Which clinical history findings are characteristic of disseminated superficial actinic porokeratosis (DSAP)?

Updated: Oct 09, 2020
  • Author: Amarateedha Prak LeCourt, MD; Chief Editor: William D James, MD  more...
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Answer

Disseminated superficial (actinic) porokeratosis (DSAP) is the most common form of porokeratosis, and may account for almost half of all cases. [54] Patients develop a few to several dozen tan, annular macules with raised peripheral ridges, developing predominantly on the distal extensor surfaces of the legs and the arms. Palms and soles are spared, and facial lesions may be seen in less than 15% of patients. Hyperkeratotic variants have been described. [60] The lesions are usually asymptomatic, but they may itch or sting slightly. [60] Extensive exposure to natural or artificial ultraviolet radiation may trigger or worsen DSAP.

The cornoid lamellae may be stained and accentuated by sunless tanning lotions containing dihydroxyacetone.

Patients are typically women in their third or fourth decade of life, with a history of ultraviolet light exposure. Patients may have a history of phototherapy for psoriasis. There is frequently a family history of DSAP, especially in other females in the family.


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