Porokeratosis Follow-up

  • Author: Linda V Spencer, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 7, 2010
 

Further Inpatient Care

Inpatient care is rarely necessary.

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Further Outpatient Care

Regularly monitoring patients for the development of malignant transformation is essential, especially in the setting of immunosuppression. Squamous cell or basal cell carcinomas can be aggressive in patients who are immunosuppressed.

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Complications

The most important complication to watch for is the development of cutaneous malignancy. Functional impairment due to involvement of critical anatomical locations may develop. Prophylactic excision should be considered in appropriate situations.

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Prognosis

The prognosis is generally excellent. This is especially true for disseminated superficial porokeratosis (DSP). Clinical settings of concern include the following:

  • Patients who develop classic porokeratosis of Mibelli (PM) or linear porokeratosis because of immunosuppression are at higher risk for the development of a squamous or basal cell carcinoma within the lesion. These cutaneous malignancies often behave aggressively, with the potential for extensive local tissue destruction (basal cell carcinoma) and distant metastasis (squamous cell carcinoma).
  • Linear porokeratosis is associated with a higher risk of malignant degeneration.
  • PM circumferentially involving the digits may induce pseudoainhum.[13]
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Patient Education

  • Patients must practice strict sun precautions. These measures include wearing protective clothing; applying sunblock; avoiding exposure to midday sunlight; and discontinuing exposure to artificial ultraviolet light, such as tanning beds and therapeutic phototherapy.
  • Patients must periodically examine their skin for lesions suggestive of malignancy. A qualified physician should promptly evaluate any change in a porokeratosis lesion.
  • Family members should be examined for porokeratosis if familial porokeratosis is suspected.
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Contributor Information and Disclosures
Author

Linda V Spencer, MD  Consulting Staff, Department of Dermatology, St Clare Medical Center

Linda V Spencer, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, and Indiana State Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Marjan Garmyn, MD, PhD  Professor, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium; Chair and Adjunct Head, Department of Dermatology, University of Leuven, Belgium

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Electrical Optical Sciences Consulting fee Consulting; Celgene Honoraria Safety monitoring committee; GSK - Glaxo Smith Kline Consulting fee Consulting; TenXBioPharma Consulting fee Safety Monitoring committee

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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Porokeratosis of Mibelli on the lower leg in a renal transplant recipient.
Disseminated superficial actinic porokeratosis on the lower legs of a female patient.
A 42-year-old woman with multiple lesions on the pretibial aspects of the legs.
A young boy with a linear lesion of porokeratotic eccrine ostial and dermal duct nevus extending onto the nailbed, causing pterygium formation.
 
 
 
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