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Case Reports
. 2024 Nov 7;16(11):e73218.
doi: 10.7759/cureus.73218. eCollection 2024 Nov.

Disseminated Superficial Non-actinic Porokeratosis: A Consequence of Post-traumatic Immunosuppression

Liliana G Popa  1 , Teodora Cristiana Gradinaru  2   3 , Calin Giurcaneanu  1 , Irina Tudose  4 , Cristina Iolanda Vivisenco  5 , Cristina Beiu  6
Affiliations
Case Reports

Disseminated Superficial Non-actinic Porokeratosis: A Consequence of Post-traumatic Immunosuppression

Liliana G Popa et al. Cureus. .

Abstract

Disseminated superficial porokeratosis (DSP) is a very uncommon dermatologic condition of unknown etiology, characterized by the clonal proliferation of atypical keratinocytes associated with aberrant keratinocyte differentiation. These lead to the development of the specific cornoid lamella that separates atypical from normal keratinocytes. DSP is most frequently encountered in immunosuppressed patients. It has been described in patients receiving immunosuppressive treatments, organ transplantation and in patients diagnosed with human immunodeficiency virus, hepatitis B and hepatitis C virus infection. We present the case of a 78-year-old patient who developed disseminated non-actinic after multiple trauma and major orthopedic surgery. To our knowledge, this is the first case of DSP occurring as a consequence of post-traumatic immunosuppression reported in the medical literature. We discuss the pathogenic mechanisms, as well as the optimal diagnostic and therapeutic approach in such cases.

Keywords: immunosuppression; major surgery; non-actinic; porokeratosis; trauma.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Clinical manifestations
Annular macules displaying a hypopigmented, slightly atrophic center and a raised, scaly border disseminated on the lower limbs
Figure 2
Figure 2. Dermoscopy
Light brown lesions with a slightly raised, scaly border
Figure 3
Figure 3. Hematoxylin-eosin stain
Hematoxylin-eosin stain showing acanthosis, hyperkeratosis, the presence of a cornoid lamella composed of several layers of parakeratosis with a vertical disposition, with subjacent areas of hypogranulosis, few dyskeratotic epidermal cells, capillary ectasia and a chronic perivascular lymphocytic inflammatory infiltrate in the papillary dermis (A: 100x); magnified image of the parakeratotic column located at the periphery of the lesion with subjacent focal  hypogranulosis and vacuolated, dyskeratotic keratinocytes  (B: 200x).
See this image and copyright information in PMC

References

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