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Generalized eruptive porokeratosis of Mibelli with associated psoriasis
Abstract:
A case of eruptive porokeratosis of Mibelli with diverse morphologic features, including circinate macular, circinate plaque and verrucous varieties is presented. No matter how variable the clinical presentation may be, the histologic hallmark of porokeratosis, the cornoid lamellae, is always present. The cornoid lamellae vary in height in relation to how prominent the thready ridge of the clinical lesion appears. Our patient also had psoriasis which initially masked the porokeratotic lesions both clinically and histologically. Awareness of the various clinical expressions of porokeratosis of Mibelli would 1) make unnecessary the segregation of certain forms of porokeratosis into separate entities, and 2) help in the recognition of less classical forms of porokeratosis.
Insights
Eruptive porokeratosis of Mibelli presents with varied forms, but the cornoid lamellae remain a consistent histological marker. Recognizing diverse clinical presentations aids in accurate diagnosis and avoids unnecessary classification of distinct entities.
Area of Science:
- Dermatology
- Histopathology
Background:
- Porokeratosis of Mibelli is a rare keratinization disorder.
- Eruptive variants present with diverse clinical morphologies.
Observation:
- A case of eruptive porokeratosis of Mibelli exhibited circinate macular, plaque, and verrucous lesions.
- Histopathology consistently revealed the hallmark cornoid lamellae, varying in height.
- Concomitant psoriasis initially obscured the clinical and histological diagnosis of porokeratosis.
Findings:
- The cornoid lamellae are the pathognomonic histological feature of porokeratosis.
- Clinical presentation variability does not necessitate separate classifications for porokeratosis variants.
Implications:
- Increased awareness of diverse clinical presentations can prevent unnecessary categorization of porokeratosis subtypes.
- Recognition of atypical porokeratosis of Mibelli cases is improved, aiding timely and accurate diagnosis.