Abstract
ABSTRACT Spiny keratoderma is a rare, easily distinguishable variant of punctate keratoderma. It is characterized by a spiny texture with multiple hard keratotic outgrowths on the palms and soles. These spines are likened to an old-fashioned music box but have been labeled by other synonyms such as palmar keratoses, punctate keratoderma, filiform hyperkeratosis, and punctuate porokeratotic keratoderma, to name a few.
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