Porokeratosis - Порокератоз
☆ Германиянын 2022-жылдагы Stiftung Warentest жыйынтыгында ModelDerm менен керектөөчүлөрдүн канааттануусу телемедициналык акы төлөнүүчү консультацияларга караганда бир аз төмөн болгон.
Катуу чыгып турган четтери мүнөздүү.
References
Porokeratosis териде сейрек кездешүүчү оору, кератинизация көйгөйлөрү менен мүнөздөлөт, натыйжада териде шакек сымал тактар же орой бүдүрлөр пайда болот. Анын микроскоп астында аныктоочу өзгөчөлүгү - теринин үстүнкү катмарында клеткалардын белгилүү бир жайгашуусу болгон корноид ламелласынын болушу. Porokeratosis ар кандай формада келет (disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, linear porokeratosis) . Porokeratosis теринин рагына айланып кетиши мүмкүн экенин белгилей кетүү маанилүү. Porokeratosis диагностикасынын эң жакшы жолу - бул чек аранын биопсиясы, бирок учурда стандарттуу дарылоо протоколу жок.
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) — кератинизациянын бузулушу. Бул порокератоздун алты түрүнүн бири жана ал адатта башкаларга салыштырмалуу чоңураак аймактарга таасир этет (linear, Mibelli's, punctate, palmoplantar disseminated, superficial porokeratosis) . Порокератоздун жарылуучу түрү көбүнчө рак, алсыз иммунитет же сезгенүү менен байланышат. Тобокелдик факторлору генетика, иммундук системаны басуу жана күн нурун камтыйт. DSAP кызгылт же күрөң бүдүрчөлөрдөн башталып, күн тийген жерлерде четтери көтөрүлүп, кээде бир аз кычыштырат. Дарылоо ар кандай болот жана жергиликтүү кремдерди, жарык терапиясын же 5-фторурацил же ретиноиддер сыяктуу дарыларды камтышы мүмкүн. Бул жаралар рак алды деп эсептелет, 7. 5 - 10 % шансы жалпак клеткага же базалдык клеткалуу ракка айланышы.
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 жаштагы эркек, мурда ден соолугу чың, бутунун төртүнчү бармагынын учундагы жалпак, шакекче сымал жамаачы менен келип түшкөн, ал 2 жылдан бери эч кандай симптомсуз болгон. Ал кичинекей, катуу бүдүрчөлөрдөн башталып, убакыттын өтүшү менен сыртка карай өсө берген. Криотерапия, кремдер, грибокко каршы каражаттар жана антибиотиктер сыяктуу ар кандай дарылоо ыкмаларын колдонууга карабастан, патч жакшырган жок. Аны дермокопсия менен жакындан текшергенде кургак, кызыл чекеси калың, орой болгон борборду көрсөттү. Жамачынын четинен алынган теринин кичинекей бөлүгү теринин сырткы катмарында анормалдуу клеткалардын өсүшүн көрсөтүп, porokeratosis of Mibelli диагнозун тастыктайт.
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.
Көбүнчө биопсия жасалат, анткени ал актиникалык кератозго же сквамо клеткалуу ракка окшош болушу мүмкүн.