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*always think about secondary syphilis when looking at the palms or soles
| • | basal cell nevus syndrome |
| • | normal variant in blacks (in the flexural creases) |
| • | lues cornée (secondary syphilis) |
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| • | punctate keratoderma (autosomal dominant) |
| • | arsenic keratosis (inorganic) |
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| • | contact dermatitis (irritant vs. allergic) |
| • | tinea (one hand, two foot) |
| • | chronic hand and foot eczema |
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*Fisher says everyone with this finding deserves two diagnostic tests: KOH and patch test
purpura of the palms = Letterer-Siwe disease (a finding seldom seen in other dermatoses), RMSF
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