Abstract: LI Chang-xing, HAN Chun-lei. Dongguan Hospital for Chronic Disease Prevention and Control, Dongguan 524001, Guangdong, China 【Abstract】 Objective To analyze the clinical, demographic and pathologic features of symmetric acral keratoderma. Methods Totally, 62 outpatients with symmetric acral keratoderma were collected at the Dongguan Hospital for Chronic Disease Prevention and Control from May 2003 to June 2012. Data on these patients, including demographic information, family history, physical and pathological examination findings, were reviewed. Results There were 55 males and 7 females among these patients. The age at onset and disease duration varied from 4 to 53 years （average: 24.02 years） and from 15 days to 10 years（average: 26.65 years） respectively. Characterized manifestation was brown keratinized patches on the dorsum of hands and digits, wrists, elbows, knees, ankles, and along the lateral margin of palms, which became white 3 to 6 minutes after immersing in water. Lesions usually resolved spontaneously in winter. Microscopic examination of lesions for fungal elements was negative. Histopathology revealed epidermal hyperkeratosis, acanthosis and mild papillomatous hyperplasia as well as dermal infiltrates with a few lymphocytes. Conclusion Symmetric acral keratoderma is a skin disease characterized by symmetric acral keratosis with apparent seasonality.