We describe the case of a 10-year-old boy with a porokeratotic eccrine ostial and dermal duct nevus (PEODDN) of late onset. The patient had an 8-year history of multiple keratotic papules on the dorsal surface, and multiple yellowish pitting lesions on the plantar surface of the right foot. Light-microscopic studies of both lesions showed multiple comoid lamella-like parakera-totic columns, which exclusively arose over eccrine sweat ducts in which the acrosyringium was dilated. Although PEODDN is considered to be a congenital hamartoma of eccrine origin, a review of the literature showed us that the frequency of a late-onset variant may be as high as 26%.

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Atrial myxoma is the most common primary tumour of the heart. Skin manifestations in patients with a cardiac myxoma are frequent and may be due to cutaneous emboli, or may be specific findings as part of more complex syndromes. We present a 33-year-old-man with a history of episodes of pain in both legs and an ischaemic neurological event, who also had episodes of acral papular erythematous lesions on the legs and feet including the soles. The histological finding of dermal vessels occluded by a myxomatous material was the clue to the diagnosis of a cardiac myxoma. The diagnosis of this entity can be very difficult, because of the broad spectrum of clinical features; rarely the skin manifestations lead to the diagnosis of this tumour. The histological recognition of the myxomatous emboli is of vital importance for the diagnosis and treatment of this disease.

The coexistence of non-Hodgkin lymphoma (NHL) and Hodgkin disease (HD) in the same patient, although previously reported, is very unusual. This situation is extremely rare when the first diagnosis is a cutaneous B NHL, and exceptional if there is no personal background of cytostatic treatment. We report a 44-year-old man who developed cutaneous nodules over a period of two years. A marginal zone cutaneous B-cell lymphoma was diagnosed. On staging investigation a mass in the lingual tonsil was found and excision biopsy showed a classical Hodgkin lymphoma.

Keratosis punctata of the palmar creases (KPPC) is a variant of keratosis punctata of palms and soles in which lesions are confined to palmar creases. We present a patient with KPPC and study the prevalence of the disease in Caucasians. The survey included 1,001 white patients, that were examined for palmar lesions. We could not find any case that fulfilled the diagnostic criteria for KPPC. We conclude that KPPC is a rare disease among Caucasians but rather common in the black race.