Chronic truncal plaques and palmoplantar keratotic lesions in an elderly man.

Clinical Description The patient complained of multiple non-healing sores on his chest and back for 2 years. He had been taking traditional medications for more than 30 years for rheumatism and asthma. He had sought treatment from other clinics previously, and was treated with cryotherapy and excision of some of the chest lesions. These had unfortunately recurred. Clinically, he had numerous erythematous plaques with adherent thick scales and moist papillomatous base on the chest (arrowheads in Fig. 1) and back (Fig. 2). His palms (arrowheads in Fig. 3) and soles had multiple cornlike keratotic lesions. The regional lymph nodes on the neck, axilla and groin were not enlarged. A biopsy was performed from the large keratotic plaque on the back (arrowhead in Fig.2). What is your diagnosis? a) Actinic keratosis with palmoplantar viral warts b) Actinic keratosis with palmoplantar callosity c) Seborrhoeic keratosis with palmoplantar viral warts d) Cutaneous dysplastic lesions with palmoplantar keratosis e) Psoriasis with palmoplantar callosities Chronic Truncal Plaques and Palmoplantar Keratotic Lesions in an Elderly Man