Rare Presentation of Marginal Papular Acrokeratoderma: A Case Report and Literature Review of Costa's Acrokeratoelastoidosis of the Hand

Acrokeratoelastoidosis (AKE) is a rare benign genodermatosis characterized by keratotic papules on the lateral aspects of hands and feet. We present a case of a 25-year-old woman with a 3-year history of asymptomatic yellowish papules forming a linear plaque on the ulnar margin of her left hand. Previous treatments with topical acids and cryotherapy proved ineffective. Histopathological examination revealed hyperkeratosis, psoriasiform acanthosis, and decreased elastic fibers, confirmed by special stains. Treatment with high-potency steroids and urea cream showed modest improvement. This case highlights the importance of considering AKE in the differential diagnosis of keratotic acral lesions and demonstrates the current therapeutic limitations in managing this uncommon condition.