A deficiency is one of several hypovitaminoses implicated in follicular hyperkeratosis. Severe cases are hard to distinguish from mild epidermolytic hyperkeratosis. Newborns with harlequin-type ichthyosis present with thick, fissured armor-plate hyperkeratosis. It is seen in skin diseases with epidermal hyperplasia and orthokeratotic hyperkeratosis. Management includes supportive care and treatment of hyperkeratosis and skin barrier dysfunction. They may be associated with acanthosis and hyperkeratosis. It has been suggested to be effective as a treatment for hyperkeratosis. Presentation includes telangiectasia, acanthosis, and hyperkeratosis. It is possible to classify epidermolytic hyperkeratosis based upon palm and sole hyperkeratosis. If a biopsy is taken, the histopathologic appearance is one of hyperkeratosis and acanthosis. The paw pads can be affected, causing marked hyperkeratosis (thickening of the pads with scale). The histologic appearance is similar to oral leukoplakia, with hyperkeratosis and acanthosis. Epidermolytic hyperkeratosis can be categorized into two types. The histologic appearance is similar to oral leukoplakia, with hyperkeratosis and possible dysplasia. The skin of the palms and soles may thicken (hyperkeratosis).