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

• PP (Punctate Porokeratosis)

What is Punctate Porokeratosis? (Definition/Background Information)

• Punctate Porokeratosis (PP) is a rare subtype of porokeratosis, an uncommon skin condition that results in the manifestation of small patches of lesions of varying sizes on skin
• Punctate Porokeratosis is generally seen in adults. No specific predisposing factors for the condition are observed
• The cause of development of Punctate Porokeratosis is not identified yet. It may be due to certain genetic mutations that are yet to be well-characterised
• The skin condition is seen as numerous red-brown lesions that begin to appear in the palms and soles of the individual. A diagnosis of Punctate Porokeratosis 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 Punctate Porokeratosis is good with appropriate treatment, since it reflects benign skin changes

Who gets Punctate Porokeratosis? (Age and Sex Distribution)

• Most cases of Punctate Porokeratosis are observed during adulthood
• Both males and females may be equally affected
• Individuals of all racial and ethnic background can be affected

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

No specific risk factors for Punctate Porokeratosis 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 Punctate Porokeratosis? (Etiology)

The exact cause of development of Punctate Porokeratosis (PP) is unknown.

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

What are the Signs and Symptoms of Punctate Porokeratosis?

The signs and symptoms of Punctate Porokeratosis include:

• Numerous skin lesions that affect the palms and soles initially, which may then spread to involve other parts of the body skin
• Mostly, only small areas of the body are involved
• The lesions are small and reddish-brown in color with raised edges
• The skin may become atrophic (skin fragility with tears and bleeding) due to the lesions
• Normal activities that involve the use of one’s hands and feet may be affected

How is Punctate Porokeratosis Diagnosed?

A diagnosis of Punctate Porokeratosis 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 Punctate Porokeratosis?

In many cases, Punctate Porokeratosis 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:

• The presence of large patches of skin lesions may result in cosmetic issues (especially when it involves the face or exposed skin areas)
• This may result in emotional stress
• More than one subtype of porokeratosis is observed more often in individuals with Punctate Porokeratosis

How is Punctate Porokeratosis Treated?

There is currently no definitive cure for Punctate Porokeratosis (PP). 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 Punctate Porokeratosis may include the use of the following measures:

• Topical 5-fluorouracil medication therapy
• Oral isotretinoin
• Cryotherapy
• Dermabrasion
• Laser therapy
• If the cause of PP is an 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 Punctate Porokeratosis be Prevented?

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

• Use of sunscreens with high sun-protection factor, wide brimmed hats, and protective clothing
• Being aware of the hazards of prolonged sun exposure and taking 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 physician
• Avoid excessive sunbathing

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

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

Additional and Relevant Useful Information for Punctate Porokeratosis:

• 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