Granular parakeratosis is an acquired keratinization disease. We describe the unusual presentation of granular parakeratosis. A 27-year-old healthy female presented with multiple erythematous and brown discoloration plaques on the dorsal aspect of her hands for eight months. Repeated washing, using detergents, and maceration of the skin could develop her lesion.

Key Clinical Message We described the first case of granular parakeratosis with an unusual presentation of brown discoloration plaques and multiple erythematous on the dorsal part of the patient's hands. Skin maceration and repeated washing could have led to the development of the lesions. Abstract Granular parakeratosis is a unique acquired keratinization disorder. Here, we described the abnormal presentation of granular parakeratosis. A healthy female aged 27 years old presented brown discoloration plaques and multiple erythematous on the dorsal part of her hands for 8 months. Using detergents, repeated washing, and skin maceration were considered the causes of her lesion.