Porokeratosis: An enigma beginning to unravel
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Date
2022-06
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Scientific Scholar
Abstract
Porokeratosis is a keratinization disorder with unclear etiopathogenesis, varied clinical presentation and characteristic histopathology, and is usually unresponsive to current therapeutic options. Until now, it was considered to be a clonal disorder with immunity, ultra violet radiation and other factors playing important roles in etiopathogenesis. It is now known that abnormalities in the mevalonate pathway are responsible for this clonal keratinization abnormality. New variants of porokeratosis like eruptive bullous, pruriginous, lichen planus like, follicular variants and porokeratoma have been described. While the cornoid lamella is the classical histopathologic feature, dermoscopy and reflectance confocal microscopy make the diagnosis clearer. Development of malignancy in a few variants is a concern. Linear, disseminated superficial actinic and giant lesions are most prone to developing malignancies. Bowen’s disease, squamous cell carcinoma, basal cell carcinoma and even melanoma have been reported in cases of long-standing porokeratosis. Newer modalities of therapy such as photodynamic therapy, ingenol mebutate and HMGCoA inhibitors may play a role in the future
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Keywords
Cornoid lamella, malignancy, mevalonate kinase, porokeratosis
Citation
Das, Anupam
Vasudevan, Biju
Talwar, Ankur. Porokeratosis: An enigma beginning to unravel. Indian Journal of Dermatology, Venereology and Leprology. 2022 Jun; 88(3): 291-299
Vasudevan, Biju
Talwar, Ankur. Porokeratosis: An enigma beginning to unravel. Indian Journal of Dermatology, Venereology and Leprology. 2022 Jun; 88(3): 291-299