Keratoderma climactericum is apparently a rare disease in North America if one is to judge by the paucity of clinical reports.1 The original report by Haxthausen1adescribed "a distinct clinical picture consisting of circumscribed hyperkeratosis, mainly of palms and soles in women in association with the climacteric, and accompanied by various general signs and symptoms, of which obesity and hypertension are the most frequently encountered." The hyperkeratoses are discrete at the beginning and project only slightly above the level of the skin. The horny layer is often slightly frayed and sometimes crossed by fissures. There are no miliary vesicles, erythema or other evidences of eczema. There is no itching unless the eruption becomes eczematized, which is when the patient seeks medical aid. The asbestos-like layer does not permit exfoliation by grattage as with psoriasis. The dermatosis is always found in association with the menopause