Disseminated Superficial Non-actinic Porokeratosis: A Consequence of Post-traumatic Immunosuppression

Disseminated superficial porokeratosis (DSP) is a very uncommon dermatologic condition of unknown etiology, characterized by the clonal proliferation of atypical keratinocytes associated with aberrant keratinocyte differentiation. These lead to the development of the specific cornoid lamella that separates atypical from normal keratinocytes. DSP is most frequently encountered in immunosuppressed patients. It has been described in patients receiving immunosuppressive treatments, organ transplantation and in patients diagnosed with human immunodeficiency virus, hepatitis B and hepatitis C virus infection. We present the case of a 78-year-old patient who developed disseminated non-actinic after multiple trauma and major orthopedic surgery. To our knowledge, this is the first case of DSP occurring as a consequence of post-traumatic immunosuppression reported in the medical literature. We discuss the pathogenic mechanisms, as well as the optimal diagnostic and therapeutic approach in such cases.