Dermatology Online Journal

Unknown: Scaly, circular papules in a healthy toddler
Wenhong Zhou MD PhD¹, Catherine Kowalewski DO¹, Eric Kraus MD¹, Mark R Matthews MD², John C Browning MD^1,3
Dermatology Online Journal 16 (9): 9

1. University of Texas Health Science Center at San Antonio, Division of Dermatology and Cutaneous Surgery, San Antonio, Texas
2. Pathology Reference Lab, San Antonio, Texas
3. University of Texas Health Science Center at San Antonio, Department of Pediatrics, Pediatric Dermatology Section, San Antonio, Texas

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Figure 1	Figure 2

Figure 3

A 2-year-old healthy Hispanic boy presents with a 1-year history of thick scaly circular “bumps” on the palms and soles. They are largely asymptomatic, but with occasional pruritus. The boy has met all of his developmental milestones and has no other physical complaints. There are no other family members affected with the same condition. Skin exam reveals scattered well demarcated, firm, hyperkeratotic papules with a central keratin plug that are distributed along both palms and soles. Some papules have a central depression (Figures 1 and 2). A punch biopsy of a papule is shown in Figure 3.

What is the diagnosis?

Answer

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