Porokeratosis - Western SummaryWestern Medicine Summary

Western Medicine

Western Summary

Porokeratosis refers to a group of conditions that includes disseminated superficial actinic porokeratosis, porokeratosis of Mibelli (plaque type), linear porokeratosis, porokeratosis palmaris plantaris et disseminate, and punctate porokeratosis. 

Symptoms

This group often presents as a lesion with a hyperkeratotic or slightly built up peripheral edge that has a characteristic appearance under the microscope referred to as a coronoid lamella. These can occur singly or in multiples and have a predilection for the extremities. 

 

Causes

Porokeratosis can occur sporadically or can be inherited.[1] Depending on the type of porokeratosis, there can be a risk for malignancy to develop within the lesion. This can be more likely with greater ultraviolet light exposure and radiation exposure. 

 

Treatments

There are no controlled studies evaluating the treatment of porokeratosis and many of the treatment reports in the scientific literature are limited.[2]  

  • Retinoid: Retinoids are used to treat porokeratosis by affecting how the cells divide, but there are not many studies evaluating the use of retinoids to porokeratosis and it is unclear if they are effective.[2] 
  • 5-fluorouracil: Treatment with 5-fluorouracil has been shown to improve porokeratosis in isolated case reports.[2]  
  • Imiquimod: Imiquimod acts by activating the immune system and has been reported to help porokeratosis.[2]
  • Diclofenac: Diclofenac is a non-steroidal anti-inflammatory drug that has been reported to partiallly improve porokeratosis lesions.[2-4]
  • Cryotherapy: Porokeratosis lesions can be treated by destruction through the use of liquid nitrogen.
  • Photodynamic therapy: Aminolevulinic acid is applied to the skin and allowed to incubate. After the incubation, the skin is exposed to red or blue light, leading to destruction of the lesions that absorbed and metabolized the aminolevulinic acid.

​1.    Luan J, Niu Z, Zhang J, et al. A novel locus for disseminated superficial actinic porokeratosis maps to chromosome 16q24.1-24.3. Hum Genet.2011;129(3):329-334; PMID: 21161278.

2.    Skupsky H, Skupsky J, Goldenberg G. Disseminated superficial actinic porokeratosis: a treatment review. J Dermatolog Treat.2012;23(1):52-56; PMID: 20964569.

3.    Marks S, Varma R, Cantrell W, et al. Diclofenac sodium 3% gel as a potential treatment for disseminated superficial actinic porokeratosis. J Eur Acad Dermatol Venereol.2009;23(1):42-45; PMID: 18702625.

4.    Vlachou C, Kanelleas AI, Martin-Clavijo A, et al. Treatment of disseminated superficial actinic porokeratosis with topical diclofenac gel: a case series. J Eur Acad Dermatol Venereol.2008;22(11):1343-1345; PMID: 18554227.