Hyperkeratosis of the palms and soles associated with internal malignancy and elevated levels of immunoreactive human growth hormone

Three cases are described of late onset hyperkeratosis of the palms and soles which was associated with internal carcinoma. In two cases high levels of immunoreactive human growth hormone (IRHGH) were present. Surface microscopy showed a cobbled appearance replacing the normal dermatoglyphics. The prognosis in each case was poor after the development of the palmar‐plantar hyperkeratosis and the relationship to the high levels of IRHGH is discussed. Comparisons are made with other palmar‐plantar hyperkeratoses associated with malignancy.