What is the role of surgery in the treatment of porokeratosis?

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

Surgical treatment is essential for porokeratosis lesions that have undergone malignant transformation. No studies showing the value of prophylactic nonexcisional surgical treatment in reducing the incidence of malignancy within porokeratosis have been reported. Surgical modalities other than excision may improve cosmesis and/or function but are frequently followed by relapses.

Excision is most appropriate when malignant degeneration develops.

Cryotherapy is helpful for porokeratosis lesions with minimally raised cornoid lamellae, such as disseminated superficial actinic porokeratosis (DSAP) and porokeratosis palmaris et plantaris disseminata (PPPD). It is a minimally invasive method of inducing resolution for large numbers of lesions.

Electrodesiccation and curettage can be used to treat small lesions or when cryosurgery is ineffective.

Diamond fraise dermabrasion has been used with conflicting reports of efficacy. It was effective in improving the appearance of linear porokeratosis in one patient, but a child with a large porokeratosis of Mibelli (PM) lesion had recurrence after treatment. [87]


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