Non-familial Acrokeratosis Verruciformis of Hopf

Abstract

Acrokeratosis verruciformis of Hopf is a rare genodermatosis with an autosomal dominant mode of inheritance. It is a disorder of keratinization, characterized by multiple, flat-topped, skin-colored keratotic lesions resembling plane warts typically observed on the dorsum of the hands and feet. Histopathologically, the lesion shows considerable hyperkeratosis, acanthosis, and papillomatosis, mimicking a "church spire", and a thickened granular layer. It arises in early life, often at birth or infancy. Herein, we report on a rare sporadic case of acrokeratosis verruciformis of Hopf. A 44-year-old Caucasian man presented with multiple, grouped, hyperkeratotic, whitish, flat papules on his shins and feet, which had been present for more than one year. Histopathological examination showed typical findings of acrokeratosis verruciformis of Hopf. Our case is unique in that the patient had no familial history of similar skin lesions.

Keywords: Acrokeratosis verruciformis of Hopf; Non-familial acrokeratosis verruciformis.

Fig. 1

Multiple asymptomatic hyperkeratotic, whitish papules measuring 0.2~0.3 cm on both shins and dorsum of the feet.

Fig. 2

Hyperkeratosis and hypergranulosis with a "church spire" (H&E, ×40). Magnified view of pure hyperkeratosis, acanthosis, and papillomatosis without parakeratosis, dyskeratosis, and vacuolization (H&E, ×100)