Granular Parakeratosis: A Comprehensive Review and a Critical Reappraisal

Granular Parakeratosis of the Eccrine Ostium: A Case Report

Granular parakeratosis (GP) is a unique keratotic disorder that often affects the intertriginous areas. GP usually presents as erythematous or brownish hyperkeratotic papules or plaques and can be further classified into five types. GP of the eccrine ostium is a rare subtype; its pathological defects are mainly localized to the stratum corneum of the eccrine ostia. Due to its rarity, there is usually a delay in diagnosing GP, and these patients are often misdiagnosed with other dermatological conditions. In this report, we present the case of a 64-year-old Thai female who presented with recurrent pruritic erythematous rashes on her neck since approximately 40 years. She was previously diagnosed with eczema or folliculitis. Histopathological examination confirmed a final diagnosis of GP of the eccrine ostium. She was advised to avoid excessive heat and keep her intertriginous areas dry. Her condition improved significantly during the follow-up visit.

Granular parakeratosis involving the dorsum of the hands; skin reactions due to irritant agents: A case report

Key Clinical Message

We described the first case of granular parakeratosis with an unusual presentation of brown discoloration plaques and multiple erythematous on the dorsal part of the patient's hands. Skin maceration and repeated washing could have led to the development of the lesions.

Abstract

Granular parakeratosis is a unique acquired keratinization disorder. Here, we described the abnormal presentation of granular parakeratosis. A healthy female aged 27 years old presented brown discoloration plaques and multiple erythematous on the dorsal part of her hands for 8 months. Using detergents, repeated washing, and skin maceration were considered the causes of her lesion.

Verrucous Granular Parakeratosis on the Groin: A Case Report

Granular parakeratosis is a rare dermatosis characterized by erythematous scaly patches or papules, and plaques, often involving intertriginous areas. In this work, a 73-year-old Chinese male patient presented with a 6-month history of pruritic verrucous papules on the bilateral groin. A skin biopsy was performed and revealed the following: the horny layer showed highly compact hyperkeratosis and parakeratosis with basophilic granules; the epidermis showed obvious acanthosis with psoriasiform hyperplasia. The final diagnosis was verrucous granular parakeratosis. We also reviewed the progress in nomenclature, etiology, clinical manifestations, differential diagnosis and treatment. Different clinical manifestations may represent different clinical entities. Dermatologists should differentiate it from other diseases to make a correct diagnosis. Treatment options should be based on the variable etiologies and clinical manifestations.

Erythematous flexural eruption in a young man

A young man presented with a 2-week history of well-defined erythematous plaques symmetrically distributed in multiple intertriginous areas. He had received topical corticosteroids, antifungals and oral prednisolone without improvement. Histopathological examination revealed confluent parakeratosis with retention of basophilic keratohyalin granules within the stratum corneum.

Granular Parakeratosis: A Case Report

Granular parakeratosis is an uncommon acquired keratinization disorder that occurs in the armpit, groin, and other parts of the body. It may be related to stimulation by detergents and antiperspirants. This article reports a case of granular parakeratosis in the groin. The patient was a young man with no predisposing factors. The clinical manifestations included symmetrical bilateral inguinal erythema, dryness, and a small amount of bran-like desquamation. After histopathological examination, the final diagnosis was granular parakeratosis, which was cured by topical application of glucocorticoid cream and silicone oil cream. Granular parakeratosis is a rare skin disease of unknown etiology. Clinicians need to pay attention to this disease and differentiate it from various diseases to avoid misdiagnosis.

Granular Parakeratosis With Spontaneous Resolution: A Case Report

Granular parakeratosis (GP) is a rare, idiopathic, and self-limiting cutaneous disorder. It clinically presents as erythematous to brown hyperkeratotic or scaly papules that can coalesce to form plaques. If GP is suspected clinically, histopathological confirmation is adequate for diagnosis. Several treatment modalities were tried with varying success, but none was consistently efficacious.

Given the rarity of GP and the variety in its clinical presentation and management, we report a case of a self-resolving infra-abdominal GP. Our patient is a 47-year-old female who presented with a one-week history of asymptomatic, multiple, linear, horizontal, brown, hyperpigmented scaly papules in the infra-abdominal fold. She had a three-year history of applying almond oil and Sudocrem Antiseptic Healing Cream®. Histopathology showed the retention of basophilic keratohyalin granules within the area of parakeratosis in the stratum corneum, which is consistent with GP. She was discharged on emollients, and on follow-up one month later, her lesions completely resolved.

In conclusion, GP is a rare cutaneous disorder characterized by hyperkeratotic plaques or papules typically on intertriginous areas. The natural history of the disease may vary from spontaneous resolution to a waxing and waning condition. In addition, given how uncommon the disease is and its variable etiologies and course, definite management is yet to be established and a standardized treatment recommendation is lacking.

Follicular Granular Parakeratosis: A Case Report, Literature Review, and Proposed Classification

Granular parakeratosis (GP) is a distinctive acquired keratotic dermatosis that is usually presented with brownish-red hyperkeratotic papules and plaques in the intertriginous areas. Follicular involvement in GP could be either extending lesions from interfollicular epithelium or originating primarily from the follicular epithelium. The latter was named follicular GP and is considered an extremely rare condition. To our knowledge, there has been one reported case so far in the literature. We herein report the second case of follicular GP in a 52-year-old Thai man presenting with multiple tiny filiform hyperkeratotic papules on his face 2 weeks after using anti-melasma cream. We also propose a classification of GP based on its distinct clinical manifestations and histopathological findings.