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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: 0] [Impact Index Per Article: 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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2
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Moore S, Rady P, Tyring S. Acquired epidermodysplasia verruciformis: clinical presentation and treatment update. Int J Dermatol 2021; 61:1325-1335. [PMID: 34403500 DOI: 10.1111/ijd.15857] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/08/2021] [Accepted: 07/28/2021] [Indexed: 12/01/2022]
Abstract
Acquired epidermodysplasia verruciformis (AEV) is a form of epidermodysplasia verruciformis (EV) that is most commonly found in immunocompromised or immunosuppressed patients. EV is commonly associated with human papillomavirus (HPV), which is often found in EV and AEV lesions. Clinical presentation of AEV in patients with organ transplantation, HIV+, congenital HIV+, hematological diseases, and other iatrogenic immunosuppression are reviewed. Treatment options include topical cidofovir, topical retinoids, topical imiquimod, topical glycolic acid, HPV 9-valent vaccine, acitretin, improving cellular immunity, and changing transplant medication to mycophenolate mofetil.
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Affiliation(s)
- Stephen Moore
- Department of Dermatology, McGovern Medical School at UTHealth, Houston, Texas, USA.,Rice University, Houston, Texas, USA
| | - Peter Rady
- Department of Dermatology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Stephen Tyring
- Department of Dermatology, McGovern Medical School at UTHealth, Houston, Texas, USA
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3
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Ko CJ, Wang A, Panse G, Lee EE, Wang RC, Whang PG, Bosenberg M, Damsky W. HPyV6- and HPyV7-negative parakeratosis and dyskeratosis in squamous cell carcinoma in situ. J Cutan Pathol 2021; 48:998-1000. [PMID: 33813761 DOI: 10.1111/cup.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Christine J Ko
- Department of Dermatology, Yale University Medical School, New Haven, Connecticut, USA.,Department of Pathology, Yale University Medical School, New Haven, Connecticut, USA
| | - Alice Wang
- Department of Dermatology, Yale University Medical School, New Haven, Connecticut, USA
| | - Gauri Panse
- Department of Dermatology, Yale University Medical School, New Haven, Connecticut, USA.,Department of Pathology, Yale University Medical School, New Haven, Connecticut, USA
| | | | - Richard C Wang
- Department of Dermatology, University of Texas Southwestern, Dallas, Texas, USA
| | - Peter G Whang
- Department of Orthopaedic Surgery, Yale University Medical School, New Haven, Connecticut, USA
| | - Marcus Bosenberg
- Department of Dermatology, Yale University Medical School, New Haven, Connecticut, USA.,Department of Pathology, Yale University Medical School, New Haven, Connecticut, USA
| | - William Damsky
- Department of Dermatology, Yale University Medical School, New Haven, Connecticut, USA.,Department of Pathology, Yale University Medical School, New Haven, Connecticut, USA
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de Wet J, Swart M, Jordaan HF, Schneider JW, Mulder S, Visser WI. An unusual case of generalized hyperkeratotic and verrucous porokeratosis. JAAD Case Rep 2020; 6:925-930. [PMID: 32923569 PMCID: PMC7475069 DOI: 10.1016/j.jdcr.2020.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Johann de Wet
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Minette Swart
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - H Francois Jordaan
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Johann W Schneider
- Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Suzanne Mulder
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
| | - Willem I Visser
- Division of Dermatology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Cape Town, South Africa
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5
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Sarfo A, Helm K, Flamm A. Cutaneous myxomas and a psammomatous melanotic schwannoma in a patient with Carney complex. J Cutan Pathol 2019; 46:93-96. [DOI: 10.1111/cup.13385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/17/2018] [Accepted: 10/22/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Akua Sarfo
- Department of Dermatology; The Pennsylvania State University College of Medicine; Hershey Pennsylvania
| | - Klaus Helm
- Department of Dermatology; The Pennsylvania State University College of Medicine; Hershey Pennsylvania
| | - Alexandra Flamm
- Department of Dermatology; The Pennsylvania State University College of Medicine; Hershey Pennsylvania
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Nguyen KD, Chamseddin BH, Cockerell CJ, Wang RC. The Biology and Clinical Features of Cutaneous Polyomaviruses. J Invest Dermatol 2018; 139:285-292. [PMID: 30470393 DOI: 10.1016/j.jid.2018.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022]
Abstract
Human polyomaviruses are double-stand DNA viruses with a conserved genomic structure, yet they present with diverse tissue tropisms and disease presentations. Merkel cell polyomavirus, trichodysplasia spinulosa polyomavirus, human polyomavirus 6 and 7, and Malawi polyomavirus are shed from the skin, and Merkel cell polyomavirus, trichodysplasia spinulosa polyomavirus, human polyomavirus 6 and 7 have been linked to specific skin diseases. We present an update on the genomic and clinical features of these cutaneous polyomaviruses.
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Affiliation(s)
- Khang D Nguyen
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA
| | - Bahir H Chamseddin
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA
| | - Clay J Cockerell
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA
| | - Richard C Wang
- Department of Dermatology, The University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, Texas, USA.
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8
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Canavan TN, Baddley JW, Pavlidakey P, Tallaj JA, Elewski BE. Human polyomavirus-7-associated eruption successfully treated with acitretin. Am J Transplant 2018; 18:1278-1284. [PMID: 29275541 DOI: 10.1111/ajt.14634] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 12/13/2017] [Accepted: 12/18/2017] [Indexed: 01/25/2023]
Abstract
Advances in molecular technologies have led to the discovery of several novel human polyomaviruses (HPyVs), including human polyomavirus-7 (HPyV-7). Although low levels of HPyV-7 are shed from apparently normal skin, recent reports have described clinically significant cutaneous infection in immunocompromised patients that manifests as generalized pruritic plaques. The pruritus can be severe, and treatment options have not been described. Herein we report HPyV-7 cutaneous infection in a heart transplant patient who experienced temporary improvement with intravenous cidofovir, and complete remission with acitretin. We report a case of HPyV-7 cutaneous infection demonstrating a good response to treatment.
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Affiliation(s)
- T N Canavan
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J W Baddley
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - P Pavlidakey
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J A Tallaj
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - B E Elewski
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, USA
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Marciano-Fellous L. [Cutaneous infections: Pathologist's role in unusual or atypical situations]. Ann Pathol 2017; 38:20-30. [PMID: 29287934 DOI: 10.1016/j.annpat.2017.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 10/26/2017] [Indexed: 11/16/2022]
Abstract
In infectious pathology, the gold standard consists of the detection of the pathogen within the sample. Identification of the pathogen is often difficult despite the presence of few and inexpensive tools, such, as special stain, immunohistochemistry, or in situ hybridization specific of the pathogen. In infectious pathology, there are morphological signs, which can guide us towards an etiology. We present some clinicopathological examples illustrating rare or unusual situations in cutaneous infectious pathology.
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Affiliation(s)
- Léa Marciano-Fellous
- Département de pathologie, groupe hospitalier Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
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Matsumoto A, Wang R, Carlson JA. Columnar dyskeratosis-A clue to Wong-type dermatomyositis? J Cutan Pathol 2017; 44:813-814. [PMID: 28707759 DOI: 10.1111/cup.12996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Andrew Matsumoto
- Department of Pathology, Albany Medical College, Albany, New York
| | - Richard Wang
- Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas
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Nguyen KD, Lee EE, Yue Y, Stork J, Pock L, North JP, Vandergriff T, Cockerell C, Hosler GA, Pastrana DV, Buck CB, Wang RC. Human polyomavirus 6 and 7 are associated with pruritic and dyskeratotic dermatoses. J Am Acad Dermatol 2016; 76:932-940.e3. [PMID: 28040372 DOI: 10.1016/j.jaad.2016.11.035] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/08/2016] [Accepted: 11/15/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Human polyomavirus (HPyV)6 and HPyV7 are shed chronically from human skin. HPyV7, but not HPyV6, has been linked to a pruritic skin eruption of immunosuppression. OBJECTIVE We determined whether biopsy specimens showing a characteristic pattern of dyskeratosis and parakeratosis might be associated with polyomavirus infection. METHODS We screened biopsy specimens showing "peacock plumage" histology by polymerase chain reaction for HPyVs. Cases positive for HPyV6 or HPyV7 were then analyzed by immunohistochemistry, electron microscopy, immunofluorescence, quantitative polymerase chain reaction, and complete sequencing, including unbiased, next-generation sequencing. RESULTS We identified 3 additional cases of HPyV6 or HPyV7 skin infections. Expression of T antigen and viral capsid was abundant in lesional skin. Dual immunofluorescence staining experiments confirmed that HPyV7 primarily infects keratinocytes. High viral loads in lesional skin compared with normal-appearing skin and the identification of intact virions by both electron microscopy and next-generation sequencing support a role for active viral infections in these skin diseases. LIMITATION This was a small case series of archived materials. CONCLUSION We have found that HPyV6 and HPyV7 are associated with rare, pruritic skin eruptions with a distinctive histologic pattern and describe this entity as "HPyV6- and HPyV7-associated pruritic and dyskeratotic dermatoses."
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Affiliation(s)
- Khang D Nguyen
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Eunice E Lee
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yangbo Yue
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jiri Stork
- Dermatohistopathological Laboratory, Charles University in Prague, Prague, Czech Republic
| | - Lumir Pock
- Bioptical Laboratory, Pilsen, Czech Republic
| | - Jeffrey P North
- Dermatology and Pathology, University of California, San Francisco, California
| | - Travis Vandergriff
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Clay Cockerell
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas; Cockerell Dermatopathology, Dallas, Texas
| | - Gregory A Hosler
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas; ProPath, Dallas, Texas
| | | | | | - Richard C Wang
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
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