Disseminated Superficial Actinic Porokeratosis on the Face Treated with Imiquimod 5% Cream

Abstract

Porokeratoses are a group of hereditary or acquired disorders characterized by annular lesions with an atrophic center and a prominent peripheral ridge. Pathologically, porokeratosis is characterized by the presence of abnormal clones of keratinocytes that form a column of parakeratotic cells, called the cornoid lamella. Fifteen percent of patients of disseminated superficial actinic porokeratosis (DSAP) have facial lesions; other regions like the extensor surface of extremities constitute the majority of reported cases. Exclusively facial lesions are probably less frequent. Rarely, actinic porokeratosis is confined to the nose only. Of reported porokeratosis cases, 7.5% have revealed a malignancy arising within the lesion. We present a case of facial sporadic DSAP that was treated with imiquimod 5% cream in conjunction with a regular sunscreen. Follow-up of this case is important to rule out the possibility of malignant transformation of the lesions.

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

“…Traditional topical treatment approaches include topical treatments like diclofenac [10][11][12], imiquimod [13][14] and calcipotriol [15][16][17][18][19]. Oral retinoids [20][21][22] and cryotherapy [15] were used in the past with no any satisfied results.…”

Localised nasal actinic porokeratosis: An independent subtype of porokeratosis?

“…DSAP is inherited as an autosomal trait with the gene locus identified at chromosome 12q and 15q [4]. The lesions begin to develop in the teenagers of affected families, with penetrance nearly complete by the third and fourth decades of life.…”

“…PK of Mibelli (PM); disseminated superficial actinic PK (DSAP); disseminated superficial PK (DSP); PK palmaris et plantaris disseminate (PPPD); punctate PK and linear PK [4]. The usual pattern of inheritance is autosomal dominant but at times it may be sporadic.…”

Facial Disseminated Superficial Actinic Porokeratosis

“…Only 15% of DSAP patients have facial lesions. 3 Two patients were reported with facial lesions by Nabai et al first in 1979. 4 There have been a few reports of exclusive facial involvement in porokeratosis with skin lesions over or near the nose.…”