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Znamenskaya LF, Chikin VV, Kappusheva IA, Kondrasheva VV. ISSEMINATED SUPERFICIAL ACTINIC POROKERATOSIS IN PATIENT SUFFERING FROM PLAQUE PSORIASIS: A CASE REPORT. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-5-91-96] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Monitoring of disseminated superficial actinic porokeratosis (DSAP) in patient suffering from plaque psoriasis treated by PUVA therapy was presented. DSAP is a rare skin disease developing in the result of keratosis disorder caused by solar radiation and appearing as clearly localized ringed or line plates. As patients with DSAP are sensitive to solar radiation, phototherapy is contraindicated for them. In this regard, subcutaneous injections of Methotrexate 10 mg once a week were prescribed to a patient suffering from psoriasis. Psoriatic rashes were regressed after the second injection, instead of them DSAP rashes remained.
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Doherty CB, Krathen RA, Smith-Zagone MJ, Hsu S. Disseminated superficial actinic porokeratosis in black skin. Int J Dermatol 2009; 48:160-1. [PMID: 19200193 DOI: 10.1111/j.1365-4632.2009.03012.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Christy B Doherty
- Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA
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HERRANZ P, PIZARRO A, DE LUCAS R, ROBAYNA M, RUBIO F, SANZ A, CONTRERAS F, CASADO M. High incidence of porokeratosis in renal transplant recipients. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1997.d01-1164.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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HOLMES G, SIDHU S, WAKELIN S, ORTON D, MARREN P. Disseminated superficial actinic porokeratosis occurring in two members of an Asian family. Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1997.tb01096.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Touraud JP, Dalac S, Collet E, Tanter Y, Justrabo E, Dutronc Y, Lambert D. Punctate porokeratosis in a renal transplant recipient. Clin Exp Dermatol 2003; 28:329-30. [PMID: 12780730 DOI: 10.1046/j.1365-2230.2003.01262.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mizukawa Y, Shiohara T. Virus-induced immune dysregulation as a triggering factor for the development of drug rashes and autoimmune diseases: with emphasis on EB virus, human herpesvirus 6 and hepatitis C virus. J Dermatol Sci 2000; 22:169-80. [PMID: 10698154 DOI: 10.1016/s0923-1811(99)00083-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There are a considerable amount of empirical and theoretic medical literature regarding the possible role of viruses in the development of drug rashes and autoimmune diseases: under these conditions, interactions of viruses with the immune system would serve as an accelerating factor of disease pathogenesis. Recent reports have provided evidence to indicate that immune responses against infections with Epstein Barr (EB) virus and human herpesvirus 6 (HHV-6), which are lymphotropic members of the herpes virus group, not only aid the direct elimination of the virus but also contribute to a favorable milieu for the initiation or acceleration of drug rashes. Viruses that can persist for the lifetime of the host despite strong immune responses against them, such as EB virus and hepatitis C virus (HCV), would be also relevant to the pathogenesis of autoimmune diseases. HCV has been reportedly associated with a wide variety of dermatoses that, in common, show histologically the lichenoid tissue reaction. Although porokeratosis that manifests lichenoid histopathological features had long been regarded as being associated with immunosuppression, we found that HCV could act as trigger for the development of porokeratosis during states of immunosuppression. Thus, the main purpose of this review is to describe recent work on the etiology of drug rashes and autoimmune disease with special reference to viral infections.
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Affiliation(s)
- Y Mizukawa
- Department of Dermatology, Kyorin University School of Medicine, Mikata-city, Tokyo, Japan
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Knoell KA, Patterson JW, Wilson BB. Sudden onset of disseminated porokeratosis of Mibelli in a renal transplant patient. J Am Acad Dermatol 1999; 41:830-2. [PMID: 10534661 DOI: 10.1016/s0190-9622(99)70336-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Porokeratosis is a disorder of epidermal keratinization of uncertain cause. Five clinical variants of porokeratosis have been described. These include porokeratosis of Mibelli, punctate porokeratosis, linear porokeratosis, porokeratosis palmaris plantaris et disseminata, and disseminated superficial porokeratosis. Disseminated superficial porokeratosis and single plaque porokeratosis of Mibelli have each been documented to occur in association with immunosuppression. To our knowledge, only 5 cases of disseminated porokeratosis of Mibelli in transplant recipients have been reported. We present a patient who developed explosive onset of disseminated porokeratosis of Mibelli shortly after renal transplantation. It is important to differentiate this unusual variety of porokeratosis from other cutaneous manifestations in transplant patients so that appropriate therapy can be instituted.
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Affiliation(s)
- K A Knoell
- Department of Dermatology at the University of Virginia, Charlottesville, USA.
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Robak E, Woźniacka A, Sysa-J&ecedil;drzejowska A, Biernat W, Robak T. Disseminated superficial actinic porokeratosis in a patient with systemic lupus erythematosus. Br J Dermatol 1999; 141:759-61. [PMID: 10583141 DOI: 10.1046/j.1365-2133.1999.03134.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mizukawa Y, Shiohara T. Porokeratosis in patients with hepatitis C virus infection: does hepatitis C virus infection provide a link between porokeratosis and immunosuppression? Br J Dermatol 1999; 141:163-4. [PMID: 10417540 DOI: 10.1046/j.1365-2133.1999.02945.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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HERRANZ P, PIZARRO A, LUCAS R, ROBAYNA M, RUBIO F, SANZ A, CONTRERAS F, CASADO M. High incidence of porokeratosis in renal transplant recipients. Br J Dermatol 1997. [DOI: 10.1111/j.1365-2133.1997.tb14891.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- V N Sehgal
- Department of Dermatology, University College of Medical Sciences, Delhi, India
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Romaní J, Pujol RM, Casanova JM, de Moragas JM. Disseminated superficial porokeratosis developing after electron-beam total skin irradiation for mycosis fungoides. Clin Exp Dermatol 1996; 21:310-2. [PMID: 8959909 DOI: 10.1111/j.1365-2230.1996.tb00105.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 74-year-old man with stage IB cutaneous T-cell lymphoma was treated with electron-beam total skin irradiation in 1988. Seven years later, multiple disseminated lesions of porokeratosis developed on the chest, extremities and abdomen. There was no family history of porokeratosis, nor history of treatment with PUVA or of excessive sun exposure. Development of disseminated porokeratosis on nonexposed sites suggests a direct role for the previous ionizing radiation. Electron-beam total skin irradiation therapy should therefore be added to the list of possible causative factors in the development of disseminated porokeratosis.
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Affiliation(s)
- J Romaní
- Hospital de la Santa Creu i Sant Pau, Spain
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Abstract
BACKGROUND Porokeratosis is a disorder of epidermal keratinization manifested clinically by a raised border and histologically by a cornoid lamella. While cutaneous malignancy has been reported to arise in porokeratosis, the risk remains unknown. In the past it has been associated with a history of radiation therapy. OBJECTIVE The purpose of this study is to estimate the frequency of cutaneous malignancy arising in porokeratosis and define those patients who are at highest risk. METHODS All cases in the English language literature in the last 30 years were reviewed. RESULTS Twenty-one (7.5%) of 281 cases reported revealed a malignancy arising within porokeratosis. Large lesions, those of long-standing duration, and the linear type were at greatest risk. Radiation therapy was an infrequently identified risk factor. CONCLUSION Porokeratosis is a premalignant condition, with certain groups of patients at greatest risk for malignant transformation.
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Affiliation(s)
- M Sasson
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Abstract
We report the cases of three patients with Crohn's disease in whom porokeratosis developed. Disseminated superficial actinic porokeratosis developed in two patients. In one of these patients, the skin lesions arose during an exacerbation of the bowel disease. In the third patient, who had congenital linear porokeratosis, the disseminated superficial form of the disorder developed during the first severe exacerbation of Crohn's disease. A family history of porokeratosis was present in one patient, but no relatives of any of these patients were known to have Crohn's disease. In all three patients, Crohn's disease was limited to the colon.
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Affiliation(s)
- C A Morton
- Department of Dermatology, Monklands District General Hospital, Airdrie, Scotland
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Tanaka M, Terui T, Kudo K, Tagami H. Inflammatory disseminated superficial porokeratosis followed by regression. Br J Dermatol 1995; 132:153-5. [PMID: 7756132 DOI: 10.1111/j.1365-2133.1995.tb08646.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
Immunosuppression may favour the development of disseminated superficial porokeratosis (DSP). We report the clinical features and the outcome of DSP in 24 patients receiving immunosuppressive treatment (group A), and compare the characteristics of the disease with those of 13 immunocompetent patients with DSP (group B). The two groups were similar with regard to age, sex, area of skin involvement and mean follow-up. There was a family history of DSP in only two patients in group A, compared with five patients in group B (P = 0.03). The skin type, based on the tanning response to sunlight, was not significantly different between the two groups. Two of the 24 patients in group A had high sun exposure, compared with five of the 13 patients in group B (P = 0.03). Moreover, 10 patients in group A and 11 in group B (P = 0.01) exhibited worsening of the disease after exposure to sunlight, usually during the summertime. These observations appear to support the hypothesis that sun exposure is not always essential for the development of porokeratosis in immunosuppressed patients. None of our patients developed skin cancer in porokeratotic lesions during the follow-up period.
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Affiliation(s)
- P L Bencini
- Istituto di Clinica Dermatologica I e Dermatologia Pediatrica Università di Milano, Ospedale Maggiore IRCCS, Italy
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Gimenez-Arnau A, Camarasa JG. Palmar filiform or spiny hyperkeratosis associated with pulmonary tuberculosis. J Eur Acad Dermatol Venereol 1994. [DOI: 10.1111/j.1468-3083.1994.tb00385.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kanitakis J, Misery L, Nicolas JF, Lyonnet S, Chouvet B, Haftek M, Faure M, Claudy A, Thivolet J. Disseminated superficial porokeratosis in a patient with AIDS. Br J Dermatol 1994; 131:284-9. [PMID: 7917997 DOI: 10.1111/j.1365-2133.1994.tb08507.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report the case of a 50-year-old male homosexual suffering from AIDS, who developed diffuse annular hyperkeratotic lesions on the arms and legs. Histopathological examination revealed typical features of porokeratosis, which clinically was of the disseminated superficial type. Ultrastructural examination showed a paucity of keratohyalin granules and lamellar bodies. Immunohistochemical studies showed an almost complete absence of Langerhans cells in lesional epidermis. Involucrin and filaggrin expression were altered in areas of cornoid lamella formation, whereas basal keratinocytes in these areas expressed PCNA/cyclin and, to a lesser degree, p53 protein. Porokeratosis may affect immunocompetent patients, but has also been reported in the setting of immunosuppression following organ transplantation. As far as we are aware, the development of porokeratosis during the course of HIV infection has not been reported previously.
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Affiliation(s)
- J Kanitakis
- Department of Dermatology, Hôpital Edouard Herriot, Lyon, France
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Zenarola P, Melillo L, Lomuto M, Carotenuto M, Gomes VE, Marzocchi W. Exacerbation of porokeratosis: a sign of immunodepression. J Am Acad Dermatol 1993; 29:1035-6. [PMID: 8245238 DOI: 10.1016/s0190-9622(08)82038-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- P Zenarola
- Department of Dermatology, Casa Sollievo Della Sofferenza Hospital, IRCCS, S. Giovanni Rotondo, Italy
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Tsambaos D, Spiliopoulos T. Disseminated superficial porokeratosis: complete remission subsequent to discontinuation of immunosuppression. J Am Acad Dermatol 1993; 28:651-2. [PMID: 8463472 DOI: 10.1016/s0190-9622(08)81788-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- D Tsambaos
- Department of Dermatology, University of Patras, Greece
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Abstract
Immunosuppression is recognized to predispose to the development of disseminated superficial actinic porokeratosis and to cause the spread of pre-existing lesions. Porokeratosis of Mibelli has been less frequently described following immunosuppression and we report a further case.
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Affiliation(s)
- S M Wilkinson
- Department of Dermatology, North Staffordshire Hospital Centre, Hartshill, Stoke-on-Trent, UK
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Neumann RA, Knobler RM, Metze D, Jurecka W. Disseminated superficial actinic porokeratosis in pemphigus foliaceus. J Am Acad Dermatol 1989; 21:1315-6. [PMID: 2584472 DOI: 10.1016/s0190-9622(89)80321-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Neumann RA, Knobler RM, Gebhart W. Unusual presentation of porokeratosis palmaris, plantaris et disseminata. J Am Acad Dermatol 1989; 21:1131-3. [PMID: 2530255 DOI: 10.1016/s0190-9622(89)70314-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Porokeratosis plantaris, palmaris et disseminata is an autosomal dominant genodermatosis characterized by multiple lesions on the palms and soles, and later on other areas, both sun-exposed and non-sun-exposed. We report a 66-year-old man with porokeratosis plantaris, palmaris et disseminata whose disease had an unusual evolution. To our knowledge this is the first case of the disease in which the lesions first appeared on the trunk and extremities and later involved the palms and soles.
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Affiliation(s)
- R A Neumann
- Department of Dermatology II, University of Vienna, Austria
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Neumann RA, Knobler RM, Metze D, Jurecka W. Disseminated superficial porokeratosis and immunosuppression. Br J Dermatol 1988; 119:375-80. [PMID: 2972310 DOI: 10.1111/j.1365-2133.1988.tb03231.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We present a patient who developed skin lesions typical of disseminated superficial porokeratosis (DSP) while on immunosuppressive therapy for pemphigus foliaceus. Phototesting with artificial light sources did not have any effect on the DSP lesions. The literature describing occurrence of DSP on immunosuppression is reviewed and possible pathogenetic mechanisms are discussed.
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Affiliation(s)
- R A Neumann
- Department of Dermatology II, University of Vienna, Austria
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