HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Not rare, hereditary or also non-hereditary, acquired, disseminated form of porokeratosis in light-exposed areas. The single-cell lesion is a skin-colored, punctate-onset, centrifugally progressing, hard, hyperkeratotic papule with formation of an annular, parakeratotic horny ridge as well as central atrophy. Usually multiple single foci.
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EtiopathogenesisThis section has been translated automatically.
- In some patients an irregular autosomal dominant inheritance can be detected.
- Several cytogenetic aberrations on the following gene loci have been detected: 1p31.3-p31.1 - 15q25.1-q26.1 and others.
- However, most patients deny a familial occurrence.
- Excessive UV exposure can be detected in almost all cases. A combination with immunosuppression (HIV-infection; immunosuppressive therapies) is not entirely rare.
- Disseminated superficial eosinophilic porokeratosis may be drug-induced (thiazides) or occur spontaneously.
ManifestationThis section has been translated automatically.
Mostly occurring in fair-skinned adults with increased sun exposure, mostly 40th-50th LJ, women seem to be preferentially affected.
LocalizationThis section has been translated automatically.
Back of the hand, forearm extension sides, lower leg extension sides, no mucosal involvement.
Clinical featuresThis section has been translated automatically.
Round to oval, 0.2-0.5-1.5 cm large, skin-coloured or brownish-red, slightly sunken horn papules or plaques with sharply defined, hyperkeratotic rim wall.
HistologyThis section has been translated automatically.
Differential diagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
- Physical procedures such as curettage or ablative lasers (Co2 or erbium YAG laser)
- Vitamin D3 analogues
- Fluorouracil therapy
- Photodynamic therapy
- A smaller study (Schilling B 2018) reported good results with so-called borderline radiation (long-wave, soft X-rays).
- Another theapy option is topical diclofenac in combination with etretinate (Shimizu S et al. 2018).
- Light protection (e.g. Anthelios), see also below Light protection products.
Progression/forecastThis section has been translated automatically.
Progression with increasing age, especially in the summer months. The risk of malignant transformation to squamous cell carcinoma or basal cell carcinoma is reported to be 7.5% to 10% (Shimizu S et al 2018).
Notice. Provocation by UV rays and drugs (thiazides)!
Note(s)This section has been translated automatically.
Superficial eosinophilic porokeratosis: As a special form, "Superficial eosinophilic porokeratosis" is described with eosinophilic spongiosis and intraepidermal microabscesses.
Eruptive pruriginous papular porokeratosis: A further, but very rare variant (up to now <15 cases have been described) is the "Eruptive pruriginous papular porokeratosis" which is characterized by a sudden itching. The plumelike parakeratosis zones are related to the follicle. Eosinophilic granulocytes are also an essential part of the inflammatory infiltrate in this form.
LiteratureThis section has been translated automatically.
- Altmeyer P et al (1988) Disseminated superficial eosinophilic porokeratosis. Akt Dermatol 14: 287-289
- Besenhard HM et al (1988) Disseminated superficial actinic porokeratosis (DSAP) with Bowen's disease. Dermatol 39: 286-290
- Biswas A (2015) Cornoid lamellation revisited: apropos of porokeratosis with emphasis on unusual clinicopathological variants. Am J Dermatopathol 37:145-155
- Boente Mdel C et al (2003) Linear porokeratosis associated with disseminated superficial actinic porokeratosis: a new example of type II segmental involvement. Pediatr Dermatol 20: 514-518
- Chernosky ME, Freeman RG (1967) Disseminated superficial actinic porokeratosis. Arch Dermatol 96: 611-624
- Chernosky ME, Anderson DE (1969) Disseminated superficial actinic porokeratosis: clinical studies and experimental production of lesions. Arch Derm 99: 401-407
- Le C, Bedocs PM (2021). Disseminated superficial actinic porokeratosis. 2020 Aug 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing PMID: 29083728.
- Nayeemuddin FA et al (2002) Topical photodynamic therapy in disseminated superficial actinic porokeratosis. Clin Exp Dermatol 27: 703-706
- Schilling B (2018) Marginal radiation in refractory actinic porokeratosis: a tolerable and effective therapy. Karger Compass 6:32-33
- Schwarz T et al (1984) Disseminated superficial actinic porokeratosis. J Am Acad Dermatol 11: 724-730.
Shimizu S et al (2018) Inflammatory disseminated superficial porokeratosis successfully controlled with a combination of topical diclofenac gel and systemic etretinate. J Eur Acad Dermatol Venereol 32:e201-e202.
- Sidwell RU et al (2003) Giant actinic porokeratosis of the scalp. Br J Dermatol 149: 654
- Takahashi H et al (2015) Disseminated superficial actinic porokeratosis in a psoriasis patient with a long-term sun-bathing habit. J Dermatol 42:532-533
- Theng CT et al (2004) Warty nodules on an annular plaque in a renal transplant recipient. Arch Dermatol 140: 121-126
- Thomas C et al (2003) Hypertrophic perianal porokeratosis in association with superficial actinic porokeratosis of the leg. Clin Exp Dermatol 28: 676-677
- Torkamani N et al (2015) Disseminated superficial actinic porokeratosis accentuated by spray tan. Int J Dermatol 54:e545-546
Incoming links (10)Actinic porokeratosis; Disseminated porokeratosis; Disseminated superficial actinic porokeratosis; Eruptive pruritic papular porokeratosis; Palmoplantar keratoderma, punctate type 2; Porokeratosis disseminated superficial actinic; Porokeratosis mibelli; SART3 Gene; SSH1 Gene; Superficial eosinophilic porokeratosis;
Outgoing links (10)Acrokeratosis verruciformis; Actinic keratosis; Diclofenac; Keratosis follicularis; Light protection; Light stabilizers; Porokeratoses (overview); Porokeratosis mibelli; Psoriasis vulgaris; Verrucae planae juveniles;
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.