Palmoplantar papules and hyperkeratosis in a deaf man

A 31-year-old man presented with a history of extensive thickened skin of the palms and soles since the age of 7. The patient reported difficulty in ambulating and in using his hands secondary to his skin condition and associated pain. He also reported being seen by numerous specialists in the past for his hands, feet, and fingernails. He tried various topical medications, none of which were successful in minimizing the lesions on the hands and feet. Pertinent review of systems was positive for complete deafness diagnosed at 9 months of age. The patient did not speak and used sign language to communicate. His family history was significant for two brothers, both of whom are deaf and who have a similar skin condition of their hands and feet, but with lesser severity than the patient. The patient had no other medical issues.