Book contents
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- 15 The Effects of Transplantation on Preexisting Dermatoses
- 16 Porokeratosis in Organ Transplant Recipients
- 17 Benign Cutaneous Neoplasms in Organ Transplant Recipients
- 18 Anogenital Cutaneous Disease in Organ Transplant Recipients
- 19 Cutaneous Graft versus Host Disease after Solid Organ Transplantation
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
16 - Porokeratosis in Organ Transplant Recipients
from Section Six - Benign and Inflammatory Skin Diseases in Transplant Dermatology
Published online by Cambridge University Press: 18 January 2010
- Frontmatter
- Contents
- List of Contributors
- Foreword by Daniel R. Salomon
- Foreword by Robin Marks
- Foreword by Kathy Schwab
- Preface
- Acknowledgments
- SECTION ONE TRANSPLANT DERMATOLOGY: AN EVOLVING DYNAMIC FIELD
- Section Two Transplant Medicine and Dermatology
- Section Three Pathogenic Factors in Transplant Dermatology
- Section Four Cutaneous Effects of Immunosuppressive Medications
- Section Five Infectious Diseases of the Skin in Transplant Dermatology
- Section Six Benign and Inflammatory Skin Diseases in Transplant Dermatology
- 15 The Effects of Transplantation on Preexisting Dermatoses
- 16 Porokeratosis in Organ Transplant Recipients
- 17 Benign Cutaneous Neoplasms in Organ Transplant Recipients
- 18 Anogenital Cutaneous Disease in Organ Transplant Recipients
- 19 Cutaneous Graft versus Host Disease after Solid Organ Transplantation
- Section Seven Cutaneous Oncology in Transplant Dermatology
- Section Eight Special Scenarios in Transplant Cutaneous Oncology
- Section Nine Educational, Organizational, and Research Efforts in Transplant Dermatology
- Index
Summary
INTRODUCTION
Porokeratosis (PK) is an uncommon disorder of epidermal differentiation with an increased incidence in organ transplant recipients (OTR). There are different clinical manifestations of PK, but all share a distinct histopathology characterised by the “cornoid lamella,” a narrow dyskeratotic column, which interrupts the granular layer with associated parakeratosis and often hydropic degeneration of the corresponding basal layer (Figure 16.1).
CLINICAL FEATURES
Porokeratosis presents as a well-demarcated, irregular plaque that expands slowly in a centrifugal fashion with a prominent hyperkeratotic, ridged border corresponding to the cornoid lamella and some central atrophy. PK was first described by Mibelli in 1893, and the classic Porokeratosis of Mibelli (PKM) is a form found commonly in OTR. PKM presents as one or more localized asymptomatic annular plaques. These may become large (up to 20 cm diameter) and are usually, but not exclusively, located on the limbs, commonly the lower legs (Figure 16.2).
Other clinical presentations of PK include:
Disseminated superficial actinic porokeratosis (DSAP): Common in countries with high ultraviolet (UV) exposure and presenting with multiple small superficial, annular lesions symmetrically distributed on sun-exposed areas of skin. Individual lesions are less prominent than those of PKM and may be overlooked or ignored. Patients often describe symptomatic exacerbations following sun exposure.
Disseminated superficial porokeratosis (DSP): Similar to DSAP, but without UV light as a precipitating factor.
Linear porokeratosis (LPK): Linear systemized lesion reminiscent of an epidermal nevus.
Porokeratosis palmaris, plantaris et disseminata (PPPD): DSAP-like lesions initially limited to the palms and soles.
Punctate porokeratosis (PPK): Punctate keratotic spines on the palms and soles, which may mimic other punctuate palmar keratoses.
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- Information
- Skin Disease in Organ Transplantation , pp. 119 - 121Publisher: Cambridge University PressPrint publication year: 2008
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