Malhotra S K, Puri K J P S, Goyal Tanu, Chahal K S
Government Medical College, Amritsar, India.
Dermatol Online J. 2007 Oct 13;13(4):15.
Linear porokeratosis is a rare variant. It can be present at birth or can develop in adult life. Lesions of linear porokeratosis are grouped and linearly arranged along the lines of Blaschko. On the extremities it affects the distal portion more than the proximal areas. On the trunk these can be zosteriform in distribution. Lesions of linear porokeratosis probably result from an abnormal clone of epidermal precursors. A 20 year old male presented with annular plaques in linear pattern following the lines of Blaschko over the left upper limb extending up to the axilla present since childhood. The lesions had atrophic centre and raised hyperkeratotic borders. The lesions were more proximal than distal. Few scattered lesions were present on left side of trunk. There was no family history of such lesions. Systemic examination of patient was normal. On histopathological examination there was hyperkeratosis and parakeratosis. A coronoid lamella was present. At the base of coronoid lamella thinned out granular layer and necrotic keratinocytes were also seen. In the dermis pigment incontinence and perivascular lymphocytic infiltrate were present. This case is being reported because of its rarity. It is an atypical presentation because the lesions were disposed more over proximal than distal area of upper limb. Linear porokeratosis is associated with an increased risk of malignant transformation.
线状汗孔角化症是一种罕见的变异型。它可在出生时就存在,也可在成年期发病。线状汗孔角化症的损害沿布氏线成群并呈线状排列。在四肢,它对远端部分的影响大于近端区域。在躯干,其分布可呈带状疱疹样。线状汗孔角化症的损害可能源于表皮前体细胞的异常克隆。一名20岁男性自幼就有沿布氏线呈线状分布的环形斑块,位于左上肢,向上延伸至腋窝。损害中央萎缩,边界为隆起的角化过度。损害近端多于远端。躯干左侧有少数散在损害。无此类损害的家族史。患者全身检查正常。组织病理学检查显示有角化过度和不全角化。可见冠样层。在冠样层底部,颗粒层变薄,还可见坏死的角质形成细胞。真皮内有色素失禁和血管周围淋巴细胞浸润。报告此病例是因其罕见。这是一种非典型表现,因为损害更多地分布在上肢近端而非远端区域。线状汗孔角化症与恶性转化风险增加有关。