Kristina R. Burke, MD, CPT, MC, USA; George W. Turiansky, MD, COL, MC, USA


Dermatology Nursing 

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Porokeratosis is a heterogenous group of disorders of disordered keratinization whose exact pathogenesis is unknown. There are five variants recognized: classic porokeratosis of Mibelli, disseminated superficial actinic porokeratosis (DSAP), linear porokeratosis, punctate porokeratosis, and porokeratosis palmaris et plantaris disseminata (Schamroth, Zlotogorski, & Gilead, 1997). This patient was diagnosed with classic porokeratosis of Mibelli that is clinically characterized by a single, or few, well-demarcated plaques up to several centimeters in diameter. The plaques have a depressed, atrophic center surrounded by a serpiginous border that is noted to have a delicate elevated hyperkeratotic ridge (O';Regan & Irvine, 2008). Porokeratosis is considered to be a genodermatosis inherited in an autosomal dominant fashion with variable penetrance though sporadic onset of porokeratosis may be associated with triggers such as sun exposure, trauma, infection, and irradiation (Prasad, Gautman, Jain, Sharma, & Kar, 1995). A higher incidence of porokeratosis has also been noted in immunosuppressed patients (Bencini, Taratina, Grimalt, Ponticelli, & Caputo, 1995). Sun-exposure is a risk factor for the development of DSAP, the most common variant of porokeratosis. Porokeratosis is generally considered to be a benign condition though malignant transformation has been seen in all but the punctate variety, necessitating regular followup of patients with porokeratosis (Maubec et al., 2005; Sasson & Krain, 1996).


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