Acral Pseudolymphomatous Angiokeratoma of Children

To the Editor.— We wish to draw your attention to a scaly acral papular eruption occurring in children that has a florid pseudolymphomatous infiltrate, but is benign. A unilateral eruption developed in five children, four girls and one boy, affecting a foot in four cases and a hand in one case. The mean age at onset of the lesions was 6 years (range, 2 to 13 years), and the lesions occurred on the sides, flexor, and extensor surfaces of the digits; the lesions clustered most on the distal part of the digit and varied in number from 10 to 40 (Fig 1). The papules were clinically suggestive of angiokeratomas in that they were bright red or violaceous and had a keratotic surface or collar around their base. The papules ranged from 1 to 4 mm in diameter and longitudinal splitting of the nails was noted in two patients, with papules