case_images: PMC3481936_01
case_images: PMC3481936_02
case_images: Symmetrical hyperkeratosis with scaling over both hands extending medially up to the elbows
case_images: IDOJ-3-54-g001.jpg
case_images: PMC3481936_02_IDOJ-3-54-g001.jpg
case_images: F1
case_images: On examination the skin over both his hands and forearms was scaly and thickened in a well-demarcated manner, almost like gloves and socks, with the hyperkeratosis and scaling extending along the medial aspect of the forearm up to the elbows, where it abruptly ended [Figures 1-3].
case_images: Symmetrical hyperkeratosis with fine scales over both feet, up to the ankle, in the 'socks' area
case_images: IDOJ-3-54-g002.jpg
case_images: PMC3481936_02_IDOJ-3-54-g002.jpg
case_images: F2
case_images: On examination the skin over both his hands and forearms was scaly and thickened in a well-demarcated manner, almost like gloves and socks, with the hyperkeratosis and scaling extending along the medial aspect of the forearm up to the elbows, where it abruptly ended [Figures 1-3].
case_images: Symmetrical hyperkeratosis with accentuated creases over both knees
case_images: IDOJ-3-54-g003.jpg
case_images: PMC3481936_02_IDOJ-3-54-g003.jpg
case_images: F3
case_images: On examination the skin over both his hands and forearms was scaly and thickened in a well-demarcated manner, almost like gloves and socks, with the hyperkeratosis and scaling extending along the medial aspect of the forearm up to the elbows, where it abruptly ended [Figures 1-3].
case_images: Lamellated hyperkeratosis, intact granular layer, acanthosis, and mild spongiosis, with mild perivascular lymphocytic infiltrate
case_images: IDOJ-3-54-g004.jpg
case_images: PMC3481936_02_IDOJ-3-54-g004.jpg
case_images: F4
case_images: The epidermis showed acanthosis in some areas, mild focal spongiosis with an intact granular layer and a moderately thickened stratum corneum showing lamellated hyperkeratosis, with parakeratosis being visible only in some fields [Figure 4].