Acrokeratoelastoidosis of Costa




Acrokeratoelastoidosis is a rare genodermatosis characterized by small, firm papules or plaques on the sides of the hands and feet. These nodules may result from an abnormality in the secretion or excretion of elastic material by fibroblasts in the dermis. Acrokeratoelastoidosis was first described in 1953 by Costa.


  • Flesh-colored lesions on palms
  • Flesh-colored lesions on soles
  • Yellowish lesions on palms
  • Yellowish lesions on soles
  • Nodular lesions on palms
  • Nodular lesions on soles
  • Thickened patches of skin on palms
  • Thickened patches of skin on soles
  • Hyperkeratosis
  • Verrucae


No local or systemic causes have been identified. Autosomal dominant transmission is common. Sporadic cases of acrokeratoelastoidosis are also described. One report described a patient with endogenous ochronosis showing clinical features similar to acrokeratoelastoidosis.


Because acrokeratoelastoidosis is a genetic disorder, no cure is available. Treatment is also not indicated as in most patients, once developed, the eruption is stable and causes no problems. Mild keratolytics such as urea cream have been used, but recurrences are common.

The other treatments such as liquid nitrogen, salicylic acid, tretinoin, and prednisone have been tried, though with limited success.


  • NIH