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Collagenous and elastotic marginal plaques of the hand (CEMPH) is a rare, chronic keratoderma characterized by hyperkeratotic linear plaques located along the radial and ulnar aspects of the hands bilaterally. As an isolated finding, CEMPH occurs secondarily to chronic trauma and photodamage. Herein, CEMPH is described as a manifestation of alkaptonuria (AKU). In addition to keloidal collagen, ochronotic fibers and fragmented, thickened elastic fibers were observed. Additionally, mucin deposition—not previously described in this clinical context—was also identified. Given their overlapping clinicopathologic features, CEMPH due to AKU should be distinguished from the acquired variant as well as acrokeratoelastoidosis.

We investigated the impact of a personalized telephone call reminder for patients that had not confirmed their clinic appointment, in addition to automated reminders, on monthly no‐show rates. Our data revealed a reduction in the monthly no‐show rate from 16.0% (SD = 3.91%) before the intervention to 13.1% (SD = 0.27%, P = 0.0997) after the intervention, which was not statistically significant. The standard deviation of the no‐show rate with the intervention was reduced, leading to a predictable monthly no‐show rate (range 12.93%‐13.51%). Thus, the number of patients attending clinic was more predictable. This study highlights the need for additional investigation of factors associated with appointment nonadherence in pediatric dermatology.

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