Mer informasjon ― Norsk

Porokeratosis er en sjelden hudtilstand preget av keratiniseringsproblemer, som resulterer i hevede, ringformede flekker eller grove støt på huden. Dens definerende funksjon under mikroskopet er tilstedeværelsen av cornoid lamell, et spesifikt arrangement av celler i hudens øverste lag. Porokeratosis kommer i forskjellige former (disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, linear porokeratosis) . Det er viktig å merke seg at porokeratosis potensielt kan utvikle seg til hudkreft. Den beste måten å diagnostisere porokeratosis er gjennom en biopsi av den forhøyede kanten, selv om det foreløpig ikke finnes noen standard behandlingsprotokoll.
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) er en sykdom med forstyrret keratinisering. Det er en av seks typer porokeratose, og den påvirker vanligvis større områder sammenlignet med de andre (linear, Mibelli's, punctate, palmoplantar disseminated, superficial porokeratosis) . Den eruptive typen porokeratose kobles ofte til kreft, svekket immunitet eller betennelse. Risikofaktorer involverer genetikk, immunundertrykkelse og soleksponering. DSAP starter som rosa eller brune nupper med hevede kanter i soleksponerte områder, noen ganger forårsaker lett kløe. Behandlinger varierer og kan omfatte aktuelle kremer, lysterapi eller medisiner som 5-fluorouracil eller retinoider. Disse lesjonene anses som precancerøse, med en 7. 5 - 10 % sjanse for å bli plateepitel- eller basalcellekarsinom.
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.

En 52 år gammel mann, tidligere frisk, kom inn med et flatt, ringformet plaster på enden av sin fjerde tå, som hadde vært der i 2 år uten å gi noen symptomer. Det startet som en liten, hard støt og vokste utover over tid. Til tross for å prøve forskjellige behandlinger som kryoterapi, kremer, soppdrepende midler og antibiotika, ble ikke plasteret bedre. Ved å undersøke det nøye med en dermokopi, viste det et tørt, rødt senter med en tykk, grov kant. Et lite stykke hud tatt fra kanten av plasteret viste unormal cellevekst i det ytre laget av huden, noe som bekreftet en diagnose 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.