates) which was more severe in both big toes, but less severe in the
small toes. C - Bilateral asymmetrical hyperkeratosis in
the form of punctate keratoderma and focal warty keratotic papules in
the palmar surface of the fingers, mainly against the interphalangeal
and metacarpophalangeal joints. D - Deformed nails of both
hands (non-specific nail changes)
abd-92-05-s1-0154-g02.jpg
PMC5726709_02_abd-92-05-s1-0154-g02.jpg
f2
Bilateral asymmetrical hyperkeratosis was present at the palmar surface of the fingers (Figure 2). The nails in the same patient were deformed (Figure 2).
Hands and feet of the patient 3. A - Soles and toes with
characteristics similar to patient 2 (see fig. 2 for description). B - Hyperkeratotic
projections onto normal skin at the medial aspect of big toe and first
web space. C - Bilateral asymmetrical hyperkeratosis in the
form of warty keratotic papules in the palmar surface of both hands and
fingers
abd-92-05-s1-0154-g03.jpg
PMC5726709_02_abd-92-05-s1-0154-g03.jpg
f3
In case 3, the edge of the keratoderma consisted of hyperkeratotic projections onto normal skin and bilateral asymmetrical hyperkeratosis was noticed on both hands and fingers (Figure 3).
PMC5726709_02
Hands and feet of the patient 2. A - Bilateral symmetrical
diffuse waxy yellowish hyperkeratosis with cracks in both plantar
aspects of the soles. B - Warty papules on the knuckles of
the dorsal aspect of the big toes. Note the dystrophic nail changes in
the form of onychographosis (hyperkeratotic and grossly thickened nail
plates) which was more severe in both big toes, but less severe in the
small toes. C - Bilateral asymmetrical hyperkeratosis in
the form of punctate keratoderma and focal warty keratotic papules in
the palmar surface of the fingers, mainly against the interphalangeal
and metacarpophalangeal joints. D - Deformed nails of both
hands (non-specific nail changes)
abd-92-05-s1-0154-g02.jpg
PMC5726709_02_abd-92-05-s1-0154-g02.jpg
f2
Bilateral asymmetrical hyperkeratosis was present at the palmar surface of the fingers (Figure 2). The nails in the same patient were deformed (Figure 2).
Hands and feet of the patient 3. A - Soles and toes with
characteristics similar to patient 2 (see fig. 2 for description). B - Hyperkeratotic
projections onto normal skin at the medial aspect of big toe and first
web space. C - Bilateral asymmetrical hyperkeratosis in the
form of warty keratotic papules in the palmar surface of both hands and
fingers
abd-92-05-s1-0154-g03.jpg
PMC5726709_02_abd-92-05-s1-0154-g03.jpg
f3
In case 3, the edge of the keratoderma consisted of hyperkeratotic projections onto normal skin and bilateral asymmetrical hyperkeratosis was noticed on both hands and fingers (Figure 3).