We report the case of a 45 year-old male with palmoplantar hyperkeratosis. He had chronic thyroiditis with severe hypothyroidism. Skin lesions improved upon thyroid hormone replacement. Complete resolution of palmoplantar keratoderma was achieved after 7 months of therapy. The association of acquired palmoplantar keratoderma with hypothyroidism even though extremely unusual, should be considered in the differential diagnosis. It is a reversible condition.