Acrokeratosis Verruciformis of Hopf Differential Diagnoses

Updated: May 11, 2018
  • Author: Sarah Sweeney Pinney, MD, FAAD; Chief Editor: William D James, MD  more...
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Diagnostic Considerations

Acrokeratosis verruciformis–like histologic features may be seen in linear epidermal nevi. [25]

Lesions identical to those of acrokeratosis verruciformis of Hopf can be observed in patients with acral Darier disease or even in relatives of such patients. A forme fruste of Darier disease may be impossible to differentiate from acrokeratosis verruciformis of Hopf on the basis of clinical findings. Looking for dyskeratosis histologically, which favors a diagnosis of Darier disease, is important. Following up with patients and performing a biopsy on the lesion is recommended if the diagnosis is in doubt. Genetic studies have recently suggested an allelic variable.

Keratosis follicularis squamosa (KFS) is a keratinizing disorder that is characterized by asymptomatic small, scaly patches with follicular plugs scattered on the trunk and thighs. [26]

Fixed drug eruptions can leave residual papules of similar appearance. [27]

The lesions also clinically resemble plane warts, but the histologic findings are distinctive.

Finally, acrokeratosis verruciformis has considerable histologic overlap with stucco keratosis.

Differential Diagnoses