PMC10076618_01
(a-c) Multiple gray-white or dark red hyperkeratotic papules on a brown background on the bilateral groin. On closer examination, the hyperkeratotic papules had a verrucous appearance, some of which had coalesced.
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The papules were slightly hard on palpation (Figure 1).
(a and b) The horny layer showed highly compact hyperkeratosis and parakeratosis with basophilic granules (white circle). The epidermis showed obvious acanthosis with psoriasiform hyperplasia (black circle). Lymphocytes had infiltrated around small vessels in the upper dermis. (HE, a x40; b x200).
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A skin biopsy was performed and revealed the following: the stratum corneum showed highly compact hyperkeratosis and parakeratosis with basophilic granules; the epidermis showed obvious acanthosis with psoriasiform hyperplasia; and lymphocytes infiltrated around small vessels in the upper dermis (Figure 2).