Maklumat lanjut ― Melayu

Porokeratosis ialah keadaan kulit yang jarang berlaku yang dicirikan oleh masalah keratinisasi, mengakibatkan tompok timbul, berbentuk cincin atau benjolan kasar pada kulit. Ciri penentunya di bawah mikroskop ialah kehadiran lamella kornoid, susunan sel tertentu di lapisan atas kulit. Porokeratosis datang dalam pelbagai bentuk, seperti disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis. Adalah penting untuk ambil perhatian bahawa porokeratosis berpotensi berkembang menjadi kanser kulit. Cara terbaik untuk mendiagnosis porokeratosis adalah melalui biopsi sempadan yang dibangkitkan, walaupun pada masa ini tiada protokol rawatan standard.
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) ialah penyakit keratinisasi yang tidak teratur. Ia adalah salah satu daripada enam jenis porokeratosis, dan ia biasanya menjejaskan kawasan yang lebih besar berbanding yang lain (linear, Mibelli's, punctate, palmoplantar disseminated, and superficial porokeratosis) . Jenis letusan porokeratosis sering dikaitkan dengan kanser, imuniti yang lemah, atau keradangan. Faktor risiko melibatkan genetik, penindasan imun, dan pendedahan matahari. DSAP bermula sebagai benjolan merah jambu atau coklat dengan tepi terangkat di kawasan yang terdedah kepada matahari, kadangkala menyebabkan sedikit kegatalan. Rawatan berbeza-beza dan mungkin termasuk krim topikal, terapi cahaya atau ubat seperti 5-fluorourasil atau retinoid. Lesi ini dianggap prakanser, dengan 7. 5 - 10 % peluang untuk bertukar menjadi karsinoma sel skuamosa atau sel basal.
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.

Seorang lelaki berusia 52 tahun, sebelum ini sihat, datang dengan tompok rata berbentuk cincin di hujung jari kaki keempatnya, yang telah berada di sana selama 2 tahun tanpa menyebabkan sebarang gejala. Ia bermula sebagai benjolan kecil dan keras dan membesar ke luar dari semasa ke semasa. Walaupun mencuba pelbagai rawatan seperti krioterapi, krim, antikulat dan antibiotik, tampalan itu tidak menjadi lebih baik. Memeriksanya dengan teliti dengan dermocopsy menunjukkan pusat kering, merah dengan sempadan tebal dan kasar. Sekeping kulit kecil yang diambil dari tepi tompokan menunjukkan pertumbuhan sel yang tidak normal pada lapisan luar kulit, mengesahkan diagnosis 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.