A 48-year-old Caucasian man recounted the onset of keratotic papules on the trunk at the age of 8 years, with subsequent spread to the forearms, scalp, and forehead. His most severe disease was present on the legs. He complained of pain, itching, and noted exacerbations in the summer and with
A 48-year-old man presented with a 4-month history of papular hyperkeratotic diffuse lesions on his trunk, arms, and neck that were highly pruritic (Figure 1). He also had "V"-shaped nicks in the nails, mucous white papules on his palate, and diffuse desquamation on the scalp. Abnormal laboratory