PMC6196674_01
Family pedigree demonstrating affected individuals and consanguinity, favoring autosomal recessive inheritance
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F1
His parents are consanguineous with generations of consanguinity reported in their respective families [Figure 1].
Compact hyperkeratotic plaques and thick scales affecting the soles
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F2
Soles and palms showed hyperkeratotic plaques [Figure 2].
Scattered thick scales with ridging over the palms and flexor aspect of the upper limb
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F3
The upper and lower extremities had thick scales with ridging, especially over the flexors [Figures 3 and 4].
Scattered thick scales with ridging over the dorsal aspect of the feet and lower extremities
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F4
The upper and lower extremities had thick scales with ridging, especially over the flexors [Figures 3 and 4].
Erythematous patches and scattered scales over the trunk
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F5
The trunk was also affected with scattered thick scales [Figure 5].
Prominent hyperkeratosis with irregular acanthosis and vacuolar degeneration of the granular and spinous layers (a and b); occasional keratohyalin bodies with minimal blistering overlying chronic inflammatory infiltrate (c); hematoxylin and eosin stain, original magnification (a and b) x10: (c) x40
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F6
In addition, there were occasional keratohyalin bodies and minimal blistering with an overlying mild perivascular chronic inflammatory infiltrate [Figure 6].