Keratosis punctata of the palmar creases in a 68-year-old African-American man.

To cite: Bonnecaze AK, Willeford W. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016216050 DESCRIPTION A 68-year-old African-American man with a history of duodenal adenocarcinoma was found to have innumerable 1 mm hyperkeratotic depressions along his palmar creases bilaterally (figures 1–3). The patient reported having these lesions since early in childhood. He also noted that all men in his family, dating back to his great-great-grandfather, had similar palmar crease pitting. He stated he was diagnosed with keratosis punctata of the palmar creases (KPPC) at an early age and failed to respond to prior therapies including topical retinoid cream and emollients. He denied any pain or prior infections to the sites; however, he did note occasional white pustular appearing discharge from some pits. KPPC is a benign condition which features innumerable sharply marginated, hyperkeratotic 1–5 mm depressions along the palmar creases. It most often affects African-Americans with an estimated