| Five patients with varying severities of hyperkeratotic verrucous thickening at the skin illustrate that the condition may occasionally become elephantoid. |
| Histologically, EIFSR is characterized by thick, well-defined hyperkeratotic lesions. |
| Cholesteatoma of the paranasal sinuses occurs when the normal respiratory epithelium is replaced by hyperkeratotic squamous epithelium. |
| On physical exam, both patients had maceration of the toe-webs with a hyperkeratotic rim, a finding noted in other reports of gram-negative toe-web infections. |
| Further examination revealed a brownish-yellow excrescence made up of dense hyperkeratotic tissue with longitudinal ridges on an erythematous base. |
| A subset of patients with HLE develop hyperkeratotic papules with central keratinous plugging clinically and histologically reminiscent of keratoacanthomas. |
