Abstract
<h3>REPORT OF A CASE</h3> A 67-year-old man presented with multiple, solitary, reddish-brown, flat, hyperkeratotic, 1- to 5-mm papules, predominantly on his left shin. The lesions were asymptomatic and had persisted for more than 20 years. On removal of the spiny scale, pinpoint bleeding was observed (<b>Figure 1</b>and<b>Figure 2</b>). An excision biopsy specimen of a lesion on the left shin is shown in<b>Figure 3.</b> What is your diagnosis? <h3>DIAGNOSIS:</h3> Hyperkeratosis lenticularis perstans (HLP) (Flegel disease). <h3>DISCUSSION</h3> Hyperkeratosis lenticularis perstans is a rare dermatosis first described in 1958 by Flege<sup>l</sup>.1 The disorder is characterized by 1- to 5-mm, asymptomatic, reddish-brown, keratotic papules located principally on the dorsa of the feet and the lower part of the legs. Involvement of the pinnae, arms, palms, soles, and even oral mucosa<sup>2</sup>has been noted. Removal of the adherent horny scale above each papule causes pinpoint bleeding.
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