This 32-year-old man was noted to have neurosensory deafness and widespread red, scaly, scaly plaques at birth. Over the next decade he developed symmetric generalized warty plaques with most prominent involvement of the face and extremities. Hair was sparse at birth and decreased as the papules and plaques thickened on the scalp, axillae, and face. Nails were atrophic at birth, and yellowing and scaling with increased friability developed during the first year. Keratoderma of the palms and soles with a leather grain-like texture typical of KID syndrome was apparent by adolescence. Chronic conjunctivitis, photophobia, and keratitis were present as well as perioral furrowing. Dramatic hyperkeratosis of plaques on the scalp and feet required regular monitoring for squamous cell carcinoma. Note the scar from excision and grafting of a tumor on the top of the left foot.
keratoderma, thick yellow warty plaques, nail dystrophy