Disseminated Superficial Actinic Porokeratosis (face)

Diagnosis: Disseminated Superficial Actinic Porokeratosis (face)

Close-up view reveals brownish lesion with elevated hyperkeratotic threadlike border and somewhat atrophic center.

Clinical Presentation

Close-up view reveals brownish lesion with elevated hyperkeratotic threadlike border and somewhat atrophic center.

Clinical History

Submitted by Alaa Saad. Originally posted October 19, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Actinic keratosis • Psoriasis • Tinea corporis • Granuloma annulare • Bowen disease • Lichen planus

Key Learnings

• Disorder of keratinization with characteristic cornoid lamella (column of parakeratotic cells) • Classic: annular plaque with raised, thread-like peripheral ridge • Subtypes: classic of Mibelli, disseminated superficial actinic (DSAP), linear, punctate, palmoplantar • DSAP is the most common variant — multiple small lesions on sun-exposed areas • Malignant transformation to SCC/BCC occurs in ~7-10% of long-standing lesions • Immunosuppression exacerbates disease and increases malignancy risk

Tags: disseminated, superficial, actinic, porokeratosis, face, alaa saad