Abstract: A 16-year-old male presented with hyperkeratosis on the hands for 3 years and relapsed for 2 months. This case with symmetrical acrokeratoderma was different from that reported previously. The lesion at early onset stage presented with pale-yellow hyperkeratotic patches distributed on the palms and lateral margin, then the black-brown hyperkeratotic patches appeared on his wrists and dorsal hands with disease severity. These lesions became white and wrinkled after soaking, with slight tension, and returned to original state after leaving the water. The diagnosis of symmetrical acrokeratoderma was made and the skin lesion almost disappeared after one month of treatment.

Key words: acrokeratoderma, symmetrical