A rare image of zinc-responsive acral hyperkeratosis

Acral hyperkeratosis that responds to zinc usually manifests as symmetrically distributed, long-lasting, well-defined hyperpigmented plaques over the acral areas of the body. It is a condition that causes thickening of the skin on the hands and feet. Zinc deficiency can be a cause of acral hyperkeratosis. A 50-year-old man came in with a six-month-old, slightly itchy, scaly, raised lesions over both feet which were darkly coloured and somewhat irritating. A cutaneous examination of the dorsum of the feet revealed bilaterally symmetrical, well-demarcated hyperpigmented plaques. The patient was treated using oral zinc with 200mg of zinc sulfate twice daily and 10% urea-containing emollient for local application. He got significant relief from raised lesions and hyperpigmented plaques.