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Correspondence |

Cole Disease: Guttate Hypopigmentation and Punctate Palmoplantar Keratoderma

Megan M. Moore, MD; Seth J. Orlow, MD, PhD; Hideko Kamino, MD; Nadia Wang, MD; Julie V. Schaffer, MD
Arch Dermatol. 2009;145(4):495-497. doi:10.1001/archdermatol.2009.54.
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Cole disease is an autosomal dominant genodermatosis characterized by guttate hypopigmentation and palmoplantar keratoses. Initially described in the Archives in 1976,1 an additional affected family has subsequently been identified.2 We herein describe a child with Cole disease, drawing attention to findings that distinguish it from other genodermatoses that feature pigmentary anomalies and punctate keratoderma.

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Figure 1.

Clinical photographs of our patient. Guttate hypopigmentation on the upper (A) and lower (B) extremities. Pink to yellowish keratotic papules on the plantar foot with a coalescence of larger lesions on the heel (C).

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Figure 2.

Histopathologic findings from our patient. Patchy hypomelanosis and a normal density of melanocytes in a biopsy specimen from a hypopigmented macule (A) (hematoxylin-eosin, original magnification ×200), with uneven pigmentation highlighted by a Fontana-Masson stain for melanin (B) (original magnification ×200). C, Orthokeratosis, acanthosis, and small dermal deposits of calcium in a biopsy specimen from a plantar papule (hematoxylin-eosin, original magnification ×200).

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