Granular Parakeratosis Treatment & Management

Author: Noah S Scheinfeld, MD, JD, FAAD; Chief Editor: Dirk M Elston, MD more...

Updated: Jul 18, 2011

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Medical Care

Although some consider granular parakeratosis rare, successful medical treatments for granular parakeratosis have been reported. These have included topical corticosteroids and oral and topical retinoids.^{[27, 28]}A 2003 report notes that topical calcipotriene and ammonium lactate also effectively treated granular parakeratosis.^[13]Calcineurin inhibitors and topical antifungal agents have been tried with some success. Isotretinoin^{[28, 29]}and tretinoin^[27]have been reported as effective for granular parakeratosis, as has botulinum toxin injection.^[30]Calcipotriene has been used to treat granular parakeratosis.^[31]

Surgical Care

Rare reports have noted that cryotherapy can effectively treat granular parakeratosis.

Activity

Patients should avoid excessive washing of intertriginous areas. They should also minimize or avoid the use of roll-on deodorants and antiperspirants.

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Contributor Information and Disclosures

Author

Noah S Scheinfeld, MD, JD, FAAD Assistant Clinical Professor, Department of Dermatology, Columbia University College of Physicians and Surgeons; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, and New York Eye and Ear Infirmary; Private Practice

Noah S Scheinfeld, MD, JD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Optigenex Consulting fee Independent contractor

Specialty Editor Board

Peter Fritsch, MD Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria

Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

References

Northcutt AD, Nelson DM, Tschen JA. Axillary granular parakeratosis. J Am Acad Dermatol. Apr 1991;24(4):541-4. [Medline].
Niesmann J, Bierhoff E, Dirschka T. [Hyperkeratotic pruritic papules in the submammary area. Diagnose: Granular parakeratosis]. J Dtsch Dermatol Ges. Aug 2010;8(8):631-3. [Medline].
Leclerc-Mercier S, Prost-Squarcioni C, Hamel-Teillac D, Fraitag S. A case of congenital granular parakeratosis. Am J Dermatopathol. Jul 2011;33(5):531-3. [Medline].
Martorell A, Sanmartín O, Hueso-Gabriel L, Guillén C. [Granular parakeratosis: disease or reactive response?]. Actas Dermosifiliogr. Jan 2011;102(1):72-4. [Medline].
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Contreras ME, Gottfried LC, Bang RH, Palmer CH. Axillary intertriginous granular parakeratosis responsive to topical calcipotriene and ammonium lactate. Int J Dermatol. May 2003;42(5):382-3. [Medline].
Pock L, Hercogova J. Incidental granular parakeratosis associated with dermatomyositis. Am J Dermatopathol. Apr 2006;28(2):147-9. [Medline].
Pock L, Cermakova A, Zipfelova J, Hercogova J. Incidental granular parakeratosis associated with molluscum contagiosum. Am J Dermatopathol. Feb 2006;28(1):45-7. [Medline].
Reddy IS, Swarnalata G, Mody T. Intertriginous granular parakeratosis persisting for 20 years. Indian J Dermatol Venereol Leprol. Jul-Aug 2008;74(4):405-7. [Medline].
Ezra N, Karunasiri D, Chiu MW. Unilateral pruritic axillary rash: axillary granular parakeratosis. Arch Dermatol. Dec 2008;144(12):1651. [Medline].
Paradisi A, Sisto T, Annessi G. Groin granular parakeratosis. Eur J Dermatol. Mar-Apr 2010;20(2):242-3. [Medline].
Niesmann J, Bierhoff E, Dirschka T. [Hyperkeratotic pruritic papules in the submammary area. Diagnose: Granular parakeratosis]. J Dtsch Dermatol Ges. Aug 1 2010;8(8):631-3. [Medline].
Resnik KS, Kantor GR, DiLeonardo M. Granular parakeratotic acanthoma. Am J Dermatopathol. Oct 2005;27(5):393-6. [Medline].
Joshi R, Taneja A. Granular parakeratosis presenting with facial keratotic papules. Indian J Dermatol Venereol Leprol. Jan-Feb 2008;74(1):53-5. [Medline].
Genebriera J, Davis MD, Yang H, Borrowman TA. Papillomatous axillary rash due to granular parakeratosis. J Eur Acad Dermatol Venereol. Aug 2007;21(7):994-5. [Medline].
Mehregan DA, Vandersteen P, Sikorski L, Mehregan DR. Axillary granular parakeratosis. J Am Acad Dermatol. Aug 1995;33(2 Pt 2):373-5. [Medline].
Resnik KS, DiLeonardo M. Follicular granular parakeratosis. Am J Dermatopathol. Oct 2003;25(5):428-9. [Medline].
Resnik KS, Kantor GR, DiLeonardo M. Dermatophyte-related granular parakeratosis. Am J Dermatopathol. Feb 2004;26(1):70-1. [Medline].
Resnik KS, DiLeonardo M. Incidental granular parakeratotic cornification in carcinomas. Am J Dermatopathol. Jun 2007;29(3):264-9. [Medline].
Brown SK, Heilman ER. Granular parakeratosis: resolution with topical tretinoin. J Am Acad Dermatol. Nov 2002;47(5 Suppl):S279-80. [Medline].
Compton AK, Jackson JM. Isotretinoin as a treatment for axillary granular parakeratosis. Cutis. Jul 2007;80(1):55-6. [Medline].
Webster CG, Resnik KS, Webster GF. Axillary granular parakeratosis: response to isotretinoin. J Am Acad Dermatol. Nov 1997;37(5 Pt 1):789-90. [Medline].
Ravitskiy L, Heymann WR. Botulinum toxin-induced resolution of axillary granular parakeratosis. Skinmed. Mar-Apr 2005;4(2):118-20. [Medline].
Samrao A, Reis M, Niedt G, Rudikoff D. Granular parakeratosis: response to calcipotriene and brief review of current therapeutic options. Skinmed. Nov-Dec 2010;8(6):357-9. [Medline].

Granular parakeratosis in an 82-year-old man who developed this yellowish, scaly plaque at his left infra-axillary area after changing deodorants. Pathology confirmed granular parakeratosis. Courtesy of David F. Butler, MD.

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