At his first well-child visit after a family move, an 8-year-old boy was noted to have bilateral erythematous plaques on the surfaces of his hands and feet. Mother reported that the condition had been present since he was 2 or 3 months old. Patient’s father and other male relatives on the paternal side (uncles, grandfather, great-grandfather) were similarly affected. No other associated symptoms, such as hyperhidrosis, reported. The child did not have a history of eczema, asthma, or food allergies; however, he did have a history of allergic rhinitis and occasional pruritus.