History: Hyperkeratotic papules and plaques involving both surfaces of both hands of three years duration. The lesions on the dorsum of both hands were severely pruritic, skin-colored and markedly hyperkeratotic (LP hypertrophicus), whereas palmar papules are coalesced together resulting in a characteristically yellowish keratoderma. Oral mucosa was involved by an asymptomatic whitish papules and plaques in a network-like pattern.