May 2001

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This is a 59-year-old white female who over the past 5 months noticed a progressive thickening and darkening of the skin of her palms, dorsal hands, and ventral wrists.. She has also noticed a texture change involving the roof of her mouth.

Physical Exam:

On full-body skin exam she had rugose thickening of the palms with dermatoglyphic accentuation (Fig. A, B) and a velvety appearance. On the soft palate was a velvety - appearing plaque (Fig. C).There were fine vellus hair growth on the forehead, nose, and cheeks. She had otherwise been feeling well without weight loss, fatigue, or other systemic complaints. She was on no medications.

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