Porokeratosis
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References
Ang Porokeratosis ay isang bihirang kondisyon ng balat na nailalarawan ng mga problema sa keratinization, na nagreresulta sa mga nakataas, hugis-singsing na mga patch o magaspang na bukol sa balat. Ang tampok na pagtukoy nito sa ilalim ng mikroskopyo ay ang pagkakaroon ng cornoid lamella, isang tiyak na pag-aayos ng mga selula sa tuktok na layer ng balat. Ang Porokeratosis ay may iba't ibang anyo (disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, linear porokeratosis) . Mahalagang tandaan na ang porokeratosis ay maaaring maging kanser sa balat. Ang pinakamahusay na paraan upang masuri ang porokeratosis ay sa pamamagitan ng biopsy ng nakataas na hangganan, bagama't kasalukuyang walang karaniwang protocol ng paggamot.
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.
Ang Disseminated superficial actinic porokeratosis (DSAP) ay isang sakit ng disordered keratinization. Isa ito sa anim na uri ng porokeratosis, at kadalasang nakakaapekto ito sa mas malalaking lugar kumpara sa iba (linear, Mibelli's, punctate, palmoplantar disseminated, superficial porokeratosis) . Ang pumuputok na uri ng porokeratosis ay kadalasang nag-uugnay sa kanser, humihinang kaligtasan sa sakit, o pamamaga. Ang mga kadahilanan ng peligro ay kinabibilangan ng genetika, pagsugpo sa immune, at pagkakalantad sa araw. Nagsisimula ang DSAP bilang mga pink o brown na bukol na may nakataas na mga gilid sa mga lugar na nakalantad sa araw, kung minsan ay nagdudulot ng bahagyang pangangati. Nag-iiba-iba ang mga paggamot at maaaring may kasamang mga topical cream, light therapy, o mga gamot tulad ng 5-fluorouracil o retinoid. Ang mga sugat na ito ay itinuturing na precancerous, na may 7. 5 - 10 % na posibilidad na maging squamous cell o 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.
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.
Isang 52-taong-gulang na lalaki, na dating malusog, ang pumasok na may flat, hugis-singsing na patch sa dulo ng kanyang ikaapat na daliri, na nandoon nang 2 taon nang walang anumang sintomas. Nagsimula ito bilang isang maliit, matigas na bukol at lumaki palabas sa paglipas ng panahon. Sa kabila ng pagsubok ng iba't ibang paggamot tulad ng cryotherapy, cream, antifungal, at antibiotics, hindi gumaling ang patch. Kung susuriin ito nang mabuti gamit ang isang dermocopsy, ipinakita ang isang tuyo, pulang sentro na may makapal, magaspang na hangganan. Ang isang maliit na piraso ng balat na kinuha mula sa gilid ng patch ay nagpakita ng abnormal na paglaki ng cell sa panlabas na layer ng balat, na nagpapatunay ng diagnosis ng 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.
Kadalasan ang isang biopsy ay ginagawa dahil maaari itong magmukhang katulad ng actinic keratosis o squamous cell carcinoma.