A 65-year-old retired man with hand eczema presented to the Dermatology clinic in October of 2001. He complained of scaly, fissured plaque-type lesions over the radial margin of his right index finger and thumb (Fig. 1). He first noticed these changes 2 years ago. There was no history of irritation from his occupation. None of the other family members were affected. There was no history of atopy or psoriasis.