Is acquired symmetrical acrokeratoderma a new dermatosis? Two case reports and Chinese literature review.
BACKGROUND
A series of cases characterized by symmetrical acral hyperkeratosis, mainly involving the dorsal surface of the hands, feet, and wrists, but sparing the palmoplantar areas, as well as rapid immersion upon exposure to water have been recently described in China, but similar disorders have not been reported in the English literature.


METHODS
The clinicopathologic features of two cases of acquired symmetrical acrokeratoderma were reported and 27 Chinese patients were reviewed.


RESULTS
The disorder typically occurred in young or middle aged men. Brown to black hyperkeratotic patches were symmetrically distributed particularly on the wrists and dorsum of hands, fingers, and feet, but without involvement of palms and soles. The lesions became whitish with mild swelling immediately after contact with water and improved generally in winter. Histopathologic examination revealed epidermal hyperkeratosis, acanthosis, and papillomatous hyperplasia, as well as superficial perivascular lymphohistiocytic infiltrate. Main ultrastructural features of the immersed lesion were epidermal hyperkeratosis and spongiosis with partial split of the desmosomes.


CONCLUSIONS
This disorder may be a new dermatosis, and the term "acquired symmetrical acrokeratoderma" could exactly reflect its clinicopathologic characteristics.
Fan
Yi-Ming
YM
Department of Dermatology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong, China. ymfan1963@163.com
Li
Shun-Fan
SF
Yang
Yan-Ping
YP
Chen
Qiu-Xia
QX
Li
Wen
W
D000328:Adult; D044466:Asian People; D001706:Biopsy; D005528:Foot; D006225:Hand; D006801:Humans; D007642:Keratosis / Q000145:classification / Q000208:ethnology / Q000473:pathology; D008297:Male; D014953:Wrist