Maklumat lanjut ― Melayu

Porokeratosis ialah keadaan kulit yang jarang berlaku, dicirikan oleh gangguan keratinisasi yang menghasilkan tompok timbul berbentuk cincin atau benjolan kasar pada kulit. Ciri penentu di bawah mikroskop ialah kehadiran lamella kornoid, susunan sel tertentu pada lapisan atas kulit. Porokeratosis hadir dalam pelbagai bentuk, seperti disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, dan linear porokeratosis. Penting untuk diingat bahawa porokeratosis berpotensi berkembang menjadi kanser kulit. Kaedah utama untuk mendiagnosis porokeratosis ialah melalui biopsi tepi yang diaktifkan, walaupun pada masa ini belum ada 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 merupakan salah satu daripada enam jenis porokeratosis, dan biasanya menjejaskan kawasan yang lebih luas berbanding jenis lain (linear, Mibelli's, punctate, palmoplantar disseminated, and superficial porokeratosis). Jenis porokeratosis ini sering dikaitkan dengan kanser, imuniti yang lemah, atau keradangan. Faktor risiko termasuk faktor genetik, penindasan imun, dan pendedahan kepada cahaya matahari. DSAP bermula sebagai benjolan berwarna merah jambu atau coklat dengan tepi terangkat pada kawasan yang terdedah kepada matahari, kadang‑kadang menyebabkan sedikit kegatalan. Rawatan berbeza‑beza dan mungkin melibatkan krim topikal, terapi cahaya, atau ubat seperti 5‑fluorourasil atau retinoid. Lesi ini dianggap prakanser, dengan peluang 7.5‑10 % 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, yang sebelum ini sihat, hadir dengan tompok rata berbentuk cincin di hujung jari kaki keempatnya. Tompok tersebut telah berada di sana selama 2 tahun tanpa sebarang gejala. Ia bermula sebagai benjolan kecil dan keras, kemudian semakin membesar secara beransur‑ansur. Walaupun telah dicuba pelbagai rawatan seperti krioterapi, krim antikulat dan antibiotik, tampalan itu tidak menunjukkan sebarang peningkatan. Pemeriksaan dermatoskopi yang teliti menunjukkan pusat kering, merah, dengan sempadan tebal dan kasar. Sampel kulit kecil yang diambil dari tepi tompok menunjukkan pertumbuhan sel abnormal pada lapisan epidermis, 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.