bubble_chart Overview

Porokeratosis is a chronic hereditary keratotic skin disease with unknown etiology, often showing familial occurrence. It is currently considered to be related to autosomal dominant inheritance. Some researchers propose that the disease may develop due to the proliferation of abnormal cell clones caused by disturbances in normal immune processes. Sun exposure frequently serves as a precipitating factor, with males being affected 2-3 times more often than females.

bubble_chart Diagnosis

Clinical manifestations 1. The primary lesion is a keratotic papule that gradually expands outward, with normal or atrophic skin in the center and a narrow, gray or light brown keratotic embankment-like elevation at the edge. The top of the elevation has an even narrower groove, and there are no subjective symptoms. 2. It commonly occurs on exposed areas and may also affect mucous membranes.

Diagnostic basis 1. The appearance of keratotic papules on exposed areas with keratotic embankment-like elevations at the edges. 2. It often appears or worsens after sun exposure. 3. Histopathological examination: The elevated keratotic edge shows significant hyperkeratosis, disappearance of the granular layer, thickening of the spinous layer, a fissure at the top of the embankment, and a keratin plug in the groove, with a band of parakeratotic cells arranged in columns in the middle.

bubble_chart Treatment Measures

Treatment Principles 1. Try vitamin A or high-dose vitamin E; 2. For minor lesions, consider electrocautery, liquid nitrogen cryotherapy, laser therapy, triamcinolone injection into the lesion, or topical application of 5-10% salicylic acid ointment or 5-fluorouracil ointment; 3. For cases related to sunlight exposure, avoid excessive sun exposure and consider oral chloroquine or nicotinamide.

Medication Principles 1. There is no specific treatment for this condition. Topical 5-fluorouracil or retinoic acid can only provide symptomatic relief; 2. For large or hypertrophic lesions, oral retinoids may be tried in addition to surgical options; 3. For cases related to sunlight exposure, oral chloroquine may be considered.

bubble_chart Cure Criteria

1. Cured: Skin lesions subside without significant scarring; 2. Improved: Most skin lesions subside, or significant scarring remains; 3. Not cured: Skin lesions do not subside.