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Background: Porokeratosis variants are relatively rare and can be clinically misdiagnosed with several common papulokeratotic mimickers. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to explore the skin in vivo up to a depth of 500 µm.
Objectives: To investigate the role of LC-OCT in the diagnosis of many porokeratosis variants in a preliminary study.
Method: In total, 130 LC-OCT images were obtained from 98 patients, 45 affected by a porokeratosis variant (69 images) and 53 with a mimicker condition (61 images).
Results: We found almost perfect interobserver agreement for LC-OCT image interpretation and perfect correspondence with the findings from histological slides. In addition, a series of morphological in vivo and three-dimensional features related to the cornoid lamella were detected by LC-OCT that were not visible from the histology.
Conclusions: This device can be proposed to assist with rapid bedside noninvasive differentiation of porokeratosis variants from their mimickers, possibly sparing incisional biopsy in patients where the diagnosis is uncertain.
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http://dx.doi.org/10.1093/ced/llae285 | DOI Listing |
Cureus
August 2025
Dermatology, St. Joseph Dermatopathology, Houston, USA.
Eruptive pruritic papular porokeratosis (EPPP) is a rare inflammatory variant of disseminated superficial porokeratosis characterized by the sudden onset of pruritic papules, primarily affecting the extremities and trunk. We present the case of a 77-year-old male who developed EPPP without any underlying malignancy or immunosuppression. Histopathology confirmed EPPP, and the patient underwent treatment with topical lovastatin 2% ointment, followed by topical calcipotriene.
View Article and Find Full Text PDFCureus
June 2025
Dermatology, University of Texas Health Science Center at Houston, Houston, USA.
Porokeratosis ptychotropica (PP) is a rare variant of porokeratosis, typically presenting as pink to brown hyperkeratotic plaques in the gluteal cleft and buttocks, defined histologically by multiple cornoid lamellae. Diagnosis of PP is challenging due to its clinical overlap with other dermatologic conditions and inconsistent terminology in the literature. This case report describes a 47-year-old woman exhibiting clinical and pathological features of PP but with a more diffuse presentation than previously documented.
View Article and Find Full Text PDFAME Case Rep
March 2025
Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Background: Cutaneous T-cell lymphomas (CTCLs) are the second most prevalent group of extranodal lymphomas second to B-cell lymphomas. Mycosis fungoides (MF) is the most common type of CTCL, often presenting as erythematous patches and plaques with scaling. However, MF is known for its wide range of clinical presentations, making it a "great mimicker" of other dermatological conditions.
View Article and Find Full Text PDFPhotodiagnosis Photodyn Ther
June 2025
Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Health, Sawangi (Meghe), Wardha, India. Electronic address:
Porokeratoses represent a rare spectrum of keratinisation disorders that commonly present as annular, scaly plaques with an atrophic center and either hyper or hypopigmentation. They can be inherited in an autosomal dominant pattern with variable penetrance or occur sporadically. Porokeratosis of Mibelli (PM) is a solitary variant that usually presents in childhood or adolescence and has been attributed to immunosuppression, although the underlying mechanisms remain unclear.
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March 2025
Dermatology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, IND.
Porokeratosis is an autosomal dominant condition of epidermal keratinization. There are many clinical and morphological variants of porokeratosis, the most prevalent of which is disseminated superficial actinic porokeratosis (DSAP), which commonly affects photoexposed areas. Here, we present a 52-year-old woman and her 24-year-old daughter having similar complaints of gradually enlarging, annular hyperpigmented plaques on photoexposed areas suggesting familial transmission.
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