Epidermolytic hyperkeratosis (EHK), also known as bullous congenital ichthyosiform erythroderma of Brocq, is a rare autosomal dominant disorder of cornification with a prevalence of 1:100,000 to 1:300,000, which affects both sexes equally, with high rates of spontaneous mutations occurring in up to 50% of the cases. The name "epidermolytic hyperkeratosis" was introduced by Frost and Van Scott for the autosomal dominant blistering form of congenital ichthyosis [1]. It presents at birth with generalized erythema, blisters, and erosions. In the months after birth, erythema and blistering decrease, while hyperkeratotic scaling that is especially prominent over the joints, neck, and dorsum of hands and feet increases. The condition is caused by mutations in either keratin 1 or keratin 10 gene, located on chromosome 12 or 17, respectively [2]. Treatment options are very limited and include urea or alpha-hydroxy acid containing creams as well as topical and systemic retinoids. Case Report A 10-year-old girl presented to the department of dermatology at the University Hospital in Sana'a, Yemen, with dirty brown, corrugated hyperkeratotic plaques distributed all over her body, most prominent over joint flexures, dorsal hands and feet, and neck. Similar lesions arranged in a cobblestone pattern were visible over the knees, elbows, and dorsum of hands and feet. The palms, soles, and central face were not affected. Her condition started at birth with generalized erythroderma and trauma-related blistering. By the age of 3 years, she developed dirty brown, corrugated hyperkeratotic plaques mainly over her joint flexures. Although she continued to develop erythema and blisters, such episodes decreased in severity and frequency with age. As the hyperkeratosis became more prominent, the skin developed a foul odor. Physical examination revealed thickened, brown, dirty hyperkeratotic corrugated plaques distributed over the neck, back, and flexural surfaces of her arms and legs (Figure. 1-6), affecting approximately 95% of her body surface area (Figure. 1,5,6). Areas of mild erythema with minimal scaling were evident on her left lower (Figure. 4,6) and upper limbs (Figure. 2). Her scalp hairs were enclosed within whitish thick scales resembling pityriasis amiantacea.