|Year : 1995 | Volume
| Issue : 2 | Page : 123-124
A Ghorpade, C Ramanan
Source of Support: None, Conflict of Interest: None
An 18 year-old-girl with multiple lesions of punctate porokeratosis on her right palm is described. The diagnosis was confirmed by histopathology. The disease has been reported rarely. Histopathology is important to distinguish it from other similar looking conditions.
Keywords: Porokeratosis, Punctate porokeratosis
|How to cite this article:|
Ghorpade A, Ramanan C. Punctuate porokeratosis. Indian J Dermatol Venereol Leprol 1995;61:123-4
| Introduction|| |
Porokeratosis is a chronic disorder of keratinization which manifests usually in the form of annular or gyrate plaques with an elevated hyperkeratotic border. The inheritance pattern is autosomal dominant. Different types of porokeratosis have been described viz. porokeratosis of Mibelli, disseminated superficial actinic porokeratosis, linear porokeratosis, giant porokeratosis, disseminated superficial porokeratosis and palmoplantar porokeratosis. Punctate porokeratosis has been rarely reported in international literature. From our country, it has been reported only twice,, of which one report was by us.
| Case Report|| |
An eighteen-year-old girl consulted us for asymptomatic skin lesions on the left palm of six months duration. There was no history of trauma or friction at the site. There was no family history of similar lesions and no history of topical applications. She had no history of any prolonged illness in the past or history suggestive of exposure to arsenic. Cutaneous examination revealed multiple, superficial, circular pits 1-2 mm in diameter situated on raised, hyperkeratotic, slightly brownish area on the middle portion of left palm, extending to the medial border [Figure - 1]. There were no other skin lesions. The hair, nails and oral mucosae were normal and systemic examination non-contributory. Histopathology from one of the skin lesions revealed marked hyperkeratosis and a parakeratotic column in the centre of a deep epidermal invagination and loss of the underlying granular layer [Figure - 2]. Topical tretinoin cream [0.05 %] resulted in slight improvement after 8 weeks.
| Discussion|| |
Punctate porokeratosis is a rare variety of porokeratosis. It is characterised by seedlike punctate keratoses and/or pits on palms and soles. Sometimes, they have a linear configuration and may be associated with linear porokeratosis.
Clinically, the disease may be confused with punctate palmoplantar keratoderma, warts, arsenical keratoses, pitted keratolysis, Darier's disease, naevoid basal cell epithelioma syndrome, Cowden's disease and naevus comedonicus. Also porokeratotic eccrine ostial and dermal duct naevus may mimick the condition. However, finding of a cornoid lamella seen as a parakeratotic column arising from a furrow in the irregularly acanthotic epidermis without an intervening granular layer, will readily clinch the diagnosis.
| References|| |
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|2.||Himmelstein R, Lynfield YL. Punctate porokeratosis. Arch Dermatol 1984;120:263-4. [PUBMED] |
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[Figure - 1], [Figure - 2]