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Recalcitrant Digital Porokeratosis of Mibelli: A Successful Surgical Treatment.

Shahmoradi Z, Sadeghiyan H, Pourazizi M, Saber M, Abtahi-Naeini B - N Am J Med Sci (2015)

Bottom Line: Cryosurgery and laser ablation did not have acceptable response.We used surgical treatment with successful cosmetic outcome.Complete surgical excision for isolated digital PM had good results.

View Article: PubMed Central - PubMed

Affiliation: Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Context: Porokeratosis of Mibelli (PM) is a rare, benign, asymptomatic, epidermal hyperkeratinization dermatitis that is characterized by annular plaque that expands through the edges and leaves an atrophic center. Many therapies have been attempted for the treatment of PM, but none of these have given satisfactory results. The efficacies of treatment options are limited, and currently there is no gold standard.

Case report: This paper reports the case of a 22-year-old female with 3-years history of PM, who had not responded to routine therapies like topical corticosteroids, topical tretinoin, topical salicylic acid, and various emollients and keratolytic agent. Cryosurgery and laser ablation did not have acceptable response. We used surgical treatment with successful cosmetic outcome.

Conclusion: The treatment of PM should be individualized considering the aesthetic and functionality, and the patient's preferences. Complete surgical excision for isolated digital PM had good results.

No MeSH data available.


Related in: MedlinePlus

PM (before treatment); raised annular hyperkeratotic border on the digit
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Figure 1: PM (before treatment); raised annular hyperkeratotic border on the digit

Mentions: A 22-year-old female was presented to Al Zahra hospital's dermatology clinic, Isfahan, Iran, with an approximately 3-years history of a solitary, slowly progressive, scaly plaque, with a slightly raised hyperkeratotic border on the second digit of her hand [Figures 1 and 2]. She did not have a history of any underlying disease. Skin examination of the second digit indicated a 3-4 cm hyperkeratotic plaque, with a distinct raised annular border and an atrophic center that was compatible with PM. Histopathological analysis showed “cornoid lamella” and confirmed the diagnosis of PM. The lesion was refractory to common treatments. She had not responded to routine therapies like topical corticosteroids, topical tretinoin, topical salicylic acid and various emollients, and keratolytic agent. Cryosurgery and laser ablation did not have acceptable response. Recently the lesion became increasingly large, pruritic, and cosmetically displeasing that induced psychological stress, shame, and anxiety about the general appearance, along with cosmetic concern. Due to the recalcitrance of lesions to common topical treatments after 2 years of appropriate treatment, it was decided that the patient would get treated with excision of the plaque and application of a STSG from her thigh. After a 4-month follow-up, hyperkeratotic lesion was resolved; there was no recurrent lesion and an acceptable result was obtained [Figure 3].


Recalcitrant Digital Porokeratosis of Mibelli: A Successful Surgical Treatment.

Shahmoradi Z, Sadeghiyan H, Pourazizi M, Saber M, Abtahi-Naeini B - N Am J Med Sci (2015)

PM (before treatment); raised annular hyperkeratotic border on the digit
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488999&req=5

Figure 1: PM (before treatment); raised annular hyperkeratotic border on the digit
Mentions: A 22-year-old female was presented to Al Zahra hospital's dermatology clinic, Isfahan, Iran, with an approximately 3-years history of a solitary, slowly progressive, scaly plaque, with a slightly raised hyperkeratotic border on the second digit of her hand [Figures 1 and 2]. She did not have a history of any underlying disease. Skin examination of the second digit indicated a 3-4 cm hyperkeratotic plaque, with a distinct raised annular border and an atrophic center that was compatible with PM. Histopathological analysis showed “cornoid lamella” and confirmed the diagnosis of PM. The lesion was refractory to common treatments. She had not responded to routine therapies like topical corticosteroids, topical tretinoin, topical salicylic acid and various emollients, and keratolytic agent. Cryosurgery and laser ablation did not have acceptable response. Recently the lesion became increasingly large, pruritic, and cosmetically displeasing that induced psychological stress, shame, and anxiety about the general appearance, along with cosmetic concern. Due to the recalcitrance of lesions to common topical treatments after 2 years of appropriate treatment, it was decided that the patient would get treated with excision of the plaque and application of a STSG from her thigh. After a 4-month follow-up, hyperkeratotic lesion was resolved; there was no recurrent lesion and an acceptable result was obtained [Figure 3].

Bottom Line: Cryosurgery and laser ablation did not have acceptable response.We used surgical treatment with successful cosmetic outcome.Complete surgical excision for isolated digital PM had good results.

View Article: PubMed Central - PubMed

Affiliation: Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Context: Porokeratosis of Mibelli (PM) is a rare, benign, asymptomatic, epidermal hyperkeratinization dermatitis that is characterized by annular plaque that expands through the edges and leaves an atrophic center. Many therapies have been attempted for the treatment of PM, but none of these have given satisfactory results. The efficacies of treatment options are limited, and currently there is no gold standard.

Case report: This paper reports the case of a 22-year-old female with 3-years history of PM, who had not responded to routine therapies like topical corticosteroids, topical tretinoin, topical salicylic acid, and various emollients and keratolytic agent. Cryosurgery and laser ablation did not have acceptable response. We used surgical treatment with successful cosmetic outcome.

Conclusion: The treatment of PM should be individualized considering the aesthetic and functionality, and the patient's preferences. Complete surgical excision for isolated digital PM had good results.

No MeSH data available.


Related in: MedlinePlus