title: Spiny keratoderma: case report, classification, and treatment of music box spine dermatoses.
abstract: The classification of palmoplantar lesions resembling music box spines is confusing, and nearly all attempts at treatment have been futile. We present the case of a 62-year-old white man with symptomatic music box spine lesions on his palms and fingers composed of parakeratotic columns over a hypogranular epidermis. Lesions and symptoms disappeared after a short course of 6 percent salicylic acid gel applied under occlusion. We suggest a classification scheme for this and similar-appearing conditions under the title spiny keratoderma, based on their histologic pattern (parakeratotic or hyperkeratotic) and anatomical location (palmoplantar, diffuse, or associated with epidermal appendages).
authors.affiliation: Dermatology Service, Fitzsimons Army Medical Center, Aurora, Colorado 80045.
authors.forename: T W
authors.initials: TW
authors.lastname: McGovern
authors.forename: R H
authors.initials: RH
authors.lastname: Gentry
mesh_terms: D004817:Epidermis / Q000473:pathology; D006801:Humans; D007645:Keratoderma, Palmoplantar / Q000145:classification / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D012459:Salicylates / Q000008:administration & dosage / Q000627:therapeutic use; D020156:Salicylic Acid
chemical_list: D012459:Salicylates; D020156:Salicylic Acid