Punctate hyperkeratosis of the palms and soles is a rare condition and has received little mention in the literature. Attention is called to it by Ormsby,1 Sutton,2 Stelwagon and Gaskill3 and Macleod4 in their textbooks. In the literature, there is described a small group of cases of punctate hyperkeratosis. The condition has received a great variety of names and by some observers has been called a porokeratosis, but as it is uncertain whether the sweat ducts are involved, the term "keratoderma punctatum" seems more appropriate. While the cases of this group are clinically similar in having punctate lesions, a careful study leads one to the conclusion that they are not all identical. Probably the earliest case of this condition was reported by Davies-Colley5 in 1879, under the name "disseminated clavus of hands and feet." He described hyperkeratotic lesions on the palms and soles; these lesions