Disseminated superficial porokeratosis (DSP) is a rare keratinization disorder of the epidermis. Treatment is poorly standardized and often difficult. A 60-year-old Filipino female presented with multiple brown, well-defined, annular keratotic papules and plaques with thread-like elevated borders on her trunk, extremities, neck and face which revealed cornoid lamellae on biopsy. A diagnosis of DSP was made. Due to the widespread distribution of lesions, she was started on oral isotretinoin 20mg/day (0.3mkd). 5-fluorouracil (5-FU) 4% cream once daily application was added after two weeks to enhance treatment efficacy, but resulted in intense erythema and painful erosions prompting its discontinuation after two weeks. She was then maintained on oral isotretinoin 30mg/day (0.5mkd) together with emollients and sunscreen. Three months after, there was a decrease in hyperpigmentation, elevation, roughness and thickness of the lesions. In our case, oral isotretinoin notably produced clinical improvement in DSP. This underlies that when treatment is warranted, oral isotretinoin may be an attractive option for managing control of DSP. However, in our case, maximum therapeutic outcome and recurrence rate were not assessed due to our limited treatment and follow up duration. Further studies with longer treatment period are still needed to confirm its efficacy and safety in the management of DSP.
Laconico-Tumalad, LL & Abesamis-Cubillan, EL. (2017). Disseminated superficial porokeratosis in an adult Filipino female treated with oral isotretinoin. Journal of the Philippine Dermatological Society, 26(1), 79-81.
Disseminated superficial porokeratosis, keratinization, disorder, epidermis
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