Treating linear porokeratosis with topical lovastatin/cholesterol cream

Buhle, Anna; Fagan, Kiley; Johnson, Nathan M.; Grider, Douglas J.

doi:10.5070/d328559247

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Recently, there have been promising cases highlighting a potential new therapy utilizing compounded topical cholesterol 2%/lovastatin 2% [ 14 ]. A literature search using the keyword “topical cholesterol lovastatin” on PubMed yielded eight articles citing successful treatments of DSAP or linear porokeratosis.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Linear Porokeratosis Treated With Topical Lovastatin 2% Monotherapy

Diep,

Pyatetsky,

Barrett

et al. 2023

Cureus

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Linear porokeratosis is a rare skin disorder that presents along dermatomal or Blashko lines. While the mechanism of linear porokeratosis formation is unknown, both disrupted cholesterol synthesis and mevalonate accumulation have been proposed as possible theories. There is a small chance of transforming into cutaneous malignancies, most commonly squamous cell carcinomas. The patient is a 61-year-old male with an unusual presentation of bilateral linear porokeratosis. His condition provided a unique opportunity to compare the efficacy of topical treatments in a single individual. A previous trial had successfully cleared the porokeratosis plaques with topical cholesterol 2%/lovastatin 2% on the patient's right arm. After a 12week trial of topical lovastatin 2% monotherapy on the left arm, our current study demonstrated a comparable reduction of porokeratosis lesions. In our PubMed search, there has been a single reported case of disseminated superficial actinic porokeratosis successfully treated with topical lovastatin 2% monotherapy, but there have not been any reported cases of linear porokeratosis treated with this therapy. While topical lovastatin monotherapy for porokeratosis subvariants requires further studies, this case demonstrates similar efficacy of treating linear porokeratosis with topical lovastatin compared to cholesterol/lovastatin dual therapy. These findings support the theory of mevalonate accumulation as a more likely cause of linear porokeratosis compared to disruption of cholesterol synthesis.

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Section: Discussionmentioning

confidence: 99%

Bilateral Linear Porokeratosis Treated With Topical Lovastatin 2% Monotherapy

Diep,

Pyatetsky,

Barrett

et al. 2023

Cureus

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“…As a cholesterol biosynthesis pathway is involved in the pathogenesis of porokeratoses, statin use has been proposed to manage LP. Topical lovastatin 2%/cholesterol 2% cream, aimed at supplementing the deficient mevalonate pathway end products, was well tolerated and moderately effective in five cases of LP [115,391,429,431]. Contrarily, a poor outcome has been reported in five cases treated with simvastatin 2%/cholesterol 5% ointment and 10% urea cream (twice daily for at least 4 weeks) [412].…”

Section: Treatmentmentioning

confidence: 94%

Porokeratoses—A Comprehensive Review on the Genetics and Metabolomics, Imaging Methods and Management of Common Clinical Variants

Pietkiewicz,

Korecka,

Salwowska

et al. 2023

Metabolites

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Porokeratosis is a heterogeneous group of keratinising disorders characterised by the presence of particular microscopic structural changes, namely the presence of the cornoid lamella. This structure develops as a consequence of a defective isoprenoid pathway, critical for cholesterol synthesis. Commonly recognised variants include disseminated superficial actinic porokeratosis, disseminated superficial porokeratosis, porokeratosis of Mibelli, palmoplantar porokeratosis (including porokeratosis palmaris et plantaris disseminata and punctate porokeratosis), linear porokeratosis, verrucous porokeratosis (also known as genitogluteal porokeratosis), follicular porokeratosis and porokeratoma. Apart from the clinical presentation and epidemiology of each variant listed, this review aims at providing up-to-date information on the precise genetic background, introduces imaging methods facilitating the diagnosis (conventional and ultraviolet-induced fluorescence dermatoscopy, reflectance confocal microscopy and pathology), discusses their oncogenic potential and reviews the literature data on the efficacy of the treatment used, including the drugs directly targeting the isoprenoid–mevalonate pathway.

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“…21 Multiple case reports of LP patients treated with topical lovastatin 2%/cholesterol 2% have demonstrated lesion improvement (decreased erythema, thickness, and scaling) without adverse events. [21][22][23][24] A case series of LP treated with topical simvastatin/cholesterol had variable results, with some patients experiencing only mild improvement or lesion recurrence. 25…”

Section: Topical Therapiesmentioning

confidence: 99%

A Review of Therapeutic Options for Linear Porokeratosis

Verma,

M. K. Shalabi,

C. Hartmann

et al. 2024

J of Skin

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Linear porokeratosis (LP) is a rare and uncommon variant of porokeratosis presenting as linear annular papules or plaques along Blaschko’s lines. It may arise spontaneously, although evidence of genetic predisposition exists via point mutations in the mevalonate pathway of cholesterol biosynthesis. Malignant transformation is the most serious complication of this chronic, progressive dyskeratosis. We review the currently available treatment options for LP, including topical, systemic, laser, photodynamic, and surgical therapies.

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Treating linear porokeratosis with topical lovastatin/cholesterol cream

Cited by 4 publications

References 7 publications

Bilateral Linear Porokeratosis Treated With Topical Lovastatin 2% Monotherapy

Bilateral Linear Porokeratosis Treated With Topical Lovastatin 2% Monotherapy

Porokeratoses—A Comprehensive Review on the Genetics and Metabolomics, Imaging Methods and Management of Common Clinical Variants

A Review of Therapeutic Options for Linear Porokeratosis

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