Eruptive disseminated porokeratosis associated with corticosteroid-induced immunosuppression

Abstract

Summary Eruptive disseminated porokeratosis (EDP) is a disease that presents clinically with sudden onset of erythematous papules and plaques, with a ridge‐like border histologically represented by a cornoid lamella. We report a case of EDP occurring in a 39‐year‐old woman 3 days after completion of a 2‐week course of oral corticosteroid therapy for an acute asthma exacerbation. The patient was treated with emollients and sun protection. Unlike the more chronic disseminated superficial (actinic) porokeratosis, EDP secondary to immunosuppression from corticosteroid therapy has very rarely been reported in the dermatological literature.

Drugs associated with development of porokeratosis: A systematic review

“…One patient received prednisone for an asthma flair secondary to viral infection and developed EDP. Prednisone was discontinued and they improved after 8 weeks 10 . The second patient received clobetazole propionate for their psoriasis vulgaris of 15 years 29 .…”

“…Prednisone was discontinued and they improved after 8 weeks. 10 The second patient received clobetazole propionate for their psoriasis vulgaris of 15 years. 29 They developed porokeratosis of Mibelli and treatment with radiofrequency surgery led to complete resolution and no recurrence in a 6 month follow-up.…”

“…Porokeratosis has also been shown to develop in immunodeficient patients and its incidence is estimated to be between 0.34% and 10.68% for patients undergoing organ transplant with immunosuppressive agents 9 . It has also occurred after systemic immunosuppression 10 and common variants are DSP and porokeratosis of Mibelli 1 . Cutaneous malignancies have been reported for PK 1 .…”

Eruptive superficial porokeratosis in a patient with nephrotic syndrome

“… 1 It is known that porokeratosis develops in association with systemic immunosuppression or under immunosuppressant therapies; however, it is still unclear as to how immunosuppression is associated with the development of porokeratosis. 2 One possible mechanism is that immunosuppression induces an epidermal keratinocyte population either directly or indirectly. 2 The abnormal clone of keratinocytes proliferates in a disorderly manner and disturbs the normal growth of the epidermis.…”

“… 2 One possible mechanism is that immunosuppression induces an epidermal keratinocyte population either directly or indirectly. 2 The abnormal clone of keratinocytes proliferates in a disorderly manner and disturbs the normal growth of the epidermis. 3 Patients with renal failure rarely develop multiple porokeratosis.…”