Porokeratosis is an uncommon dermatologic disorder. It is a disorder of keratinization that presents with keratotic papules or annular plaques with an elevated border. It has a distinct histologic hallmark of cornoid lamella, which is a column of tightly fitted parakeratotic cells in the upper epidermis. There are multiple clinical variants of porokeratosis, including disseminated superficial actinic porokeratosis, classical porokeratosis of Mibelli, porokeratosis palmaris plantaris et disseminatum, and linear porokeratosis.
Additionally, rare variants include genitogluteal porokeratosis, facial porokeratosis, giant porokeratosis, porokeratosis ptychotropica, hypertrophic verrucous porokeratosis, eruptive pruritic papular porokeratosis, follicular porokeratosis, and reticulate porokeratosis. Variants can occur together but rarely do. Porokeratosis is a precancerous lesion that can undergo malignant transformation. Evaluation of porokeratosis is best with a biopsy of the elevated border. While multiple therapies exist for porokeratosis, including topical, systemic, and surgical, there are no standard guidelines for treatment.
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