Acrokeratosis Verruciformis of Hopf Along Lines of Blaschko
A 24-year-old female presented to skin OPD with lesions over the left side of body since 5 years. Initially, few lesions started over the left thigh, which gradually progressed to involve the left side of lower limb, feet, arm, forearm, and back in the span of 5 years. No history of any complaints in the form of itching, burning, or pain present. No history of similar complaints in any of the family members. No seasonal variation or any other systemic complaints present. On examination, multiple hyperkeratotic, hyperpigmented warty papules arranged unilaterally over the left side of body, i.e., back of thigh, lateral aspect of thigh, back of knee joint, and dorsum of ankle joint were present. On the back of thigh, lesions were seen in multiple bands []. Multiple such discrete papules were present over left upper back, shoulder [], axilla, medial, and lateral aspect of the left arm [] and forearm in the distribution lines of Blaschko []. Few warty papules were also present over the left side of labia majora. Nails and oral cavity were normal.\nBiopsy taken from back of the thigh showed hyperkeratosis, acanthosis, papillomatosis with circumscribed elevation of epidermis resembling church spires []. Rete ridges were slightly elevated extending to the uniform level. Dermis showed perivascular lymphocytic infiltrate and unremarkable adenexa structure. Changes were suggestive of AKV.