Granular parakeratosisR23.4
Synonym(s)
granular parakeratosis; granular verrucosis; granulomatous parakeratosis
HistoryThis section has been translated automatically.
Northcutt, 1991; Intertriginous granular parakeratosis, Mehregan 1998;
DefinitionThis section has been translated automatically.
Rare, circumscribed, sloppy, itchy, self-limited cornification anomaly with characteristic histological aspect occurring in intertrignial zones. The clinical picture is controversial as an entity. To what extent it is identical with a " pomade crust" is not conclusively clarified.
Occurrence/EpidemiologyThis section has been translated automatically.
So far, less than 100 cases have been described worldwide since the initial description.
EtiopathogenesisThis section has been translated automatically.
Unknown; a dermatophyte-induced form has been described; a disorder in filaggrin metabolismu is discussed.
ManifestationThis section has been translated automatically.
Primarily described exclusively in women of colour (average age about 60 years). Isolated reports also exist in adolescents and children (inguinal localisation).
LocalizationThis section has been translated automatically.
Preferably located in the axles. Occurrence is also described in other intertriginous zones (submammary, inguinal, overlapping abdominal folds, popliteal fossa).
Clinical featuresThis section has been translated automatically.
The primary changes are itchy, oval, hyperkeratotic, brown, lichenoid papules. Later on, there are sharply delineated, itchy, brown-black, 2-7 cm large verrucous plaques limited to the intertriginous zone, occurring unilaterally or symmetrically. The vegetation tends to macerate with a corresponding foetus. Formation of erosions and rhagades. Spontaneous healings after 2-3 months have been observed as well as recurrent processes.
HistologyThis section has been translated automatically.
On the surface, a powerfully thickened, compact stratum corneum with flattened core fragments is impressive. A prominent histological phenomenon are retentions of basophilic keratohyalin granules, which are included in the parakeratotic horn masses (picture of "polluted hyperkeratosis").
DiagnosisThis section has been translated automatically.
Clinic, histology.
Differential diagnosisThis section has been translated automatically.
Acanthosis nigricans; pemphigus chronicus benignus familiaris (M. Hailey-Hailey); intertriginous candidiasis.
External therapyThis section has been translated automatically.
Topical glucocorticoids possibly alternating with antimycotics.
Note(s)This section has been translated automatically.
Remember! The entity of this disease first described in 1991 is disputed!
LiteratureThis section has been translated automatically.
- Braun-Falco M et al (2009) Granular parakeratosis - a clinically pathological correlation in hand 10 patients. JDDG 7: 340-344
- Chang MW et al (2004) Infantile granular parakeratosis: recognition of two clinical patterns. J Am Acad Dermatol 50(5 Suppl): 93-96
- Contreras ME et al (2003) Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate. Int J Dermatol 42: 382-383
- English JC et al (2003) Axillary granular parakeratosis. J Cutan Med Surg 7: 330-332
- Martin-Garcia RF et al (2003) Granular parakeratosis. Bol Asoc Med P R 95: 43-46
- Northcutt AD et al (1991) Granular verrucosis. J Am Acad Dermatol 24: 541-544
- Pimentel DR et al (2003) Granular parakeratosis in children: case report and review of the literature. Pediatric Dermatol 20: 215-220
- Resnik KS, DiLeonardo M (2003) Follicular granular parakeratosis. At J Dermatopathol 25: 428-429
- Woodhouse JG (2004) Granular parakeratosis. Pediatric Dermatol 21: 684