House Officer (Doctor), Auckland District Health Board, Auckland, New Zealand.
Dermatologist, Department of Dermatology, Auckland District Health Board and University of Auckland, Auckland, New Zealand.
N Z Med J. 2021 Apr 30;134(1534):128-142.
Granular parakeratosis (GP) is a benign dermatosis characterised by a rash at intertriginous sites. The pathogenesis is uncertain although it is proposed to be an irritant contact reaction with cases related to benzalkonium chloride (BAC) reported. Our experience is that patients often have delayed diagnosis. This study aims to review the clinical presentation and histopathological features of GP.
This study is a retrospective case series of adult and paediatric patients seen at dermatology clinics in Auckland, New Zealand. Information was collected on patient demographics, presentation, investigations and management.
Thirteen cases (seven adults; six children) are included. The typical presentation of GP was erythematous or brown, scaly papules and plaques with desquamation in a predominantly flexural distribution. All patients reported recent exposure to BAC in laundry rinse solution. Nine biopsies were taken from four patients. Psoriasiform and eczematous findings were common on histopathology. The mainstay of treatment was cessation of BAC exposure.
GP has a distinct clinical pattern although histopathological findings are varied. Clinicians should have a high index of suspicion for GP in patients presenting with erythematous flexural eruptions and seek a history of BAC exposure, especially in the context of the COVID-19 pandemic and increased antiseptic use.
颗粒状角化不良（GP）是一种良性皮肤病，其特征为在皱褶部位出现皮疹。发病机制尚不确定，尽管据报道与苯扎氯铵（BAC）有关的病例被认为是一种刺激性接触反应。我们的经验是，患者经常被延迟诊断。本研究旨在回顾 GP 的临床表型和组织病理学特征。
这是一项在新西兰奥克兰皮肤科诊所就诊的成人和儿科患者的回顾性病例系列研究。收集了患者的人口统计学、表现、检查和治疗信息。
共纳入 13 例（7 例成人；6 例儿童）。GP 的典型表现为红斑或棕色、鳞屑性丘疹和斑块，伴脱屑，主要分布于屈侧。所有患者均报告近期接触过含 BAC 的衣物洗涤剂。4 例患者共进行了 9 次活检。组织病理学上常见银屑病样和湿疹样表现。治疗的主要方法是停止接触 BAC。
GP 具有独特的临床模式，尽管组织病理学表现多样。对于出现红斑性屈侧皮疹的患者，临床医生应高度怀疑 GP，并询问 BAC 暴露史，尤其是在 COVID-19 大流行和消毒剂使用增加的情况下。
