Abstract • Background.— Porokeratosis is believed to be a premalignant condition of the skin. Recent flow cytometric studies showing DNA aneuploidy in the epidermis of some types of porokeratosis support this conclusion. We describe a patient with porokeratosis palmaris et plantaris disseminata in whom abnormal DNA ploidy was found in lesional epidermis with the use of flow cytometry. Observations.— DNA flow cytometry of lesional epidermis from the back showed two populations of cells, one with diploid and the other with aneuploid DNA content and DNA index of 1.1 (hyperdiploid). The coefficient of variation of the diploid and aneuploid peaks was 2.1% and 4.1%, respectively. Conclusions.— Porokeratosis palmaris et plantaris disseminata, like other forms of porokeratosis, exhibits abnormal DNA ploidy in lesional epidermis. This finding underscores the premalignant nature of this and other forms of porokeratosis.(Arch Dermatol. 1992;128:236-239) References 1. Guss SB, Osbourn RA, Lutzner MA. Porokeratosis plantaris, palmaris, et disseminata: a third type of porokeratosis . Arch Dermatol. 1971;104:366-373.Crossref 2. Shaw JC, White CR. Porokeratosis plantaris, palmaris, et disseminata . J Am Acad Dermatol. 1984;11:454-460.Crossref 3. Marschalko M, Somlai B. Porokeratosis plantaris, palmaris, et disseminata . Arch Dermatol. 1986;122:890-891.Crossref 4. Patrizi A, Passarini B, Minghetti G, Masina M. Porokeratosis palmaris et plantaris disseminata: an unusual clinical presentation . J Am Acad Dermatol. 1989;21:415-418.Crossref 5. Savage J. Porokeratosis (Milbelli) and carcinoma . Br J Dermatol. 1964;76:489. 6. Coskey RJ, Mehregan A. Bowen disease associated with porokeratosis of Mibelli . Arch Dermatol. 1975;111:1480-1481.Crossref 7. Shrum JR, Cooper PH, Greer KE. Squamous cell carcinoma in disseminated superficial actinic porokeratosis . J Am Acad Dermatol. 1982;6:58-62.Crossref 8. Otsuka F, Huang J, Sawara K, Asahina A, Ishibashi Y. Disseminated porokeratosis accompanying multicentric Bowen's disease . J Am Acad Dermatol. 1990;23(pt (2) ):355-359.Crossref 9. Lozinski AZ, Fisher BK, Walter JB, Fitzpatrick PJ. Metastatic squamous cell carcinoma in linear porokeratosis of Mibelli . J Am Acad Dermatol. 1987;16(pt (2) ):448-451.Crossref 10. Reed RJ, Leone P. Porokeratosis: a mutant clonal keratosis of the epidermis . Arch Dermatol. 1970;101:340-347.Crossref 11. Imakado S, Otsuka F, Ishibashi Y, Ohara K. Abnormal DNA ploidy in cells of the epidermis in a case of porokeratosis . Arch Dermatol. 1988;124:331-332.Crossref 12. Otsuka F, Shima A, Ishibashi Y. Porokeratosis has neoplastic clones in the epidermis: microfluorometric analysis of DNA content of epidermal cell nuclei . J Invest Dermatol. 1989;92:231S-233S.Crossref 13. Otsuka F, Shima A, Ishibashi Y. Porokeratosis as a premalignant condition of the skin: cytologic demonstration of abnormal DNA ploidy in cells of the epidermis . Cancer . 1989;63:891-896.Crossref 14. Barlogie B, Raber MN, Schumann J, et al. Flow cytometry in clinical cancer research . Cancer Res. 1983;43:3982-3997. 15. Teodori L, Capurso L, Cordelli E, et al. Cytometrically determined relative DNA content as an indicator of neoplasia in gastric lesions . Cytometry. 1984;5:63-70.Crossref 16. Coon JS, Landay AL, Weinstein RS. Advances in flow cytometry for diagnostic pathology . Lab Invest. 1987;57:453-479. 17. Wade TR, Ackerman AB. Cornoid lamellation: a histologic reaction pattern . Am J Dermatopathol. 1980;2:5-15.Crossref 18. Taylor AMR, Harden DG, Fairburn EA. Chromosomal instability associated with susceptibility to malignant disease in patients with porokeratosis of Mibelli . J Natl Cancer Inst. 1973;51:371-378. 19. McCallister RE, Estes SA, Yarbrough CL. Porokeratosis plantaris palmaris et disseminata: report of a case and treatment with isotretinoin . J Am Acad Dermatol. 1985;13:598-603.Crossref 20. Knobler RM, Neumann RA. Exacerbation of porokeratosis during etretinate therapy . Acta Derm Venereol (Stockh). 1990;70:319-322.
Archives of Dermatology – American Medical Association
Published: Feb 1, 1992
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