Acquired crateriform hyperkeratotic papules of the lower limbs: an unusualvariant of acrokeratoelastoidosis of Costa

We report a man with a 3-year-history of a striking eruption of small, 2-3 mm diameter keratotic, crateriform papules distributed symmetrically over t he lower limbs. Morphologically the individual papules closely resembled th ose described in acrokeratoelastoidosis (AK) of Costa and in focal acral hy perkeratosis of Dowd (FAH). The case is unusual, however, in that there was dramatic involvement of the legs but the hands and feet were largely spare d. Current terms used for these entities are unsatisfactory.