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Sudhesan A, Sukumaran PN, Ratnakaran R, Lazar AS. Verrucous Linear Porokeratosis with Dermal Amyloid Deposits - A Rare Presentation. Indian Dermatol Online J 2024; 15:515-517. [PMID: 38845643 PMCID: PMC11152496 DOI: 10.4103/idoj.idoj_297_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/08/2023] [Accepted: 06/11/2023] [Indexed: 06/09/2024] Open
Affiliation(s)
- Athira Sudhesan
- Department of Dermatology and Venereology, Government TD Medical College, Alappuzha, Kerala, India
| | - Pradeep N. Sukumaran
- Department of Dermatology and Venereology, Government TD Medical College, Alappuzha, Kerala, India
| | - Rashmi Ratnakaran
- Department of Pathology, Government TD Medical College, Alappuzha, Kerala, India
| | - Aswathy S. Lazar
- Department of Dermatology and Venereology, Government TD Medical College, Alappuzha, Kerala, India
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Pietkiewicz P, Korecka K, Salwowska N, Kohut I, Adhikari A, Bowszyc-Dmochowska M, Pogorzelska-Antkowiak A, Navarrete-Dechent C. Porokeratoses-A Comprehensive Review on the Genetics and Metabolomics, Imaging Methods and Management of Common Clinical Variants. Metabolites 2023; 13:1176. [PMID: 38132857 PMCID: PMC10744643 DOI: 10.3390/metabo13121176] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
Porokeratosis is a heterogeneous group of keratinising disorders characterised by the presence of particular microscopic structural changes, namely the presence of the cornoid lamella. This structure develops as a consequence of a defective isoprenoid pathway, critical for cholesterol synthesis. Commonly recognised variants include disseminated superficial actinic porokeratosis, disseminated superficial porokeratosis, porokeratosis of Mibelli, palmoplantar porokeratosis (including porokeratosis palmaris et plantaris disseminata and punctate porokeratosis), linear porokeratosis, verrucous porokeratosis (also known as genitogluteal porokeratosis), follicular porokeratosis and porokeratoma. Apart from the clinical presentation and epidemiology of each variant listed, this review aims at providing up-to-date information on the precise genetic background, introduces imaging methods facilitating the diagnosis (conventional and ultraviolet-induced fluorescence dermatoscopy, reflectance confocal microscopy and pathology), discusses their oncogenic potential and reviews the literature data on the efficacy of the treatment used, including the drugs directly targeting the isoprenoid-mevalonate pathway.
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Affiliation(s)
- Paweł Pietkiewicz
- Dermatology Private Practice, 61-683 Poznan, Poland
- Polish Dermatoscopy Group, 61-683 Poznan, Poland; (K.K.); (N.S.)
| | - Katarzyna Korecka
- Polish Dermatoscopy Group, 61-683 Poznan, Poland; (K.K.); (N.S.)
- Department of Dermatology and Venereology, Poznan University of Medical Sciences, 60-356 Poznan, Poland
| | - Natalia Salwowska
- Polish Dermatoscopy Group, 61-683 Poznan, Poland; (K.K.); (N.S.)
- Department of Dermatology, School of Medicine, Medical University of Silesia, 40-027 Katowice, Poland
| | - Ihor Kohut
- Skin Health Center, 46027 Ternopil, Ukraine;
| | | | - Monika Bowszyc-Dmochowska
- Cutaneous Histopathology and Immunopathology Section, Department of Dermatology, Poznan University of Medical Sciences, 60-356 Poznan, Poland;
| | | | - Cristian Navarrete-Dechent
- Melanoma and Skin Cancer Unit, Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile;
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Vargas-Mora P, Morgado-Carrasco D, Fustà-Novell X. Porokeratosis: A Review of its Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Brutsaert S, Macagno N, Amatore F, Cribier B, Richard MA. [Porokeratosis involving the fingers]. Ann Dermatol Venereol 2020; 147:907-909. [PMID: 32680711 DOI: 10.1016/j.annder.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/25/2020] [Accepted: 06/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- S Brutsaert
- Service de dermatologie et oncodermatologie, université Aix-Marseille, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Marseille, France.
| | - N Macagno
- Service d'anatomie et cytologie pathologiques, université Aix-Marseille, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - F Amatore
- Service de dermatologie et oncodermatologie, université Aix-Marseille, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | - B Cribier
- Clinique dermatopathologique, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France
| | - M-A Richard
- CEReSS-EA 3279, Research centrer in health services and quality of life, université Aix-Marseille, hôpital de la Timone, Assistance publique-Hôpitaux de Marseille, Marseille, France
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Vargas-Mora P, Morgado-Carrasco D, Fustà-Novell X. Porokeratosis: A Review of Its Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:545-560. [PMID: 32401728 DOI: 10.1016/j.ad.2020.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/14/2020] [Accepted: 03/30/2020] [Indexed: 12/17/2022] Open
Abstract
Porokeratosis comprises a group of heterogeneous and uncommon acquired or congenital skin diseases of unknown origin characterized by a keratinization disorder resulting from abnormal clonal expansion of keratinocytes. Numerous genetic mutations are thought to be involved. These conditions are characterized histologically by the presence of a cornoid lamella. Clinical manifestations are variable, with localized, disseminated, and even eruptive forms. Porokeratosis has been associated with immunosuppression, ultraviolet radiation, and systemic, infectious, and neoplastic diseases. Many authors consider it to be a premalignant condition because of the potential for malignant transformation to squamous cell or basal cell carcinoma. Therefore, long-term follow-up is a key component of treatment, which is usually complex and often unsatisfactory. We review the latest advances in our understanding of the pathogenesis, diagnosis, and treatment and propose a treatment algorithm.
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Affiliation(s)
- P Vargas-Mora
- Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, España.
| | - X Fustà-Novell
- Servicio de Dermatología, Althaia, Xarxa Assistencial Universitària de Manresa, España
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Koley S, Hassan S, Saha S. Giant porokeratosis: Report of three cases. Indian Dermatol Online J 2020; 11:983-987. [PMID: 33344352 PMCID: PMC7735012 DOI: 10.4103/idoj.idoj_356_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/02/2020] [Accepted: 09/12/2020] [Indexed: 11/04/2022] Open
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Abstract
BACKGROUND Porokeratosis (PK) is a rare skin disease of unknown etiology. It consists of a keratinization disorder, which may appear in several clinical forms and can undergo malignant transformation. The histopathological hallmark of PK is the cornoid lamella. While many topical, systemic, and surgical treatment modalities for PK have been described, no randomized controlled trials have been performed yet. Because of a lack of treatment standards for PK, European and international guidelines cannot be created. OBJECTIVE The aim of this systematic review is to outline options for treating PK. METHODS We performed a systematic literature search in an electronic database for published literature. A total of 88 articles fulfilling our inclusion criteria were found. RESULTS There were no randomized controlled trials on the treatment of PK, but mainly case reports and case series. Porokeratosis of Mibelli showed the best outcomes after treatment with imiquimod cream and linear PK responded well to topical or systemic retinoids. Topical vitamin D acid derivatives may be the best therapeutic option for disseminated PK. Surgical interventions and cryotherapy may be preferred in areas where the use of topical agents is difficult or contraindicated. CONCLUSION To offer patients with PK an evidence-based high-quality standardized therapy, randomized controlled trials are needed.
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Shahmoradi Z, Sadeghiyan H, Pourazizi M, Saber M, Abtahi-Naeini B. Recalcitrant Digital Porokeratosis of Mibelli: A Successful Surgical Treatment. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015. [PMID: 26199929 PMCID: PMC4488999 DOI: 10.4103/1947-2714.157485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Context: Porokeratosis of Mibelli (PM) is a rare, benign, asymptomatic, epidermal hyperkeratinization dermatitis that is characterized by annular plaque that expands through the edges and leaves an atrophic center. Many therapies have been attempted for the treatment of PM, but none of these have given satisfactory results. The efficacies of treatment options are limited, and currently there is no gold standard. Case Report: This paper reports the case of a 22-year-old female with 3-years history of PM, who had not responded to routine therapies like topical corticosteroids, topical tretinoin, topical salicylic acid, and various emollients and keratolytic agent. Cryosurgery and laser ablation did not have acceptable response. We used surgical treatment with successful cosmetic outcome. Conclusion: The treatment of PM should be individualized considering the aesthetic and functionality, and the patient's preferences. Complete surgical excision for isolated digital PM had good results.
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Affiliation(s)
- Zabihollah Shahmoradi
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Sadeghiyan
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Pourazizi
- Students' Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Mina Saber
- Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Abtahi-Naeini
- Skin Diseases and Leishmaniasis Research Center, Students' Research Committee, Isfahan, Iran
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Abstract
Abstract
Porokeratosis is a rare genodermatosis based on chronic keratinization disorder histologically characterized by the presence of a cornoid lamella and various clinical manifestations. Five most commonly described types of poroketarosis are porokeratosis of Mibelli or ”classic” porokeratosis, disseminated superfi cial actinic porokeratosis, disseminated palmoplantar porokeratosis, linear porokeratosis, and punctate porokeratosis. In all of the fi ve clinical types of porokeratosis described today, cases of planocellular skin carcinoma are described, except in punctate type cases. Use of topical CO2 laser ablation, cryotherapy and topical use of 5% Imiquimod cream, have shown favorable effects in local treatment of porokeratosis. The authors present a clinical case of a girl suffering from linear porokeratosis over the course of the last four years, spreading on the inside of her right arm along the lines of Blaschko. Linear porokeratosis was histologically confi rmed by biopsy of skin lesions and dermoscopy. Dermoscopic fi ndings, used as an auxiliary method, also indicated linear porokeratosis. Successful liquid nitrogen cryotherapy prompted the authors to present a case in which the applied treatment proved to be successful, but also to emphasize the need for timely treatment in order to prevent malignant alterations of these changes.
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NOBORIO R, MORITA A. Split-face trial of CO2laser-induced ring abrasion and high-dose tacalcitol in the treatment of disseminated superficial actinic porokeratosis. J Dermatol 2011; 39:879-80. [DOI: 10.1111/j.1346-8138.2011.01461.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bakardzhiev I, Kavaklieva S, Pehlivanov G. Successful treatment of disseminated superficial actinic porokeratosis with calcipotriol. Int J Dermatol 2011; 51:1139-42. [DOI: 10.1111/j.1365-4632.2010.04704.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Choi KH, Kim TY. A case of inflammatory disseminated superficial porokeratosis in a colon cancer patient. Ann Dermatol 2009; 21:150-3. [PMID: 20523774 DOI: 10.5021/ad.2009.21.2.150] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 10/28/2008] [Indexed: 12/19/2022] Open
Abstract
Disseminated superficial porokeratosis (DSP) is a specific disorder of keratinization. Genetic studies show that DSP is an autosomal dominant trait. Clinically, the lesions show a sharply demarcated and hyperkeratotic plaque with central atrophy. The lesions appear mainly in the extremities and generally develop with bilateral symmetry. Unusual cases of DSP accompanied by severe pruritus have been reported as "eruptive pruritic papular porokeratosis" or "inflammatory DSP." Histopathologically, inflammatory DSP is characterized by the presence of cornoid lamella with a dense infiltration of eosinophils and lymphocytes in the perivascular area of the upper dermis. Here we report a case of inflammatory DSP in a 84-year-old man with colon cancer who presented with multiple hyperpigmented atrophic macules.
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Affiliation(s)
- Koang Hyun Choi
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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De Simone C, Paradisi A, Massi G, Proietti I, Capponi A, Amerio PL, Capizzi R. Giant verrucous porokeratosis of Mibelli mimicking psoriasis in a patient with psoriasis. J Am Acad Dermatol 2007; 57:665-8. [PMID: 17870431 DOI: 10.1016/j.jaad.2007.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Revised: 03/03/2007] [Accepted: 03/31/2007] [Indexed: 02/01/2023]
Abstract
Porokeratosis of Mibelli is a disorder of epidermal keratinization characterized by annular plaques with an atrophic center surrounded by a keratotic wall. We report a case of a giant verrucous porokeratosis of Mibelli mimicking psoriasis that developed in a patient with psoriasis and therefore went unrecognized for a long time. Histologically the lesion combined features of porokeratosis at the periphery and of psoriasis at its center, a picture recently described as "psoriasis encircled by porokeratosis." The possible pathogenetic relationship between psoriasis and the development of porokeratosis is also discussed.
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Affiliation(s)
- Clara De Simone
- Department of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy
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