Porokeratosis - Porokeratoze
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Raksturīgas ir cietās izvirzītās malas.
References
Porokeratosis ir reta ādas slimība, kam raksturīgas keratinizācijas problēmas, kā rezultātā uz ādas ir izvirzīti gredzenveida plankumi vai raupji izciļņi. Tās noteicošā iezīme zem mikroskopa ir kornoīda lameļu klātbūtne, kas ir īpašs šūnu izvietojums ādas virsējā slānī. Porokeratosis ir dažādās formās, piemēram, disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis. Ir svarīgi atzīmēt, ka porokeratosis potenciāli var attīstīties ādas vēzis. Labākais veids, kā diagnosticēt porokeratosis , ir paaugstinātās robežas biopsija, lai gan pašlaik nav standarta ārstēšanas protokola.
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) ir traucētas keratinizācijas slimība. Tas ir viens no sešiem porokeratozes veidiem, un tas parasti skar lielākas platības, salīdzinot ar citiem (linear, Mibelli's, punctate, palmoplantar disseminated, and superficial porokeratosis) . Porokeratozes izvirduma veids bieži ir saistīts ar vēzi, novājinātu imunitāti vai iekaisumu. Riska faktori ir saistīti ar ģenētiku, imūnsistēmas nomākšanu un saules iedarbību. DSAP sākas kā rozā vai brūni izciļņi ar paceltām malām saulei pakļautās vietās, dažreiz izraisot nelielu niezi. Ārstēšana ir atšķirīga un var ietvert lokālus krēmus, gaismas terapiju vai tādas zāles kā 5-fluoruracils vai retinoīdi. Šie bojājumi tiek uzskatīti par pirmsvēža bojājumiem, un tiem ir 7. 5 - 10 % iespēja pārvērsties par plakanšūnu vai bazālo šūnu karcinomu.
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 gadus vecs vīrietis, iepriekš vesels, ieradās ar plakanu, gredzenveida plāksteri uz ceturtā pirksta gala, kas tur atradās 2 gadus, neradot nekādus simptomus. Tas sākās kā mazs, ciets izciļnis un laika gaitā izauga uz āru. Neskatoties uz to, ka tika izmēģinātas dažādas ārstēšanas metodes, piemēram, krioterapija, krēmi, pretsēnīšu līdzekļi un antibiotikas, plāksteris nekļuva labāks. Rūpīgi pārbaudot to ar dermokopsiju, tika atklāts sauss, sarkans centrs ar biezu, raupju apmali. Nelielam ādas gabaliņam, kas paņemts no plākstera malas, tika konstatēta patoloģiska šūnu augšana ādas ārējā slānī, apstiprinot diagnozi 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.
Bieži tiek veikta biopsija, jo tā var izskatīties līdzīgi kā aktīniskā keratoze vai plakanšūnu karcinoma.