Figure 1: Physical examination revealed a number of brown, flattened keratotic papules surrounding the hair follicles, and erythematous lesions with scales, on the right lower limb (a), and buttocks (b). (c) There was hyperkeratosis on the soles of his feet. (d) The biopsy specimen revealed irregular acanthosis and parakeratotic foci in the stratum corneum (hematoxylin–eosin staining, original magnification × 200)