What are the other Names for this Condition? (Also known as/Synonyms)

• Acanthoma with Porokeratosis Features
• Porokeratotic Acanthoma

What is Porokeratoma? (Definition/Background Information)

• Porokeratoma is an extremely rare subtype of porokeratosis, an uncommon skin condition that results in the manifestation of small patches of lesions of varying sizes on skin
• Porokeratoma may be seen in individuals of any age category. No specific predisposing factors for the condition are observed. It is also not associated with any immunosuppressive conditions
• The cause of development of Porokeratoma is not identified yet. It may be due to certain genetic mutations that are yet to be well-characterised
• Porokeratoma is often seen as a single verrucous (warty) lesion of skin that appears in various parts of the body. A diagnosis of Porokeratoma is made by studying the presenting symptoms and skin biopsy (microscopic examination of the skin lesions)
• Following its diagnosis, the condition may be treated using topical creams and gels, oral medications, and laser therapy. In general, the prognosis of Porokeratoma is good with appropriate treatment, since it is mostly benign

Who gets Porokeratoma? (Age and Sex Distribution)

• Porokeratoma is a highly-infrequent skin condition that may observed in children and adults
• Both males and females may be affected
• Individuals of all racial and ethnic background can be affected

What are the Risk Factors for Porokeratoma? (Predisposing Factors)

No specific risk factors for Porokeratoma have been identified. However, the risk factors for porokeratosis, in general, may include:

• Individuals with light skin are more prone to porokeratosis than dark-skinned individuals
• Some subtypes of porokeratosis are known to run in families, which may indicate a genetic linkage
• Exposure to ultraviolet radiation
• Weakened immune system
• Chemotherapy
• Skin trauma
• Skin infections such as hepatitis C infection
• Skin burns
• Chronic liver failure
• Presence of certain autoimmune disorders such as rheumatoid arthritis (RA) and psoriasis
• Poorly-controlled diabetes
• Long-term systemic and topical steroid therapy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Porokeratoma? (Etiology)

The exact cause of development of Porokeratoma is unknown.

• In general, porokeratosis may be due to certain genetic factors. Presently, the specific genes causing the skin condition are under study
• Typically, Porokeratoma is neither associated with a family history, nor with a history of conditions causing immune suppression in the individual

Also, it is important to note that Porokeratoma is non-contagious and it cannot be transmitted from one individual to another.

What are the Signs and Symptoms of Porokeratoma?

The signs and symptoms of Porokeratoma may include:

• Typically, a solitary skin lesion is observed that occurs as verrucous (wart-like) lesion; the lesion shows verrucous growth
• In rare cases, multiple lesions may be observed
• Porokeratoma is usually seen as a plaque, papule, or nodule with the formation of scales
• The lesions may occur in any part of the body, although common locations include the upper and lower arm, head and neck region, chest, and buttocks
• The skin may become atrophic (skin breaks and bleed) due to the lesions

How is Porokeratoma Diagnosed?

A diagnosis of Porokeratoma may involve the following:

• A thorough medical history assessment and complete physical examination
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Blood test to diagnose underlying autoimmune disorders, if any
• Culture studies to rule out any infection
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. On examination of the specimen, certain characteristic features may be noted

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Porokeratoma?

In many cases, Porokeratoma is a benign condition that does not cause any significant complications. However, the following factors may be a cause for concern in some individuals:

• Cosmetic issues resulting in emotional stress
• In some individuals, more than one subtype of porokeratosis is observed

How is Porokeratoma Treated?

There is currently no definitive cure for Porokeratoma. However, the condition may require no treatment, if the symptoms are mild. In such cases, regular observation/monitor by the healthcare provider may be sufficient treatment. However, in case they are at a body site that causes discomfort and/or present significant cosmetic worries in the individual, they may be treated accordingly.

The treatment adopted for Porokeratoma may include the use of the following measures:

• Topical 5-fluorouracil medication therapy
• Oral isotretinoin
• Cryotherapy
• Dermabrasion
• Laser therapy

Follow-up care with regular screening and check-ups are important and encouraged.

Note: Any medications containing isotretinoin, which is a known teratogenic agent (having the potential to cause fetal defects), should be avoided during pregnancy.

How can Porokeratoma be Prevented?

Currently, there are no known methods to prevent the occurrence of Porokeratoma. However, protecting oneself from the harmful ultraviolet rays of sun through the following measures may avoid aggravation of the condition:

• Use sunscreens with high sun-protection factor, wide brimmed hats, and protective clothing
• Be aware of the hazards of prolonged sun exposure and take steps to protect oneself
• Individuals who are regularly exposed to the sun, or work under the sun should get their skin periodically examined by a suitable healthcare provider
• Avoid excessive sunbathing

What is the Prognosis of Porokeratoma? (Outcomes/Resolutions)

The prognosis for Porokeratoma is usually good, in a majority of cases, since it is a benign condition that may only present some cosmetic issues. However, in many individuals, even if treatment is provided, it may not get better.

Additional and Relevant Useful Information for Porokeratoma:

• Do not pick or pop the blisters, for doing so can affect the healing process and may result in secondary infections
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse