Ann Dermatol.  2018 Apr;30(2):211-213. 10.5021/ad.2018.30.2.211.

Disseminated Superficial Actinic Porokeratosis in a Patient with Psoriasis, after Long-Term Narrowband Ultraviolet B Phototherapy

• Sim CY
• Shin JY
• Lee SY
• Park YL

• KMID: 2414683
• DOI: http://doi.org/10.5021/ad.2018.30.2.211

Abstract

Porokeratosis is a rare epidermal disorder characterized by annular or linear hyperkeratotic plaques with slightly raised thread-like borders, and in most cases, atrophic centers. Disseminated superficial porokeratosis and disseminated superficial actinic porokeratosis (DSAP), which primarily involve sun-exposed areas, are common types of porokeratoses. Histologically, a column of parakeratotic cells, a so-called cornoid lamella, is a hallmark of porokeratosis. Porokeratosis is considered to result from the inability to eliminate an abnormal keratinocyte clone induced by genetic factors and various stimuli, including sunlight, artificial ultraviolet light, viral infections, immunosuppressive conditions (hematologic malignancies, organ transplants, or autoimmune disease), and immunosuppressive therapies. Here, we report a 59-year-old Korean woman with DSAP that developed after narrowband ultraviolet B (NB-UVB) therapy for psoriasis. Our case emphasizes the occurrence of DSAP due to NB-UVB that is able to induce local immunosuppression at the irradiated site; the pathogenesis of DSAP remains unclear.

Keyword

Porokeratosis; Psoriasis; Ultraviolet therapy

MeSH Terms

Clone Cells
Female
Humans
Immunosuppression
Keratinocytes
Middle Aged
Phototherapy*
Porokeratosis*
Psoriasis*
Sunlight
Transplants
Ultraviolet Rays
Ultraviolet Therapy

Figure

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  Fig. 1 (A) Both lower legs and (B) arms of the patient show multiple 5 to 10 mm erythematous plaques with raised hyperkeratotic borders.

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  Fig. 2 Cornoid lamellae are seen on the edge of the specimen and psoriasiform acanthosis is evident in the epidermis (H&E, ×100).

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