Related Experiment Video

Updated: Jun 22, 2026

Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
06:15

Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia

Published on: August 9, 2024

Pustular porokeratosis

Daniel D Miller1, Beth S Ruben

  • 1Departments of Dermatology, University of California - San Francisco, USA.

Journal of Cutaneous Pathology
|June 11, 2009
PubMed

Insights

Disseminated superficial actinic porokeratosis (DSAP) can present with unusual pustules. This case highlights a rare variant, complicating diagnosis and underscoring the need for careful histopathologic examination in diagnosing porokeratosis.

Area of Science:

  • Dermatology
  • Histopathology
  • Clinical Case Reports

Background:

  • Disseminated superficial actinic porokeratosis (DSAP) is a common condition characterized by multiple small, scaly papules and plaques.
  • The typical histopathologic feature of porokeratosis is the cornoid lamella, a parakeratotic column of cells.
  • Pustular variants of skin conditions can present diagnostic challenges.

Observation:

  • A unique case of DSAP exhibited neutrophilic pustules within the cornoid lamellae.
  • Clinically, these corresponded to pustules observed along the characteristic elevated rim of the lesions.
  • Literature review revealed only one prior report linking pustules with porokeratosis.

Findings:

  • The histopathologic findings confirmed the presence of pustules within the cornoid lamellae in this DSAP case.
  • This represents a rare pustular variant of disseminated superficial actinic porokeratosis.
  • The co-occurrence of pustules and DSAP is exceptionally uncommon.

Implications:

  • This unusual presentation of DSAP can pose diagnostic difficulties for clinicians.
  • Recognition of this variant is crucial for accurate diagnosis and appropriate patient management.
  • Further research may elucidate the pathogenesis of pustule formation in porokeratosis.

Related Concept Videos

Accessory Structures of the Skin: Sebaceous Glands01:21

Accessory Structures of the Skin: Sebaceous Glands

A sebaceous gland is a type of oil gland found almost all over the skin ( except palms and soles) and helps lubricate and waterproof the skin and hair. Most sebaceous glands are associated with hair follicles. They generate and excrete sebum, a mixture of lipids, onto the skin surface, thereby naturally lubricating the dry and dead layer of keratinized cells of the stratum corneum, keeping it pliable.
These glands that produce the oils on the skin and hair are holocrine glands. The mature...
Cells of the Epidermis01:24

Cells of the Epidermis

The epidermis is made of four or five layers of epithelial cells, depending on its location in the body. From deep to superficial, these layers are the stratum basale, stratum spinosum, stratum granulosum, stratum lucidum, and stratum corneum.
The cells in all these layers except the stratum basale are called keratinocytes, a type of cell that manufactures and stores the protein keratin. The keratinocytes in the stratum corneum are dead and regularly slough away, being replaced by cells from...
Papillary Dermis01:11

Papillary Dermis

Dermis
The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
Papillary Layer
The papillary layer is made of loose, areolar connective tissue, which means the collagen and...
Acne Infection01:27

Acne Infection

Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...
Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Reticular Dermis01:15

Reticular Dermis

The papillary and reticular dermis are the two layers of the dermis. They are made of connective tissue with fibers of collagen extending from one to the other, making the border between the two somewhat indistinct. The dermal papillae extending into the epidermis belong to the papillary layer, whereas the dense collagen fiber bundles below belong to the reticular layer.
Reticular Layer
Underlying the papillary layer is the much thicker reticular layer, composed of dense, irregular connective...