Acral freckling with palmar pits.

Abstract

A 32-year-old female patient presented with asymptomatic hyperpigmentation of both the forearms and hands since 15 years. The pigmentation initially began over the hands and gradually extended to involve the forearms. Patient’s mother and sister also had similar complaints. Clinical examination revealed multiple hyperpigmented macules configured in a reticulate pattern involving the dorsal aspect of hands [Figure 1] and extensor aspects of both forearms [Figure 2]. Palmar aspects of both the hands had multiple fine pits [Figure 3]. Rest of the cutaneous examination was unremarkable.