Trikha Ritika, Wile Anna, King Joy, Ward Kimberley H M, Brodell Robert T
*Rosalind Franklin University of Medicine and Science, North Chicago, IL; Departments of †Internal Medicine and Dermatology, and ‡Pathology, University of Mississippi Medical Center, Jackson, MS; §Division of Dermatology, Department of Otolaryngology and Communicative Services, University of Mississippi Medical Center, Jackson, MS; ¶Departments of Dermatology and Pathology, University of Mississippi Medical Center, Jackson, MS; and ‖Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Am J Dermatopathol. 2015 Nov;37(11):e134-6. doi: 10.1097/DAD.0000000000000319.
Porokeratosis is a disorder of keratinization characterized by an abnormal cornoid lamella surrounding an annular, scaly plaque with an atrophic center. A histologic variant of this condition has been proposed, termed follicular porokeratosis, in cases where follicular involvement was contiguous with an annular cornoid lamella. There has been only 1 report of punctate follicular porokeratosis, in which cornoid lamellae originated exclusively from hair follicles with no associated annular plaque. The authors present the second case of punctate follicular porokeratosis, further supporting the contention that this entity is a unique form of porokeratosis rather than a histologic variant. A 56-year-old African American female presented to the dermatology clinic with a 3-month history of keratotic lesions localized on the right posterior shoulder. Examination revealed an area of perifollicular keratotic papules, each surrounded by an erythematous rim. Histopathology revealed a cornoid lamella originating within a hair follicle, with the parakeratotic column protruding through the follicular orifice. The static nature of the condition along with exclusive involvement of hair follicles supports the notion of punctate follicular porokeratosis as a distinct clinical entity. The diagnosis of this condition relies heavily on proper histopathologic sampling revealing punctate follicular cornoid lamellae.
汗孔角化症是一种角化异常性疾病，其特征为围绕有萎缩中心的环形鳞屑斑块出现异常角质样板。在毛囊受累与环形角质样板相邻的病例中，有人提出了这种疾病的一种组织学变体，称为毛囊性汗孔角化症。点状毛囊性汗孔角化症仅有1例报道，其中角质样板仅起源于毛囊，无相关环形斑块。作者报告了第二例点状毛囊性汗孔角化症，进一步支持了这一实体是汗孔角化症的一种独特形式而非组织学变体的观点。一名56岁非裔美国女性到皮肤科诊所就诊，有3个月右后肩部出现角化性皮损的病史。检查发现有一处毛囊周围角化性丘疹区域，每个丘疹周围有一红色边缘。组织病理学显示角质样板起源于毛囊内，角化不全柱穿过毛囊口突出。该病的静止性质以及毛囊的单独受累支持了点状毛囊性汗孔角化症是一种独特临床实体的观点。该病的诊断很大程度上依赖于适当的组织病理学取样，以显示点状毛囊角质样板。
