Porokeratosis - Порокератоз
☆ Германаас гаргасан 2022 оны Stiftung Warentest-ийн үр дүнгээс үзэхэд ModelDerm-ийн хэрэглэгчдийн сэтгэл ханамж нь төлбөртэй телемедицинийн зөвлөгөө авахаас арай доогуур байв.
Хатуу цухуйсан ирмэг нь онцлог шинж чанартай.
References
Porokeratosis нь арьсны кератинжилтын асуудлуудаар тодорхойлогддог ховор тохиолддог арьсны өвчин бөгөөд үүний үр дүнд арьсан дээр өргөгдсөн, цагираг хэлбэртэй толбо эсвэл барзгар овойлт үүсдэг. Микроскопоор түүний тодорхойлогч шинж чанар нь арьсны дээд давхарга дахь эсийн тодорхой зохицуулалт болох cornoid lamella байгаа явдал юм. Porokeratosis янз бүрийн хэлбэрээр ирдэг (disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, linear porokeratosis) . Porokeratosis арьсны хорт хавдар болж болзошгүйг анхаарах нь чухал. Porokeratosis оношлох хамгийн сайн арга бол өргөгдсөн хилийн биопси юм, гэхдээ одоогоор стандарт эмчилгээний протокол байхгүй байна.
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) бол кератинжилтын эмгэг юм. Энэ нь зургаан төрлийн порокератозын нэг бөгөөд бусадтай харьцуулахад илүү том талбайд нөлөөлдөг (linear, Mibelli's, punctate, palmoplantar disseminated, superficial porokeratosis) . Порокератозын дэлбэрэлтийн хэлбэр нь ихэвчлэн хорт хавдар, сул дархлаа, үрэвсэлтэй холбоотой байдаг. Эрсдлийн хүчин зүйлүүд нь генетик, дархлаа дарангуйлах, наранд өртөх зэрэг орно. DSAP нь наранд ил гарсан хэсэгт ирмэг нь өргөгдсөн ягаан эсвэл хүрэн овойлт хэлбэрээр эхэлдэг бөгөөд заримдаа бага зэрэг загатнах шалтгаан болдог. Эмчилгээ нь харилцан адилгүй бөгөөд сэдэвчилсэн тос, гэрлийн эмчилгээ эсвэл 5-фторурацил эсвэл ретиноид зэрэг эмүүдийг багтааж болно. Эдгээр гэмтэл нь хавдрын өмнөх гэж тооцогддог бөгөөд хавтгай эс эсвэл суурь эсийн хавдар болж хувирах магадлал 7. 5 - 10 % байна.
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 настай эрэгтэй, урьд нь эрүүл, хөлийн дөрөв дэх хурууны үзүүрт цагираг хэлбэртэй хавтгай нөхөөстэй, 2 жил ямар нэгэн шинж тэмдэг илрээгүй байсан. Энэ нь жижиг, хатуу овойлт болж эхэлсэн бөгөөд цаг хугацааны явцад гадагшаа ургасан. Крио эмчилгээ, тос, мөөгөнцрийн эсрэг эм, антибиотик гэх мэт янз бүрийн эмчилгээг туршиж үзсэн ч наалт нь сайжирсангүй. Үүнийг дермокопсиоор сайтар шалгаж үзэхэд зузаан, барзгар хүрээтэй хуурай, улаан төвийг харуулсан. Нөхөөсний ирмэгээс авсан арьсны өчүүхэн хэсэгт арьсны гадна давхаргад хэвийн бус эсийн ургалт илэрсэн нь porokeratosis of Mibelli гэсэн оношийг баталж байна.
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.
Ихэнхдээ биопси хийдэг, учир нь энэ нь актин кератоз эсвэл хавтгай хучуур эдийн хавдартай төстэй байдаг.