51 - Porokeratosis Flashcards
Porokeratosis usually occurs in
Fair-skinned individuals
Begins during infancy or childhood
Asymptotic, small, brown to skin-colored, annular plaques with a characteristic annular border
Male predominance
Porokeratosis of Mibelli
Giant porokeratoses may occur in porokeratosis of Mibelli and occur predominantly on the
Lower leg and foot
Large porokeratoses are associated with
Higher malignant potential
Most common of the porokeratoses
Disseminated superficial actinic porokeratosis
More generalized than other forms of porokeratosis
Typically more than 50 lesions located predominantly in sun-exposed sites
Spare the palms, soles, and mucous membranes
Hyperkeratotic border is subtler
Female predominance
Disseminated superficial actinic porokeratosis
Onset in the third or fourth decade
Do not spare sun-protected areas
More than 100 lesions may be present
Disseminated superficial porokeratosis
Presents early in childhood
Mosaic manifestation of porokeratosis
Unilateral lesion confined to an extremity following Blashcko lines
Linear porokeratosis
Highest potential for malignant degeneration
Linear porokeratosis
Small, relatively uniform lessons that initially appear on the palms and soles
Palmar and plantar lesions are generally more hyperkeratotic
Appears during adolescence or early adulthood
Male predominance
Porokeratosis palmaris et plantaris disseminata
Appears during adolescence or adulthood
May be seen concomitantly with other types of porokeratosis
Multiple minute and discrete punctate, hyperkeratotic lesions surrounded by a thin, raised margin on the palms and soles
Punctate porokeratosis
Small, widespread porokeratotic papules from 1 month of age, predominantly affecting the face and extremities
Autosomal recessive trait
CDAGS syndrome (craniosynostosis and clavicular hypoplasia, delayed closure of the fontanel, anal anomalies, genitourinary malformations, skin eruption) or CAP syndrome (craniosynostosis, anal anomalies, porokeratosis)
Gene mutation: porokeratosis of Mibelli
Phosphomevalonate kinase (PVMK)
Gene mutation: DSAP
Mevalonate kinase (MVK)
Malignant degeneration has been described in all variants of porokeratosis, except
Punctate porokeratosis
On histopathology, characteristic changes are evident at the _____ of the lesion
Raised and advancing edge
Stratum corneum is hyperkeratotic, with a thin column of poorly staining parakeratotic cells, the
Cornoid lamella
Although characteristic of porokeratosis, the cornoid lamella is not pathognomonic and may also be found in other conditions, such as
Viral warts
Some ichthyosis
Nevoid hyperkeratoses
First line topical treatment for porokeratosis
Photoprotection
5-fluorouracil
First line surgical therapy for porokeratosis
Cryotherapy
Malignancy is thought to arise in _____% of individuals
7-11
Most frequently associated tumor
SCC