We present the case of a 63-year-old woman with a one-year history of punctiform, hyperkeratotic lesions on the palms of both hands. The histologic examination showed the presence of a cornoid lamella and allowed the establishment of the diagnosis of punctate porkeratosis. Porokeratosis is a clonal disorder of keratinization that exhibits multiple forms of presentation, with punctate porokeratosis being an infrequent form. The differential diagnosis of palmo-plantar punctiform, hyperkeratotic lesions is composed of porokeratosis punctata, the spiny keratodermas, other punctate keratodermas, and other pathologies with distinctive characteristics. In the review of literature of this article we have focused on explaining and clarifying the historical problem concerning the terminology used for these pathologies.