[A hemorrhagic acral form of dyskeratosis follicularis Darier]

A 76-year-old woman presented with a venous leg ulcer 7. Incidentally hemorrhagic macules on hands and fingers and dystrophy of toe and fingernails were noticed. Except for submammary erythema, no further dermatologic signs were shown. Histology of palmar lesions fit with a hemorrhagic lesion of dyskeratosis follicularis in acral skin. During following months actinic induced reddish-brown hyperkeratotic papules appeared on the forehead and in seborrheic and intertriginous areas of the trunk. Papules were most prominent during summer and almost completely resolved in winter. The hemorrhagic variant of dyskeratosis follicularis represents a rare clinical variant which has to be separated from other purpuric macules on acral sites.