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Year : 1995  |  Volume : 61  |  Issue : 2  |  Page : 123-124

Punctuate porokeratosis

Correspondence Address:
A Ghorpade

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Source of Support: None, Conflict of Interest: None

PMID: 20952913

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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

How to cite this URL:
Ghorpade A, Ramanan C. Punctuate porokeratosis. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2020 Feb 22];61:123-4. Available from: http://www.ijdvl.com/text.asp?1995/61/2/123/4166

  Introduction Top

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.[1] Punctate porokeratosis has been rarely reported in international literature.[2] From our country, it has been reported only twice,[3],[4] of which one report was by us.[3]

  Case Report Top

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 Top

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.[1]

Clinically, the disease may be confused with punctate palmoplantar keratoderma, warts, arsenical keratoses,[2] pitted keratolysis, Darier's disease, naevoid basal cell epithelioma syndrome, Cowden's disease and naevus comedonicus.[5] Also porokeratotic eccrine ostial and dermal duct naevus may mimick the condition.[6] 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.[5]

  References Top

1.Atherton DJ. Naevi and other developmental defects. In:Textbook of Dermatology. (Champion RH, Burton JL, Ebling FJG, eds).5th edn. Oxford : Blackwell Scientific1992;460:1388.  Back to cited text no. 1    
2.Himmelstein R, Lynfield YL. Punctate porokeratosis. Arch Dermatol 1984;120:263-4.  Back to cited text no. 2  [PUBMED]  
3.Ghorpade A, Ramanan C. Punctate Porokeratosis-a case report. Ind J Dermatol1991;36:93-5.  Back to cited text no. 3    
4.Gharpuray ME, Kulkarni V, Mahajan PM, et al. Porokeratosis palmaris et plantaris punctata. Ind J Dermatol Venereol Leprol 1988;54:308-9.  Back to cited text no. 4    
5.Rahbari H, Cordero A, Mehregan AM. Punctate porokeratosis:A clinical variant of porokeratosis of Mibelli. J Cutan Pathol 1977;4:338-41.  Back to cited text no. 5    
6.Aloi FG, Pippione M. Porokeratotic eccrine ostial and dermal duct nevus. Arch Dermatol 1986;122:892-5  Back to cited text no. 6  [PUBMED]  


[Figure - 1], [Figure - 2]


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