Two cases of disseminated superficial actinic porokeratosis (DSAP) and treatment literature review

Abstract

Background: Disseminated superficial actinic porokeratosis (DSAP) is characterized by asymptomatic multiple papules with annular keratotic rim distributed symmetrically on the sun-exposed areas. Many approaches have been proposed in the past for treating DSAP, but the therapy is still a challenge for every physician, mostly because of the frequent relapses of the disease and the multiplicity of the skin lesions. Material and Methods: Two case reports were reported emphasizing the challenges of treatment approach. Therefore, a systemic English literature review was conducted searching Medline database using PubMed Central and Ovid software as search interface to collect evidence based on the various treatment modalities for DSAP. Results: The initial search yielded 146 articles, but only the relevant case reports, case series and studies relating to the treatment of DSAP have been described and summarized in a table. For each different therapy the efficacy of each treatment, side effects, cost-effectiveness and authors' recommendations were reported. Conclusion: Several factors need to be considered prior to physicians' decision of the most appropriate treatment for each patient like age, the extent of body surface area involvement, patients' medical history and social situation, the available resources, the side effects and cost-effectiveness of each treatment. However, l the exact value of each treatment is difficult to determine owing to the lack of controlled studies evaluating their efficacy. Due to few incidences of squamous cell carcinoma, patients need to be followed up and monitored closely for any early detection of recurrence or possible onset of malignancies.

Disseminated Superficial Actinic Porokeratosis (DSAP): A Case Report Highlighting the Clinical, Dermatoscopic, and Pathology Features of the Condition

“…These changes can be observed using a dermatoscope. Indeed, investigators have described the clinical and dermatoscopic evolution of DSAP lesions from a non-atrophic lesion with a circular contour to an atrophic lesion that is polycyclic [5][6][7]10,12].…”

“…Laser therapy-including carbon dioxide laser and fractional photothermolysis-has also been performed. Even superficial radiotherapy-using Grenz ray-has been used [6,[16][17][18].…”

“…The diagnosis of DSAP is suspected clinically; dermatoscopy and microscopic evaluation of a tissue biopsy specimen are useful aids to support and confirm the diagnosis [5][6][7][8][9][10][11][12]. An older woman with DSAP is presented.…”