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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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Follicular Porokeratoma: Report of a New Variant of Porokeratoma (Porokeratotic Acanthoma) and Literature Review. Am J Dermatopathol 2022; 44:748-752. [PMID: 35925572 DOI: 10.1097/dad.0000000000002271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Porokeratoma is a rare type of epidermal acanthoma, of which 22 cases have been published in the literature. It is characterized by the presence of multiple cornoid lamellae embedded within a single verrucous or keratotic nodule. Despite this histologic feature being shared with porokeratosis, the etiopathogenesis of porokeratoma and its relationship with porokeratosis remain unclear. We report a new case of porokeratoma involving hair follicles, a finding that has been reported in only one of the previously published cases. Analogous to follicular porokeratosis, a form of porokeratosis involving hair follicles, we have termed this lesion "follicular porokeratoma." A review of all 23 published cases (including the present case) is also provided.
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Li SS, Compton LA, Nemer KM. Porokeratoma treated with topical 5% 5-fluorouracil cream. Int J Womens Dermatol 2021; 7:830-831. [PMID: 35028392 PMCID: PMC8714602 DOI: 10.1016/j.ijwd.2021.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/11/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Steve S Li
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Leigh A Compton
- Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
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Zaar O, Polesie S, Navarrete-Dechent C, Errichetti E, Akay BN, Jaimes J, Cabo H, Cohen Sabban E, Paoli J. Dermoscopy of porokeratosis: results from a multicentre study of the International Dermoscopy Society. J Eur Acad Dermatol Venereol 2021; 35:2091-2096. [PMID: 34077570 DOI: 10.1111/jdv.17439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The diagnosis of porokeratosis can be challenging, and knowledge about its dermoscopic features is limited. OBJECTIVES To describe the dermoscopic features of porokeratosis of Mibelli and disseminated superficial actinic porokeratosis (DSAP) and the frequency of these features in a larger case series. The interobserver concordance was also assessed. METHODS In this retrospective cohort study, members of the International Dermoscopy Society contributed macroscopic and dermoscopic images of histopathologically verified cases of porokeratosis of Mibelli or DSAP. Three observers independently reviewed the collected images to identify the presence of predefined dermoscopic features. Following this, a consensus meeting was held to agree upon which dermoscopic features were present in each lesion. RESULTS In total, 78 clinical and dermoscopic images of porokeratoses were collected. The most common dermoscopic feature was keratin rim, which was present in 74 lesions (92.3%). The most common vascular structures were dotted or glomerular vessels which were present in almost half of the cases (48.7%). Other relatively frequent dermoscopic findings were as follows: non-peripheral scales (44.9%), grey-brown dots or pigmentation along the keratin rim (38.5%), and light-brown pigmentation within the keratin rim (33.3%). Shiny white structures and blood spots or erosions along the keratin rim were findings never before described in porokeratosis and were detected in 16.7% and 17.9% of the lesions, respectively. Dermoscopic findings in porokeratosis of Mibelli and DSAP were similar except for fewer blood spots or erosions along the keratin rim and more light-brown pigmentation within the keratin rim in DSAP. The interobserver concordance ranged from 0.44 (moderate) to 0.84 (almost perfect). CONCLUSIONS The dermoscopic hallmark of porokeratosis is the keratin rim, a finding also allowing for almost perfect interobserver agreement. Pigmentation or erosions along the keratin rim, vascular structures, as well as scales, pigmentation or shiny white structures within the keratin rim are additional dermoscopic clues.
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Affiliation(s)
- O Zaar
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - S Polesie
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Navarrete-Dechent
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - E Errichetti
- Institute of Dermatology, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - B N Akay
- Department of Dermatology, Medicine Faculty, Ankara University, Ankara, Turkey
| | - J Jaimes
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - H Cabo
- Dermatology Department, Medical Research Institute, University of Buenos Aires, Argentina
| | - E Cohen Sabban
- Dermatology Department, Medical Research Institute, University of Buenos Aires, Argentina
| | - J Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Qian W, Xiong S, Tian X. Porokeratoma in the nipple: A case report. Australas J Dermatol 2020; 62:e325-e326. [PMID: 33095456 DOI: 10.1111/ajd.13490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Wenjun Qian
- Institute of Dermatology, Guangzhou Medical University, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Siying Xiong
- Institute of Dermatology, Guangzhou Medical University, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
| | - Xin Tian
- Institute of Dermatology, Guangzhou Medical University, China.,Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, China
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