Keratotic Papules on the Palm of a 12‐Year‐Old Boy

Abstract

A 12-year-old boy was referred to our pediatric dermatology clinic for evaluation of skin lesions on his left palm (Fig. 1). The lesions were asymptomatic and had been present since birth. The child was otherwise in excellent general health. His medical and family histories were unremarkable.Physical examination revealed a linear arrangement of 1 to 2 mm brown, discrete keratotic papules on the left palm. Many of the larger papules were crateriform with a central filiform spicule (Fig. 2). After heat-induced sweating, focal anhidrosis was not demonstrated in the involved area by the starch-iodine technique.A biopsy specimen of lesional skin was obtained and stained with hematoxylin and eosin (Fig. 3) and with an antibody to carcinoembryonic antigen (CEA) (Fig. 4). Figure 1. Keratotic crateriform papules on the left palm.