UPP - Department of Dermatology, Dermatopathology Unit
Pooja Khera, MD; Ellen Roh, MD; Jau-Shyong Deng, MD
JULY 2008 CASE OF THE MONTH
A 65-year-old right-handed white male presented to our clinic for evaluation of a ten-year history of a lesion on his left palm. He stated that the lesion had been gradually increasing in size over the past several years. He denied symptoms, preceding trauma, and manipulating the lesion. The patient applied hydrocortisone cream for several months without resolution. He denied a personal and family history of skin cancer. His medical history included actinic keratoses, well-controlled hypertension, and hyperlipidemia.
Examination of the patient's left palm revealed a sharply circumscribed, 4.5 x 4 cm erythematous plaque with a slightly raised border on the thenar eminence (Figure I). There were no lesions on the right palm or soles. A shave biopsy was taken from the edge of the lesion.
Histopathological examination revealed normal palmar cornification with an abrupt transition to hypocornification. There was a mild superficial lymphocytic perivascular inflammatory infiltrate. Neither cornoid lamellae or keratinocyte atypia was present. (Figures II, III).
The patient declined treatment given that the lesion was asymptomatic and there was no evidence of malignancy on histological examination.