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Porokeratosis

MedGen UID:
56518
Concept ID:
C0162839
Congenital Abnormality
Synonym: Genetic porokeratosis
SNOMED CT: Porokeratosis (400080004)
 
HPO: HP:0200044
Monarch Initiative: MONDO:0006602
OMIM® Phenotypic series: PS175800
Orphanet: ORPHA183444

Definition

A clonal disorder of keratinization with one or multiple atrophic patches surrounded by a clinically and histologically distinctive hyperkeratotic ridgelike border called the cornoid lamella. [from HPO]

Term Hierarchy

Conditions with this feature

Porokeratosis of Mantoux
MedGen UID:
56517
Concept ID:
C0162838
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shapes, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), families with expression of more than one variant of porokeratosis among members, and individuals expressing more than one variant, have been reported, suggesting that the distinctions among these variants may be artificial. Porokeratosis palmaris plantaris et disseminata (PPPD) is a subtype in which lesions initially develop on the palms and soles, but later involve other parts of the body, including the trunk and limbs (Wei et al., 2003). For a discussion of genetic heterogeneity of porokeratosis, see 174800.
Porokeratosis of Mibelli
MedGen UID:
181842
Concept ID:
C0949506
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shapes, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), several families with expression of more than one variant of porokeratosis among members, and several individuals expressing more than one variant, have been reported, suggesting that the distinctions among these variants may be artificial. Mutations in the MVK gene have been found to cause multiple types of porokeratosis, which have been described as porokeratosis of Mibelli, porokeratoma, genital porokeratosis, hyperkeratotic porokeratosis, and linear porokeratosis. The preferred title of this entry was formerly 'Porokeratosis 1, Mibelli Type; POROK1.' Genetic Heterogeneity of Porokeratosis Also see porokeratosis-2 (POROK2; 175850), mapped to chromosome 12q24; POROK3 (175900), caused by mutation in the MVK gene (251170) on chromosome 12q24; POROK4 (607728), mapped to chromosome 15q25-q26; POROK5 (612293), mapped to chromosome 1p31; POROK6 (612353), mapped to chromosome 1p31; POROK7 (614714), caused by mutation in the MVD gene (603236) on chromosome 16q24; POROK8 (616063), caused by mutation in the SLC17A9 gene (612107) on chromosome 20q13; and POROK9 (616631), caused by mutation in the FDPS gene (134629) on chromosome 1q22. A palmoplantar form of punctate porokeratosis has also been described (PPKP2; 175860). Genotype/Phenotype Correlations Zhang et al. (2015) screened 12 isoprenoid genes in 134 Chinese probands with porokeratosis and identified mutations in the MVK, MVD, PMVK, and FDPS genes in 113 patients. The authors noted that giant plaque-type porokeratosis ptychotropica with lesion diameters of at least 5 cm appeared to be uniquely associated with mutation in MVK; it was observed in 19 (50%) of 38 MVK probands, but not in patients with mutations in any of the other 3 genes or in the 21 probands in whom no mutation was found. MVK patients also showed the widest range in terms of the number and size of lesions, as well as presence of porokeratosis subtypes. In patients with MVD mutations, the age of onset ranged from 5 to 70 years, and lesion diameters were generally less than 2 cm. In addition, 6 of the 62 MVD probands exhibited solar facial porokeratosis, which was not seen in any other patients. Localized genital porokeratosis and porokeratoma appeared to be uniquely associated with mutation in the PMVK gene, whereas patients with mutations in the FDPS gene had more than 500 lesions, all with diameters of 1 cm or less.
Craniosynostosis-anal anomalies-porokeratosis syndrome
MedGen UID:
351066
Concept ID:
C1864186
Disease or Syndrome
CDAGS syndrome is characterized by craniosynostosis and clavicular hypoplasia, delayed closure of the fontanel, anal and genitourinary anomalies, and skin eruption of porokeratotic lesions (Mendoza-Londono et al., 2005).
Porokeratosis 3, disseminated superficial actinic type
MedGen UID:
401352
Concept ID:
C1867981
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shapes, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), several families with expression of more than one variant of porokeratosis among members, and individuals expressing more than one variant, have been reported, suggesting that the distinctions among these variants may be artificial. Mutations in the MVK gene have been found to cause multiple types of porokeratosis, which have been described as disseminated superficial actinic porokeratosis (DSAP), nonactinic disseminated superficial porokeratosis (DSP), porokeratosis of Mibelli, giant plaque of porokeratosis ptychotropica, hyperkeratotic porokeratosis, and linear porokeratosis. The preferred title of this entry was formerly 'Porokeratosis 3, Disseminated Superficial Actinic Type; POROK3.' Disseminated superficial actinic porokeratosis is the most common subtype of porokeratosis. It is characterized by multiple small, annular, anhidrotic, keratotic lesions that are located predominantly on sun-exposed areas of the skin, such as the face, neck, and distal limbs. The lesions typically begin to develop in adolescence and reach near-complete penetrance by the third or fourth decade of life (summary by Wu et al., 2004 and Zhang et al., 2012). For a discussion of genetic heterogeneity of porokeratosis, see 175800.
Punctate palmoplantar keratoderma type 2
MedGen UID:
356886
Concept ID:
C1867982
Disease or Syndrome
A type of isolated punctate hereditary palmoplantar keratoderma with characteristics of multiple asymptomatic 1 to 2 mm-long, firm, hyperkeratotic projections (spiny keratosis) on the palms, soles and digits (typically confined to their volar and/or lateral aspects). Histopathologically compact columnar parakeratosis over hypo or agranular epidermis is observed.
Porokeratosis 6, disseminated superficial actinic type
MedGen UID:
394063
Concept ID:
C2676508
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shapes, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), reports of several families with expression of more than one variant of porokeratosis among members, and of individuals expressing more than one variant, suggest that the distinctions among these variants may be artificial. Disseminated superficial actinic porokeratosis (DSAP) is the most common subtype of porokeratosis. It is characterized by multiple small, annular, anhidrotic, keratotic lesions that are located predominantly on sun-exposed areas of the skin, such as the face, neck, and distal limbs. The lesions typically begin to develop in adolescence and reach near-complete penetrance by the third or fourth decade of life (summary by Wu et al., 2004 and Zhang et al., 2012).
Porokeratosis 7, multiple types
MedGen UID:
766463
Concept ID:
C3553549
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shapes, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), several families with expression of more than one variant of porokeratosis among members, and individuals expressing more than one variant, have been reported, suggesting that the distinctions among these variants may be artificial. Mutations in the MVD gene have been found to cause multiple types of porokeratosis, which have been described as disseminated superficial actinic porokeratosis (DSAP), nonactinic disseminated superficial porokeratosis (DSP), solar facial porokeratosis, linear porokeratosis, and hyperkeratotic porokeratosis. The preferred title of this entry was formerly 'Porokeratosis 7, Disseminated Superficial Actinic Type; POROK7.' Disseminated superficial actinic porokeratosis (DSAP) is the most common subtype of porokeratosis. It is characterized by multiple small, annular, anhidrotic, keratotic lesions that are located predominantly on sun-exposed areas of the skin, such as the face, neck, and distal limbs. The lesions typically begin to develop in adolescence and reach near-complete penetrance by the third or fourth decade of life (summary by Wu et al., 2004 and Zhang et al., 2012). For a discussion of genetic heterogeneity of porokeratosis, see 175800.
Porokeratosis 8, disseminated superficial actinic type
MedGen UID:
863565
Concept ID:
C4015128
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shape, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), the existence of several families with expression of more than one variant of porokeratosis among members, and individuals expressing more than one variant, suggest that the distinctions among these variants may be artificial. Disseminated superficial actinic porokeratosis (DSAP) is the most common subtype of porokeratosis. It is characterized by multiple small, annular, anhidrotic, keratotic lesions that are located predominantly on sun-exposed areas of the skin, such as the face, neck, and distal limbs. The lesions typically begin to develop in adolescence and reach near-complete penetrance by the third or fourth decade of life (summary by Wu et al., 2004 and Zhang et al., 2012). For a discussion of genetic heterogeneity of porokeratosis, see 175800.
Porokeratosis 9, multiple types
MedGen UID:
894586
Concept ID:
C4225262
Disease or Syndrome
Porokeratosis is a rare skin disorder characterized by one or more annular plaques with a surrounding raised horny border that spreads centrifugally. Variants of porokeratosis have been described that differ in morphologic shapes, distribution, and clinical course (Schamroth et al., 1997). However, as noted by Sybert (2010), several families with expression of more than one variant of porokeratosis among members, and individuals expressing more than one variant, have been reported, suggesting that the distinctions among these variants may be artificial. Mutations in the FDPS gene have been found to cause multiple types of porokeratosis, which have been described as disseminated superficial actinic porokeratosis (DSAP) and nonactinic disseminated superficial porokeratosis (DSP). For a discussion of genetic heterogeneity of porokeratosis, see 174800.

Professional guidelines

PubMed

Vargas-Mora P, Morgado-Carrasco D, Fustà-Novell X
Actas Dermosifiliogr (Engl Ed) 2020 Sep;111(7):545-560. Epub 2020 May 13 doi: 10.1016/j.ad.2020.03.005. PMID: 32401728
Atzmony L, Lim YH, Hamilton C, Leventhal JS, Wagner A, Paller AS, Choate KA
J Am Acad Dermatol 2020 Jan;82(1):123-131. Epub 2019 Aug 23 doi: 10.1016/j.jaad.2019.08.043. PMID: 31449901Free PMC Article
Weidner T, Illing T, Miguel D, Elsner P
Am J Clin Dermatol 2017 Aug;18(4):435-449. doi: 10.1007/s40257-017-0271-3. PMID: 28283894

Recent clinical studies

Etiology

Santa Lucia G, Snyder A, Lateef A, Drohan A, Gregoski MJ, Barton V, Elston DM
JAMA Dermatol 2023 May 1;159(5):488-495. doi: 10.1001/jamadermatol.2023.0205. PMID: 36947042Free PMC Article
Atzmony L, Ugwu N, Hamilton C, Paller AS, Zech L, Antaya RJ, Choate KA
Pediatr Dermatol 2022 Nov;39(6):903-907. Epub 2022 Jul 19 doi: 10.1111/pde.15094. PMID: 35853659Free PMC Article
Vargas-Mora P, Morgado-Carrasco D, Fustà-Novell X
Actas Dermosifiliogr (Engl Ed) 2020 Sep;111(7):545-560. Epub 2020 May 13 doi: 10.1016/j.ad.2020.03.005. PMID: 32401728
Atzmony L, Lim YH, Hamilton C, Leventhal JS, Wagner A, Paller AS, Choate KA
J Am Acad Dermatol 2020 Jan;82(1):123-131. Epub 2019 Aug 23 doi: 10.1016/j.jaad.2019.08.043. PMID: 31449901Free PMC Article
Schierbeck J, Vestergaard T, Bygum A
Acta Derm Venereol 2019 Apr 1;99(4):360-369. doi: 10.2340/00015555-3123. PMID: 30653245

Diagnosis

Muradia I, Khullar G, Pareek V
JAMA Dermatol 2023 Feb 1;159(2):209. doi: 10.1001/jamadermatol.2022.5108. PMID: 36515921
Atzmony L, Ugwu N, Hamilton C, Paller AS, Zech L, Antaya RJ, Choate KA
Pediatr Dermatol 2022 Nov;39(6):903-907. Epub 2022 Jul 19 doi: 10.1111/pde.15094. PMID: 35853659Free PMC Article
McNally MA, Farooq S, Brown AE, Rees A, Hsu S, Motaparthi K
Clin Dermatol 2022 Sep-Oct;40(5):466-479. Epub 2021 Dec 31 doi: 10.1016/j.clindermatol.2021.12.009. PMID: 34979268
Vargas-Mora P, Morgado-Carrasco D, Fustà-Novell X
Actas Dermosifiliogr (Engl Ed) 2020 Sep;111(7):545-560. Epub 2020 May 13 doi: 10.1016/j.ad.2020.03.005. PMID: 32401728
Schierbeck J, Vestergaard T, Bygum A
Acta Derm Venereol 2019 Apr 1;99(4):360-369. doi: 10.2340/00015555-3123. PMID: 30653245

Therapy

Santa Lucia G, Snyder A, Lateef A, Drohan A, Gregoski MJ, Barton V, Elston DM
JAMA Dermatol 2023 May 1;159(5):488-495. doi: 10.1001/jamadermatol.2023.0205. PMID: 36947042Free PMC Article
Atzmony L, Ugwu N, Hamilton C, Paller AS, Zech L, Antaya RJ, Choate KA
Pediatr Dermatol 2022 Nov;39(6):903-907. Epub 2022 Jul 19 doi: 10.1111/pde.15094. PMID: 35853659Free PMC Article
Atzmony L, Lim YH, Hamilton C, Leventhal JS, Wagner A, Paller AS, Choate KA
J Am Acad Dermatol 2020 Jan;82(1):123-131. Epub 2019 Aug 23 doi: 10.1016/j.jaad.2019.08.043. PMID: 31449901Free PMC Article
Sertznig P, von Felbert V, Megahed M
J Eur Acad Dermatol Venereol 2012 Apr;26(4):404-12. Epub 2011 Sep 20 doi: 10.1111/j.1468-3083.2011.04275.x. PMID: 21929548
Bencini PL, Tarantino A, Grimalt R, Ponticelli C, Caputo R
Br J Dermatol 1995 Jan;132(1):74-8. doi: 10.1111/j.1365-2133.1995.tb08628.x. PMID: 7756155

Prognosis

Liu W, Liu JW, Ma DL
JAMA Dermatol 2019 Jul 1;155(7):845. doi: 10.1001/jamadermatol.2019.0602. PMID: 31090870
Biswas A
Am J Dermatopathol 2015 Feb;37(2):145-55. doi: 10.1097/DAD.0000000000000039. PMID: 24423932
Kanitakis J, Euvrard S, Faure M, Claudy A
Eur J Dermatol 1998 Oct-Nov;8(7):459-65. PMID: 9854155
Sehgal VN, Jain S, Singh N
J Dermatol 1996 Aug;23(8):517-25. doi: 10.1111/j.1346-8138.1996.tb02644.x. PMID: 8854582
Bencini PL, Tarantino A, Grimalt R, Ponticelli C, Caputo R
Br J Dermatol 1995 Jan;132(1):74-8. doi: 10.1111/j.1365-2133.1995.tb08628.x. PMID: 7756155

Clinical prediction guides

Zagoras T, Inci R, Kantere D, Holmström P, Broström J, Gillstedt M, Polesie S, Peltonen S
Acta Derm Venereol 2023 Aug 24;103:adv12404. doi: 10.2340/actadv.v103.12404. PMID: 37615526Free PMC Article
Singh AK, Khuraijam S, Devi GC, Kansal NK, Azad S, Agrawal S, Phulware RH
Skinmed 2022;20(5):377-378. Epub 2022 Oct 31 PMID: 36314706
Lu JD, Mufti A, Sachdeva M, Rahat S, Lansang RP, Yeung J
Dermatol Ther 2021 Jan;34(1):e14560. Epub 2020 Dec 1 doi: 10.1111/dth.14560. PMID: 33210788
Biswas A
Am J Dermatopathol 2015 Feb;37(2):145-55. doi: 10.1097/DAD.0000000000000039. PMID: 24423932
Bencini PL, Tarantino A, Grimalt R, Ponticelli C, Caputo R
Br J Dermatol 1995 Jan;132(1):74-8. doi: 10.1111/j.1365-2133.1995.tb08628.x. PMID: 7756155

Recent systematic reviews

Casale F, Walters N, Peach A, Dong J
J Drugs Dermatol 2023 Dec 1;22(12):1160-1165. doi: 10.36849/JDD.7775. PMID: 38051843
Lu JD, Mufti A, Sachdeva M, Rahat S, Lansang RP, Yeung J
Dermatol Ther 2021 Jan;34(1):e14560. Epub 2020 Dec 1 doi: 10.1111/dth.14560. PMID: 33210788
Alhatem A, Patel N, Lambert WC, Heller DS
J Low Genit Tract Dis 2019 Jul;23(3):235-240. doi: 10.1097/LGT.0000000000000478. PMID: 31149956
Weidner T, Illing T, Miguel D, Elsner P
Am J Clin Dermatol 2017 Aug;18(4):435-449. doi: 10.1007/s40257-017-0271-3. PMID: 28283894
Aird GA, Sitenga JL, Nguyen AH, Vaudreuil A, Huerter CJ
Lasers Med Sci 2017 May;32(4):945-952. Epub 2017 Feb 27 doi: 10.1007/s10103-017-2179-9. PMID: 28239750

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