Granular parakeratosis (GP) is a rare, idiopathic, and benign skin condition that presents classically as erythematous to brown hyperkeratotic papules that can coalesce into plaques. Axillary GP was initially observed by Northcutt and colleagues and has since been described in various other areas of the body including other intertriginous and non-intertriginous sites. The term "granular parakeratosis" is now used to describe not only the skin condition, but also a distinctive histological reactive pattern on biopsy specimens that are either regarded as the disease itself, or merely as an incidental finding. Upon review of the current findings, opinions, and associations of this entity, we propose the reappraisal of GP as a reactive pattern, rather than a distinct entity.

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Stenotrophomonas maltophilia is an aerobic gram-negative bacillus that most commonly causes infection in immune-compromised hospitalized individuals, especially those with hematologic malignancy, neutropenia, and history of treatment with broad-spectrum antibiotics. This infection has been known to affect multiple organ systems, but cutaneous involvement has been increasingly recognized over the years, albeit still relatively rare. Here we report a case of ulcerations on the palm and wrist, which were found to be positive for S. maltophilia. We also review the various skin and mucocutaneous findings that have been reported with this organism as well as treatment for this often multiple drug resistant organisms.