A woman with axillary red‐brown plaques

Brouwer, Marijke Willemijn Dorothée; Kemperman, P. M. J. H.

doi:10.1111/bjd.12732

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…3,[14][15][16] However, rare reports of congenital onset, and development of granular parakeratosis following administration of systemic medications, highlight that the exact pathogenesis remains elusive and is a subject that warrants further investigation. [17][18][19] Notably, our review highlights that findings of parakeratosis and retention of keratohyalin granules within the stratum corneum, despite its name, is not always present on histologic examination of granular parakeratosis. Kumarasinghe et al propose that the histologic features may fluctuate developing on the stage of clinical progression and ascribed the term hyperkeratotic flexural erythema as a better encompassing description.…”

Section: Discussionmentioning

confidence: 93%

“…This, combined with reported resolution observed following treatment with systemic antibiotics, has lent support to the role of an altered microbiome in the development of granular parakeratosis 3,14–16 . However, rare reports of congenital onset, and development of granular parakeratosis following administration of systemic medications, highlight that the exact pathogenesis remains elusive and is a subject that warrants further investigation 17–19 …”

Section: Discussionmentioning

confidence: 93%

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Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review

2022

Int J Dermatology

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Background Granular parakeratosis is a rare disorder characterized by erythematousbrown hyperkeratotic papules and erythematous patches with scaling, occurring predominantly in the flexures and sites of occlusion. While the exact underlying pathogenesis remains unknown, there has been a wide variety of precipitating factors and treatment options reported in the literature.Objective We systematically reviewed and identified precipitants of granular parakeratosis, as well as its clinical and histologic features and treatment outcomes.Method A comprehensive literature search was conducted using MEDLINE and Embase in March 2021.Results A total of 60 studies with 129 patients were included for analysis. An inciting factor was identified in 53.4%, the most common being topical agents including zinc oxide (17.1%), deodorant/antiperspirant (15.5%), and those containing benzalkonium chloride (7.0%). The majority presented with bilateral (68.2%) eruption of hyperkeratotic papules or erythematous patches and plaques, most frequently involving the axilla (56.5%). The prevailing histologic feature was retained keratohyalin granules within the stratum corneum in punch biopsy (97.2%) and curette (100%) specimens. Treatment options with reported success ranged from topical corticosteroids and systemic antibiotics to surgical interventions. ConclusionWe provide a systematic review of reported precipitants, clinical features, and treatment options that clinicians should consider when granular parakeratosis is considered.under-reporting in the literature. 4 We systematically reviewed the literature on granular parakeratosis to provide insights into their etiologic factors, clinical features, histologic findings, and treatment outcomes. MethodsThe systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search was conducted using MEDLINE and Embase from inception to March 16, 2021, using the terms "granular parakeratosis" or "hyperkeratotic flexural erythema".

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review

2022

Int J Dermatology

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“…One unusual presentation of GP associated with chemotherapy resolved after discontinuation of doxorubicin [26]. Likewise, and as mentioned earlier, one case of GP thought to be secondary to simvastatin resolved with discontinuation of the drug [19]. Spontaneous remission has also been commonly observed.…”

Section: Treatmentmentioning

confidence: 73%

“…One author asserts that GP occurs secondary to dermatophytes altering cornification; however, this has not been proven or frequently described [18]. Interestingly, a recent report described simvastatin as a cause of GP, which resolved upon cessation of the drug and returned on reintroduction of the drug [19].…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

Granular Parakeratosis: A Comprehensive Review and a Critical Reappraisal

2015

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Granular parakeratosis (GP) is a rare, idiopathic, and benign skin condition that presents classically as erythematous to brown hyperkeratotic papules that can coalesce into plaques. Axillary GP was initially observed by Northcutt and colleagues and has since been described in various other areas of the body including other intertriginous and non-intertriginous sites. The term "granular parakeratosis" is now used to describe not only the skin condition, but also a distinctive histological reactive pattern on biopsy specimens that are either regarded as the disease itself, or merely as an incidental finding. Upon review of the current findings, opinions, and associations of this entity, we propose the reappraisal of GP as a reactive pattern, rather than a distinct entity.

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Simvastatin

2014

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A woman with axillary red‐brown plaques

Cited by 4 publications

References 10 publications

Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review

Clinical features, histology, and treatment outcomes of granular parakeratosis: a systematic review

Granular Parakeratosis: A Comprehensive Review and a Critical Reappraisal

Simvastatin

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