Circumscribed acral hypokeratosis (CAH) is characterized by solitary or multiple circular, depressed, slightly erythematous patches on the palms or soles. Keratinization defects on acral sites or prior trauma to the affected area have been considered as potential triggers of CAH. Although affected Patients typically present with a long-term history of the disease and characteristic cutaneous lesions, CAH is not well known by dermatologists. In this article, we describe 2 patients with CAH. From a clinical point of view, we emphasize its unique cutaneous expression, and from a histologic perspective, we speculate on protracted or repetitive blunt trauma in the elicitation of this dermatosis, perhaps only in patients with a genetic predisposition.