Porokeratosis - Порокератоза
☆ В резултатите от Stiftung Warentest за 2022 г. в Германия, потребителското удовлетворение от ModelDerm е само малко по-ниско, отколкото при платените телемедицински консултации.
Твърдите изпъкнали ръбове са характерни.
References
Porokeratosis е рядко състояние на кожата, характеризиращо се с проблеми с кератинизацията, водещи до надигнати, пръстеновидни петна или груби подутини по кожата. Неговата определяща характеристика под микроскоп е наличието на корноидна ламела, специфично подреждане на клетки в горния слой на кожата. Porokeratosis се предлага в различни форми, като например disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis. Важно е да се отбележи, че porokeratosis може потенциално да се развие в рак на кожата. Най-добрият начин за диагностициране на porokeratosis е чрез биопсия на повдигнатата граница, въпреки че в момента няма стандартен протокол за лечение.
Porokeratosis is an uncommon dermatologic disorder. It is a disorder of keratinization that presents with keratotic papules or annular plaques with an elevated border. It has a distinct histologic hallmark of cornoid lamella, which is a column of tightly fitted parakeratotic cells in the upper epidermis. There are multiple clinical variants of porokeratosis, including disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis. Porokeratosis is a precancerous lesion that can undergo malignant transformation. Evaluation of porokeratosis is best with a biopsy of the elevated border. There are no standard guidelines for treatment.
Porokeratosis is an uncommon dermatologic disorder. It is a disorder of keratinization that presents with keratotic papules or annular plaques with an elevated border. It has a distinct histologic hallmark of cornoid lamella, which is a column of tightly fitted parakeratotic cells in the upper epidermis. There are multiple clinical variants of porokeratosis, including disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis. Porokeratosis is a precancerous lesion that can undergo malignant transformation. Evaluation of porokeratosis is best with a biopsy of the elevated border. There are no standard guidelines for treatment.
Disseminated superficial actinic porokeratosis (DSAP) е заболяване на нарушена кератинизация. Това е един от шестте типа порокератоза и обикновено засяга по-големи площи в сравнение с останалите (linear, Mibelli's, punctate, palmoplantar disseminated, and superficial porokeratosis) . Еруптивният тип порокератоза често се свързва с рак, отслабен имунитет или възпаление. Рисковите фактори включват генетика, имунна супресия и излагане на слънце. DSAP започва като розови или кафяви подутини с повдигнати ръбове в изложените на слънце области, понякога причиняващи лек сърбеж. Леченията варират и могат да включват локални кремове, светлинна терапия или лекарства като 5-флуороурацил или ретиноиди. Тези лезии се считат за предракови, с 7. 5 - 10 % шанс да се превърнат в плоскоклетъчен или базалноклетъчен карцином.
Disseminated superficial actinic porokeratosis (DSAP) is a disease of disordered keratinization. Disseminated superficial actinic porokeratosis is one of six variants of porokeratosis. It has more extensive involvement than most other variants. These other variants include linear porokeratosis, porokeratosis of Mibelli, punctate porokeratosis, porokeratosis palmaris et plantaris disseminata, and disseminated superficial porokeratosis. The eruptive form of porokeratosis is associated with malignancy, immunosuppression, and a proinflammatory state. Risk factors for porokeratosis include genetics, immunosuppression, and ultraviolet light. The lesions in disseminated superficial actinic porokeratosis start as pink to brown papules and macules with a raised border in sun-exposed areas that can be asymptomatic or slightly pruritic. There are many options for the treatment of disseminated superficial actinic porokeratosis, including topical diclofenac, photodynamic therapy (PDT), 5-fluorouracil (5-FU), imiquimod, vitamin D analogs, retinoids, and lasers. These lesions are considered precancerous. There is a 7.5 to 10% risk of malignant transformation to squamous cell carcinoma or basal cell carcinoma.
Disseminated superficial actinic porokeratosis (DSAP) is a disease of disordered keratinization. Disseminated superficial actinic porokeratosis is one of six variants of porokeratosis. It has more extensive involvement than most other variants. These other variants include linear porokeratosis, porokeratosis of Mibelli, punctate porokeratosis, porokeratosis palmaris et plantaris disseminata, and disseminated superficial porokeratosis. The eruptive form of porokeratosis is associated with malignancy, immunosuppression, and a proinflammatory state. Risk factors for porokeratosis include genetics, immunosuppression, and ultraviolet light. The lesions in disseminated superficial actinic porokeratosis start as pink to brown papules and macules with a raised border in sun-exposed areas that can be asymptomatic or slightly pruritic. There are many options for the treatment of disseminated superficial actinic porokeratosis, including topical diclofenac, photodynamic therapy (PDT), 5-fluorouracil (5-FU), imiquimod, vitamin D analogs, retinoids, and lasers. These lesions are considered precancerous. There is a 7.5 to 10% risk of malignant transformation to squamous cell carcinoma or basal cell carcinoma.
52-годишен мъж, преди това здрав, дойде с плоска, пръстеновидна петна на края на четвъртия пръст на крака, която беше там от 2 години, без да причинява никакви симптоми. Започна като малка, твърда подутина и се разрасна навън с течение на времето. Въпреки изпробването на различни лечения като криотерапия, кремове, противогъбични средства и антибиотици, пластирът не се подобри. Внимателното изследване с дермокопия показа сух, червен център с дебела, груба граница. Малко парче кожа, взето от ръба на пластира, показа необичаен клетъчен растеж във външния слой на кожата, потвърждавайки диагнозата porokeratosis of Mibelli.
A 52-year-old man with no past medical history presented with an asymptomatic annular atrophic patch on the distal portion of the fourth toe of 2 years’ duration. The lesion began as a small keratotic papule that gradually enlarged centrifugally. He had received multiple treatments including cryotherapy, topical corticosteroids, antifungals, and antibiotics without improvement. Dermoscopic examination revealed a scaly atrophic erythematous central area with a sharply demarcated peripheral hyperkeratotic structure. A skin biopsy of the edge of the lesion revealed a cornoid lamella with a column of parakeratotic cells extending from an invagination of the epidermis with absence of granular layer. The clinicopathologic correlation was consistent with porokeratosis of Mibelli.
A 52-year-old man with no past medical history presented with an asymptomatic annular atrophic patch on the distal portion of the fourth toe of 2 years’ duration. The lesion began as a small keratotic papule that gradually enlarged centrifugally. He had received multiple treatments including cryotherapy, topical corticosteroids, antifungals, and antibiotics without improvement. Dermoscopic examination revealed a scaly atrophic erythematous central area with a sharply demarcated peripheral hyperkeratotic structure. A skin biopsy of the edge of the lesion revealed a cornoid lamella with a column of parakeratotic cells extending from an invagination of the epidermis with absence of granular layer. The clinicopathologic correlation was consistent with porokeratosis of Mibelli.
Често се извършва биопсия, защото може да изглежда подобно на актинична кератоза или плоскоклетъчен карцином.