Keratosis Punctata of the Instep

We present a case of keratosis punctata involving the instep of both feet in addition to palmar and plantar creases, a finding not previously reported to our knowledge. We also discuss a closely related entity, keratosis punctata palmaris et plantaris (KPPP), and why we believe our case does not simply represent a variant of keratosis punctata of the palmar creases (KPPC).