Porokeratosis
☆ در نتایج Stiftung Warentest 2022 از آلمان، رضایت مصرف کنندگان از ModelDerm فقط اندکی کمتر از مشاوره های پزشکی از راه دور بود.
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References
Porokeratosis یک بیماری پوستی نادر است که با مشکلات کراتینه شدن مشخص می شود و در نتیجه لکه های حلقه ای شکل برجسته یا برجستگی های خشن روی پوست ایجاد می شود. ویژگی بارز آن در زیر میکروسکوپ وجود لاملا کورنوئید، آرایش خاصی از سلول ها در لایه بالایی پوست است. Porokeratosis به اشکال مختلفی مانند disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis موجود است. توجه به این نکته مهم است که porokeratosis به طور بالقوه می تواند به سرطان پوست تبدیل شود. بهترین راه برای تشخیص porokeratosis از طریق بیوپسی از مرز برجسته است، اگرچه در حال حاضر هیچ پروتکل درمانی استانداردی وجود ندارد.
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) یک بیماری کراتینه سازی اختلال است. این یکی از شش نوع پوروکراتوزیس است و معمولاً مناطق بزرگ‌تری را در مقایسه با سایرین تحت تأثیر قرار می‌دهد (linear, Mibelli's, punctate, palmoplantar disseminated, and superficial porokeratosis) . نوع فوران کننده پوروکراتوزیس اغلب با سرطان، ضعف ایمنی یا التهاب مرتبط است. عوامل خطر شامل ژنتیک، سرکوب سیستم ایمنی و قرار گرفتن در معرض نور خورشید است. DSAP به صورت برآمدگی های صورتی یا قهوه ای با لبه های برجسته در نواحی در معرض آفتاب شروع می شود که گاهی باعث خارش خفیف می شود. درمان‌ها متفاوت است و ممکن است شامل کرم‌های موضعی، نور درمانی یا داروهایی مانند 5-فلوئورواوراسیل یا رتینوئیدها باشد. این ضایعات پیش سرطانی در نظر گرفته می شوند، با 7. 5 - 10 درصد احتمال تبدیل به کارسینوم سلول سنگفرشی یا سلول بازال.
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.
مردی 52 ساله که قبلاً سالم بود، با لکه‌ای صاف و حلقه‌ای شکل در انتهای انگشت چهارم پا وارد شد که 2 سال بدون هیچ علامتی در آنجا بود. به عنوان یک برآمدگی کوچک و سخت شروع شد و با گذشت زمان به سمت بیرون رشد کرد. علیرغم تلاش برای درمان های مختلف مانند کرایوتراپی، کرم ها، ضد قارچ ها و آنتی بیوتیک ها، پچ بهتر نشد. بررسی دقیق آن با درموکوپسی مرکز خشک و قرمز با حاشیه ضخیم و خشن را نشان داد. تکه کوچکی از پوست که از لبه پچ گرفته شده بود رشد غیرطبیعی سلولی را در لایه بیرونی پوست نشان داد که تشخیص porokeratosis of Mibelli را تایید می‌کرد.
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.
اغلب بیوپسی انجام می شود زیرا می تواند شبیه کراتوز اکتینیک یا کارسینوم سلول سنگفرشی باشد.