Porokeratosis - Porokeratoza
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U rezultatima Stiftung Warentest iz Njemačke za 2022., zadovoljstvo potrošača s ModelDermom bilo je samo malo niže nego s plaćenim konzultacijama o telemedicini.
U rezultatima Stiftung Warentest iz Njemačke za 2022., zadovoljstvo potrošača s ModelDermom bilo je samo malo niže nego s plaćenim konzultacijama o telemedicini.
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ReferencesPorokeratosis je rijetko stanje kože karakterizirano poremećajem keratinizacije, koje se manifestira kožnim lezijama koje počinju kao mali smeđkasti papuli i postupno se povećavaju, tvoreći nepravilne, prstenaste, hiperkeratotične ili bradavicaste lezije. Često se radi biopsija jer lezije mogu nalikovati aktiničkoj keratozi ili karcinomu ploščicama. Njegovo definirajuće obilježje pod mikroskopom je prisutnost kornoidne lamele, specifičnog rasporeda stanica u gornjem sloju kože. Porokeratosis dolazi u različitim oblicima, kao što su disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum i linear porokeratosis. Važno je napomenuti da se porokeratosis potencijalno može razviti u rak kože. Najbolji način za dijagnosticiranje porokeratosisa je putem biopsije uzdignutog ruba, iako trenutno ne postoji standardni protokol liječenja.
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) je bolest poremećene keratinizacije. To je jedna od šest vrsta porokeratoze i obično zahvaća veća područja u usporedbi s ostalima (linearna porokeratoza (linear porokeratosis), porokeratoza Mibelli (porokeratosis of Mibelli), puntata porokeratoza (punctate porokeratosis), porokeratoza palmaris et plantaris disseminata (porokeratosis palmaris et plantaris disseminata) i disseminirana površna porokeratoza (disseminated superficial porokeratosis)). Eruptivni tip porokeratoze često je povezan s rakom, imunosupresijom ili proinflamatornim stanjem. Čimbenici rizika uključuju genetiku, slabljenje imuniteta i izlaganje suncu. DSAP počinje kao ružičaste ili smeđe kvržice s podignutim rubovima na područjima izloženim suncu, ponekad uzrokujući lagani svrbež. Tretmani se razlikuju i mogu uključivati lokalne kreme, svjetlosnu terapiju ili lijekove poput 5-fluorouracila ili retinoida. Ove se lezije smatraju prekancerozama, s 7.5‑10 % šanse da se pretvore u karcinom pločastih stanica ili bazalnih stanica.
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-godišnji muškarac, prethodno zdrav, došao je s asimptomatskom atrofnom prstenastom mrljom na distalnom dijelu četvrtog nožnog prsta, koja je bila prisutna 2 godine. Lezija je započela kao mala keratotična papula koja je postupno centrično rasla. Primio je višestruke tretmane, uključujući krioterapiju, topikalne kortikosteroide, antifungalna sredstva i antibiotike, bez poboljšanja. Dermoskopski pregled otkrio je ljuskavato atrofno eritematozno središte s oštro demarkiranim perifernim hiperkeratotičnim rubom. Uzorak kože uzet s ruba lezije pokazao je kornoidnu lamelu s kolonama parakeratotičnih stanica koje proizlaze iz invaginacije epidermisa uz odsutnost granularnog sloja, što je u skladu s dijagnozom porokeratoze Mibellija (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.
Često se izvodi biopsija jer može izgledati slično aktiničkoj keratozi ili karcinomu skvamoznih stanica.