A 30-year-old male presented with asymtomatic, well-marginated, red scaly plaques involved the upper inner thighs and hands of many years duration. The plaques on the hands produced keratoderma with fissuring of the palms. Most topical anti-psoriatic therapies failed to produce significant improvement. Shifting the patient to Acitretin 25 mg per day yielded excellent response in thigh lesions and satisfactory improvement of palmar lesions.