J Yeungnam Med Sci.  2023 Oct;40(4):423-425. 10.12701/jyms.2022.00549.

Porokeratosis ptychotropica: a case report

• Ryoo YW
• Kim Y
• Yun JM
• Kim SA

• KMID: 2547367
• DOI: http://doi.org/10.12701/jyms.2022.00549

Abstract

Porokeratosis ptychotropica is an uncommon form of porokeratosis, which was initially described in 1995. It is clinically characterized by symmetrical reddish to brown-colored hyperkeratotic, verrucous, or psoriasiform plaques on the perianal and gluteal regions. The lesions tend to integrate and expand centrally, with small peripheral satellite lesions. Early skin biopsy and appropriate diagnosis are essential because malignant change occurs in 7.5% of porokeratotic lesions. Conventional treatment options include topical steroid, retinoid, imiquimod, 5-fluorouracil, isotretinoin, excimer laser, photodynamic therapy, intralesional steroid or bleomycin injection, cryotherapy, carbon dioxide (CO2) laser, and dermatome and excision, but none seem to achieve complete clearance. A 68-year-old woman presented with diffuse hyperkeratotic scaly lichenoid plaques on the buttocks that had persisted for several years. A skin biopsy of the buttocks revealed multiple cornoid lamellae and intense hyperkeratosis. There were some dyskeratotic cells beneath the cornoid lamellae and the granular layer was absent. Porokeratosis ptychotropica was diagnosed based on the characteristic clinical appearance and typical histopathological manifestations. She was treated with a CO2 laser in one session and topical application of urea and imiquimod cream for 1 month. The lesions slightly improved at the 1-month follow-up. We herein present a rare case of porokeratosis ptychotropica.

Keyword

CO laser; Porokeratosis; Porokeratosis ptychotropica

Figure

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  Fig. 1. (A) Asymptomatic diffuse hyperkeratotic scaly lichenoid plaques on the buttock that had persisted for several years. (B) The lesions are slightly improved at the 1-month follow-up.

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  Fig. 2. (A) Skin biopsy of the buttocks reveals multiple cornoid lamellae and intense hyperkeratosis (hematoxylin and eosin [H&E] stain, x40). (B, C) Beneath the cornoid lamellae, there are some dyskeratotic cells and the granular layer is absent (H&E stain; [B] x100, [C] x200).

Reference

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