Granular Parakeratosis Treatment & Management

Updated: Dec 13, 2019
  • Author: Sheevam A Shah, MD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Although some consider granular parakeratosis rare, successful medical treatments have been reported. These have included topical corticosteroids and oral and topical retinoids. [44, 45]

A 2003 report notes that topical calcipotriene and ammonium lactate also effectively treated granular parakeratosis. [26]

Calcineurin inhibitors and topical antifungal agents have been tried with some success.

Isotretinoin [45, 46] and tretinoin [44] have been reported as effective for granular parakeratosis.

Calcipotriene has been used to treat granular parakeratosis. [47, 48] Additional vitamin D-3 analogs, such as maxacalcitol, have been used effectively for treatment. [19]

Owing to the association between granular parakeratosis and hyperhidrosis, one reported case showed use of injectable botulinum toxin to be an effective treatment for axillary granular parakeratosis. [49]

In biopsy specimens from psoriatic patients after and before acitretin, methotrexate, and phototherapy treatments, parakeratosis decreases, implying that these agents could be helpful for granular parakeratosis. [50]

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Surgical Care

Rare reports have noted that cryotherapy and laser therapy [51] can effectively treat granular parakeratosis.

Although not a first-line consideration, surgical mastopexy has been shown to be an effective treatment in one refractory case of submammary granular parakeratosis. [4]

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Activity

Patients should avoid excessive washing of intertriginous areas. They should minimize or avoid the use of roll-on deodorants and antiperspirants. Additionally, they should consider avoidance of antiseptics, household cleaning agents, and laundry detergents containing benzalkonium chloride if they are not responding to other methods.

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Prevention

Once granular parakeratosis resolves and the inciting substances are avoided, granular parakeratosis does not tend to recur. However, sometimes, granular parakeratosis has a chronic and relapsing course. Patients should not use occlusive compounds and should avoid excessive washing of axillary areas, groin, or other affected areas.

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