Unilateral punctate porokeratosis - Case report
Our case involved a 20-year-old basically healthy adult male with multiple keratotic papules, central keratin plug, 2-3 mm in diameter, located on the left palmar surface of the third finger, hypothenar eminence and fifth finger. Some papules had a central depression ( and ). These lesions, all asymptomatic, occurred when he was a teenager. No similar lesions were found elsewhere, (e.g. soles of the feet). He was unaware of ever having been exposed to arsenic, and as far as he knew none of his relatives had been affected with the same lesions.\nA punch biopsy specimen of one of the palmar papules revealed the presence of compact columns of parakeratotic hyperkeratosis - cornoid lamella - sharply demarcated by a surrounding prominent orthokeratotic hyperkeratosis (). Below the cornoid lamella, the granular layer was thinner, and dyskeratotic cells and vacuolation of some keratinocytes were present (). The underlying papillary dermis presented an inflammatory infiltrate of mononuclear cells. Given the typical clinical manifestations and histopathological findings, the diagnosis of punctate porokeratosis was established. The patient had no complaints or signs of discomfort - the reason why no treatment regime had been hitherto established.