We report a rare case of sporadic keratosis punctata palmaris et plantaris in a 49-year-old woman. Thirty years ago, firm semitranslucent papules developed on the middle portion of her palms without any subjective symptom. The lesions had flat-topped smooth surfaces. They were concentrated along the margins of the hands, especially on the lateral surfaces of both index fingers and finger tips/ Ten years ago, similar hyperkeratotic papules with or without central craters developed on the weight bearing portions of her soles. Her family and past histories were negative. The biopsy specimen revealed a dense hyperderatotic stratum corneum which fitted into a cup shaped depression in the stratum malpighii and a turning inward of the rete ridges at the margin. The Masson trichrome and elastic strains showed no peicific dermal changes.