Circumscribed palmar or plantar hypokeratosis: A distinctive epidermal malformation of the palms or soles  Amparo Pérez, MDa, Arno Rütten, MDb, Reinhard.

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Circumscribed palmar or plantar hypokeratosis: A distinctive epidermal malformation of the palms or soles  Amparo Pérez, MDa, Arno Rütten, MDb, Reinhard Gold, MDc, Francisco Urbina, MDd, Carlos Misad, MDd, Maria José Izquierdo, MDe, Celia Requena, MDa, Adolfo Aliaga, MDa, Heinz Kutzner, MDb, Luis Requena, MDe  Journal of the American Academy of Dermatology  Volume 47, Issue 1, Pages 21-27 (July 2002) DOI: 10.1067/mjd.2002.120466 Copyright © 2002 American Academy of Dermatology, Inc Terms and Conditions

Fig. 1 Clinical appearance of lesions. A, Case 1. B, Case 6. C, Case 3. D, Case 2. Journal of the American Academy of Dermatology 2002 47, 21-27DOI: (10.1067/mjd.2002.120466) Copyright © 2002 American Academy of Dermatology, Inc Terms and Conditions

Fig. 2 Histopathologic features in case 6. A, Depression of epidermis, with sharp stair in horny layer between normal and involved skin. B, Epidermis covering depression showed thinner horny and granular cell layers when compared with adjacent noninvolved skin. C, Corneocytes of border of stair appeared frayed and more eosinophilic than adjacent normal basophilic corneocytes. (Hematoxylin-eosin stain; original magnifications: A, ×20; B, ×100; C, ×200.) Journal of the American Academy of Dermatology 2002 47, 21-27DOI: (10.1067/mjd.2002.120466) Copyright © 2002 American Academy of Dermatology, Inc Terms and Conditions

Fig. 3 Histopathologic features in case 4. A, Stair of transition between normal and thin horny layer seems to be related with an acrosyringium, but this could not be demonstrated in other cases. Furthermore, acrosyringium crossing area of depressed epidermis (arrow) was also involved because it showed thinner horny layer than normal adjacent acrosyringia. B, Epidermis in depressed area showed thinner granular and horny layers than did adjacent normal skin. C, Higher magnification demonstrated absence of cornoid lamella at stair of depression of horny layer. (Hematoxylin-eosin stain; original magnifications: A, ×20; B, ×100; C, ×200.) Journal of the American Academy of Dermatology 2002 47, 21-27DOI: (10.1067/mjd.2002.120466) Copyright © 2002 American Academy of Dermatology, Inc Terms and Conditions

Fig. 4 Histopathologic study of case of porokeratosis of Mibelli involving palmar skin. A, Low-power magnification showed depression of epidermis with sharp transition between normal and involved skin. B, Higher magnification, showed keratin-filled invagination at peripheral ridge of lesion, from which emerged parakeratotic column, “cornoid lamella.” C, In epidermis beneath this cornoid lamella, there was no granular layer; pyknotic keratinocytes and dyskeratotic cells were irregularly arranged. (Hematoxylin-eosin stain; original magnifications: A, ×20; B, ×100; C, ×200.) Journal of the American Academy of Dermatology 2002 47, 21-27DOI: (10.1067/mjd.2002.120466) Copyright © 2002 American Academy of Dermatology, Inc Terms and Conditions