Palmar filiform or spiny hyperkeratosis associated with pulmonary tuberculosis

Abstract

Abstract A case of palmar filiform or spiny hyperkeratosis in a 50‐year‐old man is reported. The development of pulmonary tuberculosis was followed by “music box spine” keratotic plugs and pits on both hands, apart from the palmar creases. Histological examination revealed a well delineated column of hyperkeratosis with basal parakeratosis not developing a true cornoid lamella. This case is interesting because of its rarity, the lack of heredity and the clinical association with pulmonary tuberculosis, although Herman (1973) reported bronchial carcinoma with punctate porokeratosis. We discuss the relationship between immunosuppression and the development of these cutaneous lesions. We also review cases described as “porokeratosis punctata palmaris et plantaris” clinically identical to our patient, who did not present true cornoid lamella. Palmar filiform hyperkeratosis is an unespecific keratinization disorder which could be considered secondary to other diseases.