multiple minute digitate hyperkeratosis multiple minute digitate hyperkeratosis multiple minute digitate hyperkeratosis (also known as "digitate keratoses," "disseminated spiked hyperkeratosis," "familial disseminated piliform hyperkeratosis," and "minute aggregate keratosis") is a rare cutaneous condition, with about half of cases being familial, inherited in an autosomal dominant fashion, while the other half are sporadic. multiple minute digitate hyperkeratosisspecialtydermatology this disease has a unique histology, so a biopsy and further tests should be done to confirm the diagnosis and rule out other disorders and malignancy.