A 34-year-old black woman reported an intermittent history of blistering and scaling bilaterally on her palms and soles. The eruptions have been occurring since late adolescence. The patient complained of periodic itching and burning; rarely, she experienced pain. OTC topical antibiotic ointment and antifungal creams had brought no relief; she had not tried any prescription treatments. She denied new household or work exposures. Her past medical history was significant for type 2 diabetes and hypertension.