Hereditary keratosis palmoplantaris varians of Wachters (keratosis palmoplantaris striata et areata)

Keratosis palmoplantaris varians of Wachters is a rare autosomal dominant disorder. A 17-year-old boy with characteristic clinical and histopathologic findings of 10 years' duration is described. He displayed yellowish patchy and linear hyperkeratoses of the palms and nummular keratoses on the soles that were symmetrical and often confluent, specifically on the pressure points. Because there was no family history of a similar pattern, he probably represented an isolated case in his family. The typical clinical presentation, differential diagnosis, and classification of hereditary palmoplantar keratoses are discussed.