A rough, keratotic, scaly change along the sides of the fingers in an older man with significant sun damage is characteristic. Nomenclature varies. Some have called this Keratoelastoidosis marginalis of the hands (KEMH) or degenerative collagenous plaques of the hands. Broadly, it falls under the marginal papular acrokeratodermas.


A combination of urea 40% and clobetasol cream worked very well for one patient of mine. Topical keratolytics may reduce the roughness, but as of yet, there is no cure. Sunscreen may prevent progression.

Additional Pictures



Of note--and very rarely--if there is a bluish color, alkaptonuria should be considered as seen here. JAAD 2011;65, Issue 2, Pages e45–e46


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