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Circumscribed palmar or plantar hypokeratosis: report of an italian case.

Tosi D, Sala F, Crosti C - Indian J Dermatol (2011)

Bottom Line: Circumscribed palmar or plantar hypokeratosis is a rare benign epidermal malformation of the skin.Its main histopathologic feature shows a characteristic epidermal depression with an abrupt decrement in the thickness of the stratum corneum, with a sharp stair between normal and involved skin.We describe a case of a 68-year-old woman who presented with an erythematous, asymptomatic, well-circumscribed, depressed patch, on the right thenar eminence which had been present for years.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Intensive Care and Dermatological Sciences, Università degli Studi di Milano, IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan via Pace 9, Milan, 20122, Italy.

ABSTRACT
Circumscribed palmar or plantar hypokeratosis is a rare benign epidermal malformation of the skin. Clinically it shows asymptomatic, well-circumscribed, and depressed erythema persisting for many years on the palms or soles. Its main histopathologic feature shows a characteristic epidermal depression with an abrupt decrement in the thickness of the stratum corneum, with a sharp stair between normal and involved skin. We describe a case of a 68-year-old woman who presented with an erythematous, asymptomatic, well-circumscribed, depressed patch, on the right thenar eminence which had been present for years.

No MeSH data available.


Related in: MedlinePlus

A circular and well-circumscribed area of depressed and erythematous skin on the right thenar eminence
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Figure 1: A circular and well-circumscribed area of depressed and erythematous skin on the right thenar eminence

Mentions: A 68-year-old woman presented with an acquired, asymptomatic, slowly enlarging erythematous patch on the thenar eminence of her right hand. The patient did not have a history of any local trauma or infectious disease. Her medical history included a mammary adeno-carcinoma treated with surgery and radio-therapy 10 years before. Examination revealed over the right eminence thenar an approximately 15 × 10 mm, well-circumscribed circular erythematous area, depressed, with sharp step between involved and uninvolved skin [Figure 1]. The lesion was unique, without any lesion on the soles of the feet. A full clinical examination was otherwise non-significant. We performed a mycologic examination, which showed normal results. A 4-mm punch biopsy was taken through the edge of the lesion. Histopathology showed a sharply demarcated depressed area with markedly thinned stratum corneum with normal basal layers. The stratum corneum was orthokeratotic and no parakeratois was seen. Slight dilatation of the dermal superficial vessels was noted, with poor lymphocytic infiltration and edema. There was no evidence of cornoid lamella excluding a diagnosis of porokeratosis. Corneocytes of the upper layers showed signs of vacuolization and they became eosinophilic at the edge [Figure 2]. Based on these findings, the diagnosis of circumscribed palmar hypokeratosis was established. Immunohistochemistry was negative for human papilloma virus (HPV). Topical treatment with corticosteroid was of no benefit. The patient is currently on clinical follow-up and in 7 years there has been no evidence of enlargement or evolution.


Circumscribed palmar or plantar hypokeratosis: report of an italian case.

Tosi D, Sala F, Crosti C - Indian J Dermatol (2011)

A circular and well-circumscribed area of depressed and erythematous skin on the right thenar eminence
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3108526&req=5

Figure 1: A circular and well-circumscribed area of depressed and erythematous skin on the right thenar eminence
Mentions: A 68-year-old woman presented with an acquired, asymptomatic, slowly enlarging erythematous patch on the thenar eminence of her right hand. The patient did not have a history of any local trauma or infectious disease. Her medical history included a mammary adeno-carcinoma treated with surgery and radio-therapy 10 years before. Examination revealed over the right eminence thenar an approximately 15 × 10 mm, well-circumscribed circular erythematous area, depressed, with sharp step between involved and uninvolved skin [Figure 1]. The lesion was unique, without any lesion on the soles of the feet. A full clinical examination was otherwise non-significant. We performed a mycologic examination, which showed normal results. A 4-mm punch biopsy was taken through the edge of the lesion. Histopathology showed a sharply demarcated depressed area with markedly thinned stratum corneum with normal basal layers. The stratum corneum was orthokeratotic and no parakeratois was seen. Slight dilatation of the dermal superficial vessels was noted, with poor lymphocytic infiltration and edema. There was no evidence of cornoid lamella excluding a diagnosis of porokeratosis. Corneocytes of the upper layers showed signs of vacuolization and they became eosinophilic at the edge [Figure 2]. Based on these findings, the diagnosis of circumscribed palmar hypokeratosis was established. Immunohistochemistry was negative for human papilloma virus (HPV). Topical treatment with corticosteroid was of no benefit. The patient is currently on clinical follow-up and in 7 years there has been no evidence of enlargement or evolution.

Bottom Line: Circumscribed palmar or plantar hypokeratosis is a rare benign epidermal malformation of the skin.Its main histopathologic feature shows a characteristic epidermal depression with an abrupt decrement in the thickness of the stratum corneum, with a sharp stair between normal and involved skin.We describe a case of a 68-year-old woman who presented with an erythematous, asymptomatic, well-circumscribed, depressed patch, on the right thenar eminence which had been present for years.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Intensive Care and Dermatological Sciences, Università degli Studi di Milano, IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan via Pace 9, Milan, 20122, Italy.

ABSTRACT
Circumscribed palmar or plantar hypokeratosis is a rare benign epidermal malformation of the skin. Clinically it shows asymptomatic, well-circumscribed, and depressed erythema persisting for many years on the palms or soles. Its main histopathologic feature shows a characteristic epidermal depression with an abrupt decrement in the thickness of the stratum corneum, with a sharp stair between normal and involved skin. We describe a case of a 68-year-old woman who presented with an erythematous, asymptomatic, well-circumscribed, depressed patch, on the right thenar eminence which had been present for years.

No MeSH data available.


Related in: MedlinePlus