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This man could not walk or open his hands because of the pain induced by the lesions on his soles and palms. He had no oralcomplaints.

1. keratosis palmaris et plantaris

A heredofamilial ectodermal defect transmitted as a mendelian dominant, affecting all races, and appearing in both sexes with aboutequal frequency. Hyperkeratosis of the palms and soles characterize this disorder, but involvement of the gums and tongue—especially to the extentexhibited by this patient—has not been described heretofore. Moreover, the degree of keratosis of his feet (image below) is remarkable, perhapsunique.

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Source:  OpenStax, Images of memorable cases: 50 years at the bedside. OpenStax CNX. Dec 08, 2008 Download for free at http://cnx.org/content/col10449/1.7
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