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

• Verrucous Porokeratosis, Porokeratosis Ptychotropica type

What is Porokeratosis Ptychotropica? (Definition/Background Information)

• Porokeratosis Ptychotropica 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
• Porokeratosis Ptychotropica is usually seen in middle-aged men. No specific predisposing factors for the condition are observed
• The cause of development of Porokeratosis Ptychotropica is not identified yet. It may be due to certain genetic mutations that are yet to be well-characterised
• Porokeratosis Ptychotropica is often seen as a single verrucous (warty) plaque on the buttocks. A diagnosis of Porokeratosis Ptychotropica is made by studying the presenting symptoms and skin biopsy. Clinically, the lesion may be misdiagnosed as a   psoriasis plaque
• Following its diagnosis, the condition may be treated using topical creams and gels, oral medications, and laser therapy. In general, the prognosis of Porokeratosis Ptychotropica is good with appropriate treatment, since it is mostly benign. Nevertheless, the lesions are not known to respond to therapy

Who gets Porokeratosis Ptychotropica? (Age and Sex Distribution)

• Porokeratosis Ptychotropica is a highly-infrequent skin condition that is typically observed in middle-aged adults (mean age 47 years). However, a wide age group of adults may be affected (27-84 years)
• Both males and females may be affected, although a high male predominance is noted (male-female ratio is 9:1)
• Individuals of all racial and ethnic background can be affected

What are the Risk Factors for Porokeratosis Ptychotropica? (Predisposing Factors)

No specific risk factors for Porokeratosis Ptychotropica 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; 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 Porokeratosis Ptychotropica? (Etiology)

The exact cause of development of Porokeratosis Ptychotropica is unknown.

• In general, porokeratosis may be due to certain genetic factors. Presently, the specific genes causing the skin condition are under study
• It is important to note that Porokeratosis Ptychotropica is non-contagious and it cannot be transmitted from one individual to another

What are the Signs and Symptoms of Porokeratosis Ptychotropica?

The signs and symptoms of Porokeratosis Ptychotropica include:

• Typically a solitary skin lesion is observed that occurs as verrucous (wart-like) lesion. Porokeratosis Ptychotropica is present as a single plaque
• The skin lesions are mostly itchy, leading to bleeding from scratching
• The most common location for the lesion is the buttocks (near the gluteal cleft), but other areas may include the upper/lower extremities
• Lesions in the buttocks may cause sitting and walking difficulties
• The skin may become atrophic (skin breaks and bleed), due to the lesions

Based on its appearance, Porokeratosis Ptychotropica may be misdiagnosed as a psoriasis plaque.

How is Porokeratosis Ptychotropica Diagnosed?

A diagnosis of Porokeratosis Ptychotropica 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 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 Porokeratosis Ptychotropica?

In many cases, Porokeratosis Ptychotropica is a benign condition, and it 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
• Generally, Porokeratosis Ptychotropica is known to be treatment-resistant

How is Porokeratosis Ptychotropica Treated?

There is currently no definitive cure for Porokeratosis Ptychotropica. 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 Porokeratosis Ptychotropica includes the use of the following measures:

• Topical 5-fluorouracil medication therapy
• Oral isotretinoin
• Cryotherapy
• Dermabrasion
• Laser therapy
• If the cause of Porokeratosis Ptychotropica is underlying autoimmune disorder, then treatment for the same is necessary

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 Porokeratosis Ptychotropica be Prevented?

Currently, there are no known methods to prevent the occurrence of Porokeratosis Ptychotropica. However, protecting oneself from the harmful ultraviolet rays of sun through the following measures (below) 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 yourself
• Individuals who are regularly exposed to the sun, or work under the sun should get their skin periodically examined by a physician
• Avoid excessive sunbathing

The lesions of Porokeratosis Ptychotropica are not on sun-exposed skin, but the above guidelines are sensible for other skin regions.

What is the Prognosis of Porokeratosis Ptychotropica? (Outcomes/Resolutions)

• The prognosis for Porokeratosis Ptychotropica 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, the condition does not respond to appropriate therapy

Additional and Relevant Useful Information for Porokeratosis Ptychotropica:

• 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