Asymptomatic Palmar Pits: Clinical Evaluation of Six Cases and Review of the Literature

Abstract

Palmar pits are intriguing and are found in association with diverse dermatologic conditions. Some are innocuous, whereas others have sinister implications. Six cases of asymptomatic palmar pits are described, and the literature is reviewed in brief. Of the six patients, five were male and one was female, with a mean age of 63.5 years. In all six patients, the palmar pits were noticed incidentally during a cutaneous examination for some other unrelated dermatoses, except in one in whom the pits were the reason for visiting a dermatologist. The number of pits varied from one to nine. Dupuytren contracture was observed in five patients. Sole involvement was seen in only one patient. None had overlying hyperkeratosis or associated symptoms relating to palmar pits. Palmar pits may have sinister implications in conditions such as nevoid basal cell carcinoma syndrome or Cowden syndrome. The association of palmar pits and Dupuytren contracture seems to be common but is underreported. Palmar pits may be the clinical cutaneous sign of systemic diseases and may sometimes provide a diagnostic clue to other dermatoses. This report emphasizes the significance of the art of clinical observation in dermatology.