PMC5735254_01
Palm and sole prior to treatment for primary biliary cirrhosis.
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A 57-year-old white woman presented with a 3-month history of thickening of the skin diffusely distributed on her palms and soles with slight erythema (Fig 1).
High-powered histologic view highlighting hyperkeratosis and acanthosis of the palm.
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A repeat biopsy specimen was obtained and showed orthokeratotic hyperkeratosis associated with hypergranulosis and moderate, regular acanthosis (Fig 2).
Partial response (left) while on treatment prior to diagnosis of primary biliary cirrhosis and resolution (right) postdiagnosis after initiation of ursodeoxycholic acid.
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Over the ensuing 2 months, the patient's palms and soles cleared entirely (Fig 3).