Circumscribed palmar hypokeratosis -- the first case from south-east Europe

Circumscribed palmar or plantar hypokeratosis (CPH) is a rare condition, usually asymptomatic, consisting of a well-demarcated erythema with central depression and hyperkeratotic border which divides it from the normal skin. We report a 77-year-old woman with a characteristic lesion of circumscribed palmar hypokeratosis on the right palm. Clinically, the lesion simulated porokeratosis of Mibelli, but histologically there was no cornoid lamella, while the characteristic depression of epidermis, with sharp stair in stratum corneum between the normal and involved skin was present. This is the first case of CPH reported in south-east Europe. After 9-year follow-up and various treatment modalities, we confirmed resistance of CPH. Since malignant transformation has been documented, careful follow-up was recommended.