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Porokeratoma.

Sarah N Walsh1, Mark A Hurt, Daniel J Santa Cruz

  • 1Department of Pathology and Immunology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO, USA.

The American Journal of Surgical Pathology
|November 29, 2007
PubMed
Summary
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A new benign skin tumor, termed porokeratoma, presents as a solitary lesion with distinctive cornoid lamellation. This distinct pattern of epidermal maturation is a key diagnostic feature, differentiating it from typical porokeratosis.

Area of Science:

  • Dermatology
  • Pathology
  • Oncology

Background:

  • Cornoid lamellation, characterized by parakeratosis columns, is the hallmark of porokeratosis.
  • Porokeratosis is a group of disorders affecting epidermal maturation.

Purpose of the Study:

  • To describe a distinct pattern of solitary cornoid lamellation.
  • To characterize the clinical and histological features of these lesions.
  • To propose a new classification for these benign acanthomas.

Main Methods:

  • Clinical presentation and follow-up of 11 patients with solitary lesions.
  • Histological examination of lesional biopsies.
  • Review of patient history for porokeratosis or immunosuppression.

Main Results:

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  • Eleven patients (9 male, 2 female; mean age 57) presented with solitary, hyperkeratotic, verrucous plaques or nodules on limbs.
  • Histology revealed acanthosis, verrucous hyperplasia, and multiple confluent cornoid lamellae.
  • No additional lesions, family history, or immunosuppression were noted during a mean 34-month follow-up.

Conclusions:

  • Solitary lesions with multiple confluent cornoid lamellae represent benign acanthomas with porokeratosis features.
  • These findings suggest a distinct entity, proposed as 'porokeratoma'.
  • Porokeratoma is akin to warty dyskeratoma and epidermolytic acanthoma as a solitary tumorlike lesion.