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An unusual palmoplantar pigmentation
  1. G Sethuramana,
  2. M D'Souzaa,
  3. M Vijaikumara,
  4. K Karthikeyana,
  5. K Ramachandra Raob,
  6. D M Thappaa
  1. aJawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India: Departments of Dermatology and Sexually Transmitted Diseases, bDivision of Cytogenetics (Department of Anatomy)
  1. Dr Mariette D'Souza, Type V/12, Dhanvantari Nagar, JIPMER Campus, Pondicherry 605 006, Indias_m77{at}

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Answers on p 277.

A 60 year old man had asymptomatic progressive pigmentation of the palms (fig 1), fingertips (fig 2), and soles for the last 20 years. Besides this, he had discoloration of his sclerae (fig 3). He was well but for low backache and joint pains of a few months' duration. Histopathological examination of the skin lesion was diagnostic (fig4).

Figure 1

Palms showing progressive pigmentation.

Figure 2

Fingertips showing progressive pigmentation.

Figure 3

Discoloration of sclerae.

Figure 4

Histopathology of the skin lesion.


What is your diagnosis?
What are the bedside tests by which you can confirm your diagnosis?
What are the complications of this disease?


All photographs reproduced with patient's permission.

Answers on p 277.

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