1. Acrokeratosis
verruciformis of Hopf
F. Peral Rubio, M.D.
Department of Dermatology
Hospital Universitario Virgen Macarena
Seville, Spain

2. Acrokeratosis
verruciformis of Hopf
A 60 -years-old woman.
 The patient was referred to us for the
assessment of lesions on the hands 20
years previously.

3. symmetrical lesions

6. skin-colored, wart-like lesions

10. punctate keratoses

11. Acrokeratosis
verruciformis of Hopf
 Skin biopsy was performed and
histological examination showed:
• Mild acanthosis with slight papillomatosis.
• There was also hyperkeratosis, most marked
at the edges of the lesion, with moderate
hypergranulosis and a thin layer of
orthokeratosis.
• The dermis was infiltrated with a few
inflammatory cells surrounding the vessels

12. Acrokeratosis verruciformis of
Hopf
 Acrokeratosis verruciformis of Hopf is an
autosomal dominant genodermatosis.
 It is characterized by multiple, localized,
symmetrical, flat, skin-colored, wart-
like lesions, typically observed on the
dorsum of the hands and feet

13. Acrokeratosis verruciformis of
Hopf
 Lesions are usually present at birth, but
they may appear later in infancy or in
some cases, onset may be delayed
until the fifth decade of life.
 Apart from the typical skin-colored, flat,
warty papules, examination may reveal
thickening of palmar skin and punctate
keratoses on the palms and the soles.

14. Acrokeratosis
verruciformis of Hopf
F. Peral Rubio, M.D.
Department of Dermatology
Hospital Universitario Virgen Macarena
Seville, Spain