Circumscribed Palmar or Plantar Hypokeratosis

  • Adult or elderly women
  • No known associated malignancies

  • Unknown
  • Possible role for trauma
  • Possible role of impaired keratinocyte palmoplantar differentiation
    • Suggested by reduced keratin 9 expression

  • Well demarcated, isolated mildly erythematous, circular depression on palms (thenar / hypothenar) and medial plantar regions

Pathology:

  • Stratum corneum thinning, reduced granular layer

Differential:

  • Bowen disease
  • Porokeratosis

  • Topical calcipotriene
  • 5-fluorouracil
  • Cryotherapy
  • Photodynamic therapy
  • Excision