Punctate porokeratotic keratoderma-its occurrence with internal neoplasia

Summary Punctate porokeratotic keratoderma (PPK) represents a diffuse involvement of palms and soles by multiple, acuminate keratotic papules and plugs, histologically identified by parakeratotic cornoid lamellae. A possible association between PPK and internal malignancy has been previously noted by Herman in 19732. A patient with a 3‐month history of PPK is described in which a bronchial carcinoma was recently diagnosed. This association led us to speculate that PPK could be a sign of internal neoplasia, as already established for other forms of palmoplantar keratoderma. We suggest that the presence of an underlying malignancy must be screened for when a diagnosis of PPK is proposed.