Disseminated superficial actinic porokeratosis. Clinical studies and experimental production of lesions

Bullous and Pruritic Variant of Disseminated Superficial Actinic Porokeratosis: Successful Treatment with Grenz Rays

“…Despite the fact that he has not been extensively exposed to the sun in the last 20 years, DSAP spread and extended not only to light-exposed areas but also to covered areas of the trunk. His major complaint was pruritus, which seems not to be uncommon according to the literature [12, 13, 17, 18]. Interestingly, the patient had not only the typical lesions of porokeratosis with the characteristic histopathological features [13, 19], but also a bullous eruption, especially on the legs, without evidence of genuine bullous disease.…”

“…It is difficult to say whether genetic predisposition is being unmasked by the immune modulation or if an altered immune status will initiate the process of porokeratosis. Reed and Leone [20]have suggested that in a genetically predisposed individual, the disease results from the proliferation of abnormal clones of epidermal cells, which may be triggered by several stimuli, including sunlight or artificial UV light [18, 21, 22], exposure to electron beam radiotherapy [23], immunosuppressive treatments (as e.g. chemotherapy, immunosuppressive drugs or systemic corticosteroids) [4, 5, 6, 7, 8, 9, 10]or HIV infection [11].…”

“…It is important to notice that malignant skin tumors occur in 7–11% of all porokeratosis patients but remain rare in DSAP [1, 18, 19, 21, 24, 25]. Therefore clinical surveillance of patients is indicated when there is a history of intense sun exposure, X-ray irradiation or immunosuppressive disorders [4, 6, 18, 19, 21, 24, 25, 26, 27].…”

“…Therefore clinical surveillance of patients is indicated when there is a history of intense sun exposure, X-ray irradiation or immunosuppressive disorders [4, 6, 18, 19, 21, 24, 25, 26, 27]. …”

Generalized Eruptive Porokeratosis of Mibelli with Associated Psoriasis

“…Indeed, an apparent similarity exists even at the ultrastruetural level; Darier's disease also shows perinuclear vacuoles in the involved eells (Gottlieb & Lutzner 1975). The possibility that LJV light aeted to precipitate the onset of porokeratotic lesions should be considered in view of the circumstances found in Chernosky's eases (Chernosky & Ereeman 1967, Chernosky & Anderson 1969. This defect might possibly be uneovered by subjecting predisposed individuals to eertain stimulus agents.…”