Granular Parakeratosis

Question 1

Describe the histological features

Answer 1

Parakertosis
stratum corneum is thickened and compacted
increased eosinophilic staining

retained nuclie throughout the keratin layer

visible retention of basophilic keratohyalin granules within these areas of parakeratosis

Question 2

What chemical is associated with granular parakeratosis?

Answer 2

Benzylkonium Chloride

Question 3

What are the clinical features of granular parakeratosis?

Answer 3

keratotic, brownish-red papules that can have a conical shape

These may coalesce into larger, well-demarcated plaques with various degrees of maceration

Lesions can persist for months or longer and recur.

Pruritus is the most common complaint, but irritation is also a problem if there are erosions or fissures.

Question 4

Who gets granular parkeratosis?

Answer 4

F > M

Middle age, older adult

Question 5

What causes granular parakeratosis?

Answer 5

Unknown

Thought to be a disorder of keratinization characterized by a basic defect in the processing of profilaggrin to filaggrin

Benzylkonium chloride is a common culprit

Question 6

DDx for granular parakeratosis?

Answer 6

seborrheic dermatitis
candidiasis
inverse psoriasis
erythrasma

Hailey–Hailey disease
Darier disease
Pemphigus vegetans