Disseminated Porokeratosis with Idiopathic Thrombocytopenia - Case Report and Literature Review of Porokeratosis and Related Disorders


  • Anastasiya Atanasova Chokoeva Medical University Plovdiv, Dermatology and Venereology, Vasil Aprilov 15A, Plovdiv 4000
  • Uwe Wollina Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen
  • Torello Lotti University G. Marconi of Rome - Dermatology and Venereology, Rome
  • Georgi Konstantinov Maximov ”Onkoderma” - Policlinic for Dermatology and Dermatologic Surgery, Sofia
  • Ilia Lozev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia
  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia; ”Onkoderma” - Policlinic for Dermatology and Dermatologic Surgery, Sofia




Porokeratosis, Acitretin, Betamethasone, Outcome, Therapy, Cryosurgery


BACKGROUND: Porokeratosis is characterised by one or more atrophic patches surrounded by a distinctive peripheral keratotic ridge, typically found on sun-exposed areas, with several clinical variants and typical histological findings. Despite ultraviolet radiation, varies antibody - related autoimmune disease treated with systemic steroids and other immunosuppressive conditions such as chronic liver disease, HIV and organ transplantations have been implicated in its etiopathology.

CASE REPORT: We present a case of porokeratosis, associated with idiopathic thrombocytopenia in 74 - year old, otherwise healthy male patient, as we discuss the previously reported associated disorders.

CONCLUSION: Regarding all of the polymorphism of clinical presentation, associated disorders and treatment responses, we could conclude that disseminated porokeratosis is still an unknown well disorder, which will continue to surprise the physicians in future. The screening and follow up of the patients is mandatory in all cases because as we see, porokeratosis has multiple unexpected faces, which require circumstantial clinical and paraclinical behaviour.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Sun RF, Chen H, Zhu W, Lian S. Dermoscopic Features and Gene Mutation in the Mevalonate Pathway of Five Sporadic Patients with Porokeratosis. Chin Med J. 2017; 130:1747-8. https://doi.org/10.4103/0366-6999.209905 PMid:28685731 PMCid:PMC5520568

Anderson I1, Routt ET2, Jim On SC. Disseminated superficial actinic porokeratosis treated with ingenol mebutate gel 0.05. Cutis. 2017; 99(3):E36-E39. PMid:28398427

Tebet AC, Oliveira TG, Oliveira AR, Moriya FS, Oliveira J Filho, Cucé LC. Porokeratosis ptychotropica. An Bras Dermatol. 2016; 91(5 suppl 1):134-136. https://doi.org/10.1590/abd1806-4841.20164399 PMid:28300921 PMCid:PMC5325020

Walsh SN, Hurt MA, Santa Cruz DJ. Porokeratoma. Am J Surg Pathol. 2007; 31(12):1897-901. https://doi.org/10.1097/PAS.0b013e31806910c7 PMid:18043046

Llamas-Velasco M, Hilty N, Kempf W. Porokeratotic adnexal ostial naevus: review on the entity and therapeutic approach. J Eur Acad Dermatol Venereol. 2015; 29(10):2032-7. https://doi.org/10.1111/jdv.12732 PMid:25255914

Li X, Zhou Q, Zhu L, Zhao Z, Wang P, Zhang L, Zhang G, Wang X. Analysis of clinical and genetic features of nine patients with disseminated superfacial actinic porokeratosis. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2017; 34(4):481-485. PMid:28777842

Robak E, Wozniacka A, Sysa-Jedrezejowska A, Biernat W, Robak T. Disseminated superficial actinic porokeratosis in a patient with systemic lupus erythematosus. Br J Dermatol. 1999; 141:759 – 761. https://doi.org/10.1046/j.1365-2133.1999.03134.x PMid:10583141

Nakamura M, Fukamachi S, Tokura Y. Acute onset disseminated superficial porokeratosis associated with exacerbation of diabetes mellitus due to development of anti-insulin antibodies. Dermatoendocrinol. 2010; 2(1):17-8. https://doi.org/10.4161/derm.2.1.11816 PMid:21547143 PMCid:PMC3084960

Diluvio L, Campione E, Paterno EJ, et al. Acute onset disseminated superficial porokeratosis heralding diffuse large B-cell lymphoma. Eur J Dermatol. 2008; 18:349 – 350. PMid:18474476

di Meo N, Fluehler C, Perkan V, Trevisan G. Disseminated superficial porokeratosis and pyoderma gangrenosum. Dermatol Online J. 2010; 16(10):15. PMid:21062609

Mundi JP, Cerullo L, Cotliar J. Porokeratosis in a patient with hepatitis of unclear etiology. J Drugs Dermatol. 2010; 9(3):258-60. PMid:20232588

Monteagudo-Sánchez B, Ginarte M, Durana C, Labandeira J, de las Heras C, Cacharrón JM. Porokeratosis in a patient with dermatomyositis. Actas Dermosifiliogr. 2006; 97(10):650-2. https://doi.org/10.1016/S0001-7310(06)73487-1

Kluger N, Guilpain P, Leclerc-Mercier S, Emilie S, Guillevin L, Mouthon L. Superficial porokeratosis of the lower limbs during systemic scleroderma Presse Med. 2009; 38(1):146-8. https://doi.org/10.1016/j.lpm.2008.06.023 PMid:18990541

Terranova M, Amato L, Massi D, Fabbri P. Disseminated superficial actinic porokeratosis in a patient with Sjögren syndrome. Skinmed. 2003; 2(6):390-1. https://doi.org/10.1111/j.1540-9740.2003.02261.x PMid:14673257

Jung JY, Yeon JH, Ryu HS, Youn SW, Park KC, Huh CH. Disseminated superficial porokeratosis developed by immunosuppression due to rheumatoid arthritis treatment. J Dermatol. 2009; 36(8):466-7. https://doi.org/10.1111/j.1346-8138.2009.00678.x PMid:19691753

Cannavó SP, Borgia F, Adamo B, Guarneri B. Simultaneous development and parallel course of disseminated superficial porokeratosis and ovarian cancer: Coincidental association or true paraneoplastic syndrome? J Am Acad Dermatol. 2008; 58(4):657-60. https://doi.org/10.1016/j.jaad.2007.12.030 PMid:18258333

Rongioletti F1, Rebora A. Disseminated porokeratosis with fatal metastatic squamous cell carcinoma: an additional case of "malignant disseminated porokeratosis". Am J Dermatopathol. 2002; 24(2):144-8. https://doi.org/10.1097/00000372-200204000-00007

Brodkin RH, Rickert RR, Fuller FW, Saporito C. Malignant disseminated porokeratosis. Arch Dermatol. 1987; 123(11):1521-6. https://doi.org/10.1001/archderm.1987.01660350121027 PMid:3674910

Kanitakis J, Arbona-Vidal E, Faure M. Porokeratosis in patients with polycythemia rubra vera: a new side effect of hydroxyurea? J Eur Acad Dermatol Venereol. 2012; 26(8):1040-1. https://doi.org/10.1111/j.1468-3083.2011.04202.x PMid:21812837

Torchia D, Romanelli P, Schachner LA. Disseminated superficial actinic porokeratosis associated with pseudoxanthoma elasticum. Eur J Dermatol. 2011; 21(4):600-1. PMid:21616751

Benmously Mlika R, Kenani N, Badri T, Ben Romdhane S, Debbiche A, Souissi A, Ben Ayed M, Mokhtar I, Fenniche S. Localized genital porokeratosis in a female patient with multiple myeloma. J Eur Acad Dermatol Venereol. 2009; 23(5):584-5. https://doi.org/10.1111/j.1468-3083.2008.02967.x PMid:18759788

Luelmo-Aguilar J, Gonzalez-Castro U, Mieras-Barcelo C, Castells-Rodellas A. Disseminated porokeratosis and myelodysplastic syndrome. Dermatology. 1992; 184(4):289. https://doi.org/10.1159/000247571 PMid:1498397

Levin RM, Heymann WR. Superficial disseminate porokeratosis in a patient with myelodysplastic syndrome. Int J Dermatol. 1999; 38(2):138-9. https://doi.org/10.1046/j.1365-4362.1999.00504.x

Inamoto N, Watanabe T, Nakamura K. Porokeratosis of Mibelli: benzylhydrochlorothiazide-induced new lesions accompanied by eosinophilic spongiosis. J Am Acad Dermatol. 1984; 11(2 Pt 2):357-61. https://doi.org/10.1016/S0190-9622(84)70172-1

Nakamura Y, Yamaguchi M, Nakamura A, Muto M. Calcipotriol and adapalene therapy for disseminated superficial actinic porokeratosis. Indian J Dermatol Venereol Leprol. 2014; 80:373-4. https://doi.org/10.4103/0378-6323.136981 PMid:25035379

Böhm M, Luger TA, Bonsmann G. Disseminated superficial actinic porokeratosis: treatment with topical tacalcitol. J Am Acad Dermatol. 1999; 40(3):479-80. https://doi.org/10.1016/S0190-9622(99)70502-5

Tchernev G, Chokoeva AA, Ivanova B, Mangarov H, Vidolova NG. Disseminated superficial actinic porokeratosis (DSAP): significant improvement after local administration of calcipotriol/betamethasone gel? Wien Med Wochenschr. 2017; 167(3-4):85-88. https://doi.org/10.1007/s10354-016-0484-8 PMid:27468973



How to Cite

Chokoeva AA, Wollina U, Lotti T, Maximov GK, Lozev I, Tchernev G. Disseminated Porokeratosis with Idiopathic Thrombocytopenia - Case Report and Literature Review of Porokeratosis and Related Disorders. Open Access Maced J Med Sci [Internet]. 2018 Jan. 13 [cited 2022 Oct. 1];6(1):139-42. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.017

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>